Should Physicians Follow Hollywood's Script?

I’ve already gotten pretty bored reading about AI in medicine. So many of the articles cover the same ground, either breathlessly celebrating AI’s promise or bemoaning the brave new world on the horizon. This article from Dr. Mendoza made me feel embarrassed that I have not even considered this angle.

Adam Cifu

Medical decision making is the creative intellectual property of physicians. It also serves as the basis for algorithms to support the AI revolution. EHR and tech companies are combining years of medical training and practice with data input (including vital signs, physical exam findings, labs) to generate diagnoses and plans for patients via algorithms. These companies generate profits based on our inputs and analysis. Physicians are now even becoming holograms to interact with rural patients. To this point, physicians are not being properly compensated for their intellectual property. Perhaps we can take a page from recent events in Hollywood.

Some Hollywood actors and writers view AI as a risk to their livelihoods. They worry that AI tools will replace their creative work without proper compensation. A recent open letter to the White House highlights their concerns. They claim that changes will allow Big Tech to develop and use AI based on their work without fair compensation, arguing that copyright law has not kept up with technology. Physicians can learn from Hollywood’s AI battle to protect their interests and share in the profits.

To start, the physician compensation model needs a reboot. Stuck in the 1960s with the creation of Medicare and Medicaid, physician compensation has been held captive to opaque “benchmarks”. Physicians aren’t trained in contract elements and negotiations. Additionally, with health care consolidation, physicians’ leverage to advocate for compensation in line with their expertise and increasing complexity of patient care has fallen behind. Add to this the technology revolution in and physicians might look at their role more like the Hollywood creatives or student athletes with NIL (“Name Image Likeness”) rights to retain leverage over their intellectual property and fair compensation.

Without our medical licenses and decision-making expertise, health care entities don’t have a business. The employment of tens of thousands of people in the medical-industrial complex - from the hospital cafeteria worker to the CEO, the phlebotomist to the software engineer, and even those at the center of the AI revolution in healthcare - flows from physicians' intellectual property and hard work. Physicians need to update their relationship with the market by requiring their compensation to reflect the profits earned from their work in the 21st century. How do we (re)gain our central role in shaping technology to actually serve our mission to care for patients while maintaining a prosperous, attractive culture for current and future physicians? As one of the most influential tech pioneers said “think differently.”

Carrie Mendoza is an Emergency Medicine physician practicing in Chicagoland.