It’s a thin line between PAs and AI physio

Dr Copperfield on the connection between the rolling out of physician associates and the movement towards AI in healthcare, asking where GPs sit in all of this

My, how we laughed when we discovered that the next big idea is AI physiotherapy. In my patch, this most hands-on of specialties has already been reduced to an arms-length service of links and leaflets – and those with crooked knees and sprained ankles are in too much pain to limp to the surgery to protest. So it seems a natural extension to dehumanise the process entirely.

Less hilarious, though, is the realisation that you can trace a direct line from the current PA fiasco right the way through to this latest AI initiative. It’s the train of thought that starts by thinking GPs can be replaced by noctors, and ends up believing that noctors could then be replaced by Chat-Not-Doc-Bots. And it’s typically justified with a bullshit bingo of ‘convenience’, ‘access’, ‘modernising’ etc etc.

This reductive nightmare is way more obvious to those on the inside looking out, than those on the outside looking in. Us GPs, in other words. 

We realise, for example, that: symptoms are everywhere; often mean nothing; and are usually self-limiting. We know that symptoms reaching medical attention often defy explanation. That patients may need reassurance rather than diagnosis. That the best action may be inaction. That much of our role is to carry all the uncertainty to prevent patient and system buckling. And, that F2F and hands-on treatment by the trustworthy is needed for this to work.

In other words, a personal, compassionate and wise system – rather than the minimally supervised, self-service, auto-check out healthcare nightmare we’re heading for.

And if you think this is just ‘Jurassic Doc’ with a plea for medicine as art, then it is and I am. But that doesn’t make it any less true. If you don’t believe me, ask ChatGPT.

Dr Tony Copperfield is a GP in Essex