“The good physician treats the disease; the great physician treats the patient who has the disease.”

William Osler, physician educator


The author delineates competence (cure-oriented and based on reason and objectivity) and warmth (care-oriented and based on emotion and subjectivity) as two essential dimensions of patient care, and argues that the former is no longer the prerogative of physicians solely but now to be shared between physicians and autonomous algorithmic decision-making systems.

In other words, in this current era of artificial intelligence, the time-honored relationship between the physician and the patient has transitioned from a dyad to possibly a triad (or at least a dyad and a half).

The author discusses the advent of autonomous algorithmic decision making systems (AADMS) as the new actors in the care of patients. I think artificial intelligence with human cognition to provide oversight to the former is perhaps the best strategy, so decision-making with artificial intelligence is still mainly a human-derived process but with some augmentation from artificial intelligence. This support may actually liberate the physicians from an overabundance of burden and provide them with more time and/or focus at the bedside or in the clinic for the human elements of not only warmth, but also creativity, ethics, and judgment.

While I agree with the author that reconciling these two dimensions can be a challenge and that artificial intelligence can potentially disrupt this balance even further, it may be a bit unfair to assume that these two dimensions are necessarily antagonistic and therefore cannot be synergistic.

The author further details the two hypothetical scenarios: the first being that physicians remain the conductors and in the dominant role as decision makers and the second being that physicians having a lesser role as a supporter of the algorithms but provide the warmth needed.

It is entirely possible that we can reduce the stress of the clinician and therefore increase the potential for warmth by deploying artificial intelligence tools to decrease the electronic health record burden or reduce the administrative work of complex patients in disease management.

I think that by possessing both of these dimensions to the fullest extent creates a third (convolved) dimension, that of a highly competent and an extremely warm and empathetic physician.


The full paper can be read here