From the Dean: Remembering our veterans and serving our communities
This past Wednesday I returned from a trip to the annual meeting of the Association of American Medical Colleges (AAMC) known as Learn Serve Lead (LSL). I left LSL a little early to travel to Bethesda, Md., for an all-day meeting Tuesday at the National Institutes of Health (NIH) since recently I was asked to join what is called the Scientific Management Review Board (SMRB) at the NIH. Reporting to the Director of the NIH, the U.S. Congress, and the public at large, the meeting of the SMRB set the stage for our review of the NIH, including questions such as “Should we consolidate two or more of the 27 institutes and centers that make up the NIH?” These questions certainly are appropriate for an institution like the NIH that has an annual budget of nearly $50 billion! We plan to meet at least six times during 2025. Our sessions are all open to the public, and I think that helping the SMRB make good progress in our examination of the functioning of the NIH will be time very well spent.
This year’s LSL was its usual productive meeting. Representative faculty, staff, and students from virtually all the 159 medical schools in the U.S. were on hand. As is typical for these types of meetings, a good portion of the learning occurs in informal interactions in the halls and corridors and around the meal tables. The “official” presentations were uniformly excellent, touching on many aspects of all medical schools’ teaching, research, and service functions.
As I thought about the takeaways from the meeting, it occurred to me that two important concepts could potentially collide at some point in the not-too-distant future. These two critically important forces are the rapid emergence of artificial intelligence (AI) on the one hand, along with the great importance of humanism and effective human interaction in our care delivery model on the other. For as AI grows, might it not “force out” effective and caring provider-patient interactions? I’ll give you an example of how that is happening already, at least in a very preliminary way. Doctors can now put their cell phone down on the desk as they obtain the patient’s history, and the AI algorithm in the phone doesn’t merely transcribe the ensuing conversation, it actually generates a coherent note using the clues provided by the doctor and the responses from the patient. It is not far-fetched to look ahead to the day when the doctor doesn’t even obtain the history from the patient – I’ll bet there are settings now where the history is obtained solely by a voice-enabled AI app that then writes up a note. AI can certainly construct a robust differential diagnosis list of probabilities and order the appropriate tests as well. The only element missing from this automated scenario is the physical exam – but is the day so far away when a machine might be designed to do just that? In which case, one has to ask – what is the role of the provider?
One answer that was given at LSL is that there is a saving of time when the AI app obtains and writes the history, and that time can then be devoted to meaningful discussions and interactions between the patient and the provider about treatment options and the like.
But I think that any time-saving produced will quickly be translated into an expectation by the provider’s employer of an increase in patients seen. The metric of such interactions often is the volume of patients seen rather than patient satisfaction.
I certainly don’t have the answer to this arm-wrestle between machine (AI) and human (provider), but it sure has given me (and I hope you) something to think about.
On a final note, this past Monday was Veterans Day, named in honor of the many people who have served this nation through service in the armed forces. I always remember that the 11th hour of the 11th day of the 11th month (i.e., Nov. 11 at 11 a.m.) remembers when the armistice was signed in 1918 to end World War I – but only after some 20 million combatants and civilians had been killed. Although the AAMC did make some mention of Veterans Day on Monday, unfortunately there was no official comment at 11 a.m. Although I was at a great workshop, I took it upon myself to rise (and walk to the side of the room) precisely at 11 a.m. I stood in honor of all the people who perished, but I especially remembered the veterans. I usually attend the memorial service that takes place each Nov. 11 at the UND Alumni Association & Foundation’s Gorecki Alumni Center. This year I couldn’t because of the timing of LSL. Fortunately, next year’s LSL runs from Nov. 1-5, so there should be no conflict. I hope to see you at the Gorecki Alumni Center next Nov. 11!
Joshua Wynne, MD, MBA, MPH
Vice President for Health Affairs, UND
Dean, UND School of Medicine & Health Sciences
