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Twenty-first-century healers are about to experience something they had never imagined could happen. They are about to enter an era where their professional survival will be threatened. As a consequence, they will be encouraged to turn against one another.

Artificial intelligence (AI) is revolutionizing industries across the globe, and healthcare is no exception. While AI promises to improve patient outcomes and reduce costs, it also threatens to automate away many physician jobs. According to recent studies, millions of doctors are projected to be displaced by AI systems in the coming decades.

A 2021 report by the World Economic Forum estimated that AI could replace or radically transform 85 million jobs worldwide by 2025, including many in healthcare. The analysis projected that 22% of physician and surgeon roles could be automated using AI technologies.

Looking further ahead, a 2023 study by McKinsey Global Institute predicted that 29% of physician tasks could be automated by 2040, potentially jeopardizing hundreds of thousands of doctor positions in the U.S. alone. Radiologists, pathologists, and other doctors who focus on diagnosis through image analysis are at particular risk, with AI expected to outperform humans at many of these visual recognition tasks. This estimate does not include a prediction of how AI will disrupt “face-to-face” specialties (such as psychiatry, psychology, primary care, etc., etc.) and surgeons. Perhaps the only brake on the implementation of AI-driven medical care will be how soon humanoid robots can be deployed.

A recent report from Goldman Sachs offered an even more dire outlook, estimating that AI could eventually replace as many as 80% of physicians in the developed world. Extrapolating globally would translate to over 7 million doctor jobs lost to automation. In my opinion, this is a gross underestimate of how significantly AI will render physicians redundant.

While these are long-range forecasts with significant uncertainty, experts agree that AI disruption of the medical professions is a question of when, not if. “The technology is advancing rapidly and it’s a matter of time before we see significant job displacement,” said Dr. Atul Gawande, a surgeon and professor at Harvard School of Public Health. “We need to start preparing the healthcare workforce for this transition now.”

The projected job losses have raised alarm within the medical community. In a 2022 survey by the American Medical Association, 65% of physicians said they were concerned about AI displacing their roles, with 42% supporting policies to protect doctor jobs from automation.

Healthcare worker unions are also mobilizing around this issue. “We cannot allow corporate profit motives and blind faith in technology to put patient care and providers’ livelihoods at risk,” said Mary Kay Henry, president of the Service Employees International Union, which represents over 1 million healthcare workers. “We need proactive policies to manage the implementation of AI and ensure that its benefits are shared equitably.”

Policymakers are beginning to grapple with the challenges posed by AI-driven job losses in healthcare. In 2023, the White House Office of Science and Technology Policy released a set of principles for the responsible development and deployment of AI in healthcare, including prioritizing patient safety, privacy, and provider input. The European Union is considering legislation that would require healthcare AI systems to undergo rigorous testing and human oversight before implementation.

As the AI revolution unfolds, healthcare leaders, policymakers, and advocates must work together to navigate this disruption while upholding the values of the medical profession. With foresight, planning, and a commitment to ethics and equity, the healthcare system can harness the power of AI to improve patient care while also supporting the doctors and workers who make it all possible. The stakes could not be higher – not just for the millions of physician jobs at risk, but for the future of medicine itself.

These disruptive changes are likely to create significant conflict and division within the healthcare professions. Many doctors will understandably feel threatened by AI systems that jeopardize their jobs and challenge their expertise and authority. Tensions may arise between physicians whose roles are protected versus those whose are automated away. The professional identity and cohesion of doctors, which has long been based on specialized knowledge and irreplaceability, may be shaken. With fewer job opportunities available, competition between physicians could intensify. Overall, the displacement caused by AI could splinter the healthcare professions.

However, I suggest that although policies and legislative regulations are important, they are simply inadequate. We need to address the most important determinant of our response to the coming crisis i.e.: we need to reexamine the values that shape and motivate our behaviors. The philosophical framework of the traditional Western medical model provides few resources for navigating this upheaval. Modern biomedical ethics has focused on a narrow set of deontological principles like autonomy, beneficence, non-maleficence, and justice. While important, this approach is ill-equipped to grapple with the bigger picture questions raised by technological disruption. What is the proper role of the physician in an age of AI? What are the fundamental values and virtues that should guide the medical professions? Deontological ethics, being rule-based and action-focused, offers limited insight into these deeper issues of professional identity, meaning, and purpose.

To adapt to the coming AI revolution, healthcare professionals must look to a more robust ethical foundation centered on virtues and character. The Dalai Lama’s book Ethics for the New Millennium is a valuable guide in this regard. His Holiness outlines several key principles: The cultivation of inner peace and equanimity; Compassion and care for all beings; Honesty and integrity; Dedication to being of service.

Each of these principles is deeply relevant to physicians and healthcare workers grappling with AI disruption in their fields:

• Maintaining inner peace and equanimity will be essential for navigating the stresses and uncertainties of professional upheaval. As the Dalai Lama writes, “A calm mind enables us to better judge a situation and to see what needs to be done more clearly.”
• Putting compassion and care for patients first, above self-interest and professional territorialism, can be an ethical north star. “If our motivation genuinely is the wish to benefit others, our actions will naturally be ethical,” His Holiness advises.
• Honesty and integrity in confronting the realities of AI disruption, acknowledging professional limitations, and being transparent with patients and colleagues will be crucial for maintaining trust.
• Ultimately, remembering that the core purpose of healthcare is being of service – to relieve suffering, heal illness, and improve quality of life – can help physicians stay grounded. As the Dalai Lama teaches, “The more we draw satisfaction from helping others, the more likely we are to benefit others genuinely.”

By building their professional identity and practice on these virtues, healthcare professionals can remain resilient and adaptable even in a time of technological disruption. Organizing around a shared ethical commitment to compassion, honesty, and service may help maintain cohesion and camaraderie even as traditional roles and structures change. As His Holiness writes, “ethics consists less in rules to be obeyed than in principles for inner self-regulation to promote those aspects of our nature which we recognize as conducive to our own well-being and that of others.”

While the coming AI revolution in healthcare presents great challenges, it is also an opportunity for physicians to reflect more deeply on their values and ethical commitments. By embracing a virtue-based moral framework and the timeless wisdom offered by great spiritual leaders like the Dalai Lama, the medical professions can evolve and thrive in this time of momentous change.

In 2002, David Bowie famously once said; “Music itself is going to become like running water or electricity.” His remark seemed strange and unimaginable. He was right. Medical knowledge is becoming like running water or electricity. Within a few years anyone will be able to access personalized scientific information and how this pertains to them and their healthcare. We will look back at today’s physicians in the same way I now look back on the years I was forced to learn Latin! If they are no longer the high priests of medical scientific secrets, what role will physicians play in our future healthcare system? Perhaps they will become extinct – just like the typewriter repair man? But perhaps these inevitable changes will open another opportunity. Perhaps the most important attribute of the twenty-first-century healer will be their compassion, joy, loving-kindness, and equanimity – and not their exclusive domain over scientific facts. A return to their ancient role as journeymen with their patients through their suffering and always holding a vision of each person’s capcity to flourish.