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Primary care challenges: AI and virtual clinics

Nick Jenkins, MD
Physician
August 26, 2023
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As I clicked onto the homepage of Amazon Clinic, I got a little bit nervous. Low up-front costs, straight-forward medical decision-making, bread and butter medicine at the patient’s fingertips. Have a UTI? As long as it is simple, no problem, here’s your antibiotic. Just a few clicks. Male pattern baldness? Click. Erectile dysfunction? Click.

Just barebones medicine without the pesky face-to-face human interaction. And with easy-to-follow “guidelines,” we don’t even need doctors anymore. Let’s just give ChatGPT prescribing authority. He never gets tired, never gets burnt out, never has a family emergency, or asks for a raise. Are we, as doctors, fighting a losing battle?

Yes.

If the primary care doctors of America hope to maintain their place in patient care, then we need to rethink our strategy. AI is already smarter than us. Bots have blown the licensure exam out of the water, and ChatGPT can diagnose rare conditions faster and more accurately than us (at least on a test). Doctors are losing their authority as arbiters of “the truth” when it comes to medicine.

I can understand the need for virtual options in care. People love choice, and our system is primed for disruption. We are overworked. With constantly increasing documentation requirements and booming burnout rates, it has been harder to convince medical students to pursue careers in primary care.

Our system is simply not equipped to deal with the number of patients that are out there. Good doctors are getting hard to find. I frequently hear stories about patients waiting for weeks to see their PCP for routine issues and being sent to urgent care because the doctor is “too busy.” This isn’t good enough.

In September of last year, I left the grind of an academic hospitalist practice to start my own Direct Primary Care clinic. I did this to be more true to my original calling. I am still building my practice, but I love what I do. I get plenty of time to ruminate with my complex clients, and I am able to form the long-term relationships I longed for in my hospitalist days. I have learned more in the last six months than in the last six years. While DPC may not be the answer for the whole system, it has been the answer for me. I have experienced a new love for medicine.

To truly keep ourselves relevant in the age of AI and Amazon Clinic, we have to be true to ourselves—knowledge isn’t enough, nor are degrees or big, fancy buildings. We must rediscover the things that got us into medicine in the first place. We must rediscover our curiosity and the love of our fellow man. We can only save medicine by leveraging the thing that a computer will never have: our humanity.

Nick Jenkins is an internal medicine physician.

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