I had an interesting – both funny and disturbing – what-if discussion with a colleague at work the other day. I was lamenting how so many previously desirable, secure jobs were at risk of being rendered obsolete or nearly so by the rise of increasingly efficient and sophisticated automation. My colleague, who has a deep appreciation for standardization of process, maximizing efficiency and quality control assurance (and the famed “Watson” robot), could nonetheless not help but also feel a bit vulnerable, himself, as a knowledge worker.
We both began musing about what jobs might be left in the future, which would remain viable and not easily susceptible to automation. We could only come up with two: being a musician or being an artist (e.g., visual arts). I’m sure there are many others in the creative arts, but that’s the point. Isn’t it interesting how as kids we were purposefully steered clear of the arts and instead encouraged to follow the tried and true, safe path to what was ostensibly viewed as predictable, stable employment (usually, something in the applied sciences) only to find out years later – largely unforeseen by most – that the technological revolution would totally upend what constitutes secure employment. Imagine telling your kids today to focus on developing their creativity because that’s how they will land interesting, stable employment. Sounds strange, doesn’t it?
Consider the work of a pharmacist, for example. Traditionally, pharmacy work focused on the provision of a product (i.e., a medication), which usually implied some sort of physical preparation (“compounding”) – think pastry class, but instead of making chocolates, you’re making suppositories, which like chocolate, melt at body temperature, but are not so melt-in-your-mouth delicious… All this to say that pharmacists of yesteryear (perhaps your grandfather or even your father) spent most of their time as pharmaceutical iron chefs toiling away behind the counter in their dispensary kitchens engaging in a sort of small-scale manufacturing prior to dispensing the finished medicinal product to the patient or customer. Nowadays, most medications are mass-produced almost exclusively by large pharmaceutical companies in various formats and volumes, all but obviating the need for the comparatively more expensive, boutique-style “local” production that typified pharmacy practice for a good part of the last century. As the profession slowly evolved from a primary manufacturing role to one in which practising pharmacists would position themselves as the go-to information resource for all things medication-related, the internet age had dawned, arguably signalling the biggest gamechanger for the profession yet. Nowadays, with the ease of access to the internet and sophisticated software support systems, drug information is increasingly being accessed like a commodity at the user’s fingertips without the involvement of the pharmacist. So, just what is the role of the pharmacist today? While we still need pharmacies as a medication distribution channel, how essential are pharmacists anymore? Does it make sense for them to preside over drug distribution when there are now less costly alternatives available, such as regulated pharmacy technicians or ATM-like machines? Are there better ways to leverage or apply pharmacists’ specialized technical skills and knowledge?
What I see happening to the profession of pharmacy is just one example of a steady erosion of formerly stable professions. To me, a sure sign that employees sense trouble within their field is when you start seeing more and more climbing for higher ground – in this case, higher academic ground. More nurses pursuing Master’s to become higher-level Nurse Practitioners with prescribing authority. More pharmacists pursuing hospital residencies or a Doctorate in Pharmacy, with resultant opportunities for more advanced clinical work including collaborative prescribing agreements. In the crowded alphabet soup that typifies primary health care with its MDs, PAs, RNs, NPs, RDs, RPhs, SWs, etc, one can start to see increasing instances of overlapping scopes of practice. The more similar the various professions appear, however, the more suspeptible I think they are to having their unique contribution to patient care questioned. Are they so unique afterall? Is their salary justified by their skills? If everyone can prescribe, should they? Is it safer and more effective to have multiple prescribers or a Watson-like super-computer doing all of the prescribing based on best available evidence? How are a patient’s health outcomes affected by multiple (human) prescribers?..
As someone with a background in the health professions, myself, I look ahead to what the future may hold for me personally as a practising health professional, and feel more than a twinge of anxiety. It is really hard to say for certain how these various helping professions will tranform under the dizzying pace of technological innovation, and as such, how to anticipate change and still remain viable – and most importantly, be passionate about your work. I think my initial childhood whim of running away and becoming an artist (or cartoonist with Disney – ok, maybe change that to Pixar) might not have been so impractical afterall…