The Future of the Professions
How Technology Will Transform the Work of Human Experts
Oxford University Press, 2017
Richard Susskind and Daniel Susskind
Reviewed by Johny Van Aerde
This book provides a descriptive, predictive, and normative account of why our professional institutions, including health care and medicine, will not and should not endure in their current state. Although it addresses all professions (health, education, clergy, law, architecture, and a few others), they share similarities, and one section addresses health and physicians specifically.
The Susskinds, father and son lawyer/academics, argue that professions have earned a privileged position in society, a mandate for control in their fields of specialization. In essence, the professions operate under a type of social contract: they are the gatekeepers of specialized knowledge and expertise, they are allowed to self-regulate their activities, and we place our trust in them to advise and help us.
This social contract has many drawbacks: the professions are notoriously conservative and reluctant to change, and they have become antiquated, opaque, and unaffordable. Until recently, there was no better system, but soon technology will allow alternatives. It is these alternatives, some of which exist already, that the book explores.
The authors challenge the social contract and they propose seven possible new models for producing and distributing expertise in society: Top
No doubt some physicians will find doom and gloom in these predictions. Although the authors see a steady decline in the demand for human professionals in the long term, they think a great deal of work has to be done by humans in the near term. And although machines will take over some tasks, there will be new tasks and physicians will have to think about the future of the professions from the point of view of the recipients of professional work, i.e., the patients. Top
Skeptics will say that some tasks can only be done by humans. The authors argue that routine tasks, even extremely complex ones, can be done by rules-based machines, and, although physicians like to think otherwise, much of what they do is fairly routine. Do the benefits of mechanization (e.g., increased access) outweigh the loss of craft, the preference for human interaction, and the need for empathy. The authors argue that the benefits probably do outweigh any single one of these costs.
This book is recommended reading because society, professionals, and physicians, in particular, are operating with limited vision and flawed assumptions about the future of professional work. You might disagree, but the Susskinds are correct when they caution us not to let our mental models from the last few centuries limit our thoughts as to what might come to be. We might as well be prepared and participate in the coming revolution.
Johny Van Aerde, MD, MA, PhD, FRCPC, is editor-in-chief of the Canadian Journal of Physician Leadership and a former president of the Canadian Society of Physician Leaders. Top