Mal Fletcher considers the implications of the threat to carry forward the junior doctors' strike indefinitely.



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There is nothing wrong with a doctor, during a consultation, double-checking a diagnosis where necessary, or consulting the latest news on drug developments. The medical and pharmaceutical sciences are moving forward at a rapid rate; doctors don't often have the time to keep track of the changes.

However, when GPs spend more time consulting screens than they do evaluating and reassuring the human beings sitting before them, they send a message which they may not have intended. That is, that people are right to trust digital apps for even the most important aspects of their healthcare.

There is another reason why a loss of public trust in doctors might lead to a downturn in public health, at least in the short-term: it might lead to fewer training opportunities for doctors.

Already, we reportedly have fewer doctors-in-training than we need. This can only become more of a problem as the population continues to grow and to age.

We are also losing qualified medicos to other nations. This is particularly with countries like Australia, where British training is held in high regard and entry visas are relatively easy to come by if you're in medicine. In time, some British students may seek a medical degree here with the sole intention of using it as leverage for permanent relocation.

Public health can only suffer if Britain's capacity for training and keeping enough practitioners continues to drop. Advances in automotive technologies may, of course, offer some respite for patients - but perhaps very little comfort for doctors who're worried about their future.

Automation may replace as many as 230 million jobs worldwide within the next twenty years. These losses, however, will not be limited to low-paying unskilled jobs. Far from it.

Already advances in automation are threatening jobs in highly-paid professional fields. Machine learning, for example, is allowing writing engines such as Quill to pen, from scratch, articles which feature in major publications, including Forbes Magazine.

Granted, these programmes are not yet anywhere near winning a Pulitzer, they can effectively "learn" from their mistakes and rewrite their own programming as they learn. Journalism is one profession that will be directly affected by machine learning.

Consider too the even greater disruptive capacities of "social bots" which read and emulate human emotions; and Cloud robotics, which will, at least in theory, allow machines to share their "knowledge" with other machines via a type of universal technical "mind".

Big Data analytics makes it possible to track patterns of illness in a community. In the short term, this might represent huge potential benefits for doctors in terms of making diagnoses more quickly.

In the longer term, though, it might also mean that the doctor-as-knowledge-provider becomes obsolete.

Meanwhile, machine "chatbots" are now able to fool people into thinking a conversation with them is a chat with another human being. A combination of big data and chatbot technology might eventually make a trip to a human doctor little more than a luxury.

True, as things stand doctors are guaranteed an income because of NHS structures, underwritten by taxes. But would those structures remain if fewer people wanted, or felt they needed, to consult doctors?