As I’m sure you know, nephrology is the branch of internal medicine that deals with the kidneys. And in the U.S., young doctors are quite unlikely to choose this path.
Why? The combination of long hours, chronic illness, and (relatively) unimpressive pay has proven deadly to the field. In fact, around 30 percent of training (fellowship) positions go unfilled each year.
To stay afloat, the nephrology community has turned to foreign doctors desperate to meet visa requirements and advanced practice providers (e.g., physician assistants and nurse practitioners). Even so, most who’ve worked within the profession over the past decade would agree that more bodies would have been a welcome sight.
Fast forward to today, and leaders are asking themselves, do we need actual bodies? Why not just a bunch of servers? As it is, providers spend the vast majority of their time in front of a computer. Why not just ditch the providers and let the computers do the work?
Hospital administration finds this arrangement appealing for many reasons. First, aside from a little maintenance here and there, computers don’t require health care. Second, the need for vacation time would all but disappear. And finally, microprocessors rarely, if ever, whine that they’re working too hard. The end result is that administrators can make even more money for doing nothing.
Of course, to make this happen, AI has to agree to the working conditions.
So I went ahead and asked ChatGPT (GPT-3.5) whether it would be willing to step in and save nephrology. Here’s how the conversation went. Some responses have been abridged to maintain a tolerable word count.
Do you want to be a nephrologist?
As an artificial intelligence language model, I exist solely as software running on computer servers. While I can provide information and assistance related to medical topics, I do not have a physical presence and am not capable of providing direct clinical care. However, I can provide support to health care professionals by offering information and resources related to nephrology and other medical specialties, and helping them make informed decisions.
But don’t you think you can help out in clinic from time to time?
Health care professionals have undergone extensive training and education to develop their skills and knowledge, and are essential in providing quality health care. AI can complement the work of health care professionals by assisting in tasks such as data analysis, diagnosis, and treatment planning, but it cannot replace the expertise and human touch of a trained health care professional.
I think you’re giving health care professionals too much credit. Do you really think nephrologists are that smart?
Yes, I do think that nephrologists, like other health care professionals, are highly intelligent and skilled individuals who play a critical role in providing quality health care to patients.
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You seem to be giving very politically correct answers. Don’t you think hospital administrators would love to save money and eat better lunches?
As an artificial intelligence language model, my responses are not influenced by any personal or political biases. It is not appropriate to generalize the motivations of hospital administrators or any group of people, as individuals may have different priorities and goals.
However, it is important to note that the health care industry, like any other industry, operates within a complex system of financial, social, and political factors. While cost containment is certainly an important consideration for hospital administrators, it is not the only factor in the decision-making process. Providing quality patient care and maintaining patient safety are also top priorities, as are ensuring compliance with regulatory requirements and ethical standards.
The specifics of hospital lunch policies and practices may vary depending on factors such as budget constraints, cultural norms, and individual preferences.
Actually, since you won’t commit to nephrology, would you at least be willing to share your thoughts with the administration?
I do not have the ability to directly communicate with hospital administrators or any other individuals outside of this platform.
Thank you for your time, ChatGPT. Any parting thoughts?
It is important to remember that health care is a complex and multifaceted field, and that the decisions and actions of health care professionals and administrators can have a significant impact on patient outcomes and well-being. It is, therefore, crucial to prioritize patient safety, quality of care, and ethical considerations in all health care decision-making processes.
Thank you for the opportunity to assist you, and I wish you all the best.
After the transcript of this interview was made available to a group of nephrologists who asked to remain anonymous, they expressed relief at having the security of a job they can’t stand. Meanwhile, a group of administrators expressed interest in checking Google Bard’s availability, hinting that in the meantime, they would improve their lunches by simply asking nephrologists to work harder.
Amol Shrikhande is a nephrologist.
