Artificial Intelligence and the Future of Primary Care: Exploratory Qualitative Study of UK General Practitioners’ Views

Abstract

Background The potential for machine learning to disrupt the medical profession is the subject of ongoing debate within biomedical informatics and related fields. Objective This study aimed to explore general practitioners’ (GPs’) opinions about the potential impact of future technology on key tasks in primary care. Methods In June 2018, we conducted a Web-based survey of 720 UK GPs’ opinions about the likelihood of future technology to fully replace GPs in performing 6 key primary care tasks, and, if respondents considered replacement for a particular task likely, to estimate how soon the technological capacity might emerge. This study involved qualitative descriptive analysis of written responses (“comments”) to an open-ended question in the survey. Results Comments were classified into 3 major categories in relation to primary care: (1) limitations of future technology, (2) potential benefits of future technology, and (3) social and ethical concerns. Perceived limitations included the beliefs that communication and empathy are exclusively human competencies; many GPs also considered clinical reasoning and the ability to provide value-based care as necessitating physicians’ judgments. Perceived benefits of technology included expectations about improved efficiencies, in particular with respect to the reduction of administrative burdens on physicians. Social and ethical concerns encompassed multiple, divergent themes including the need to train more doctors to overcome workforce shortfalls and misgivings about the acceptability of future technology to patients. However, some GPs believed that the failure to adopt technological innovations could incur harms to both patients and physicians. Conclusions This study presents timely information on physicians’ views about the scope of artificial intelligence (AI) in primary care. Overwhelmingly, GPs considered the potential of AI to be limited. These views differ from the predictions of biomedical informaticians. More extensive, stand-alone qualitative work would provide a more in-depth understanding of GPs’ views.

Perceptions of artificial intelligence in healthcare: findings from a qualitative survey study among actors in France

“…Indeed, these health professionals have been the first to be exposed to the AI revolution and they already agree that AI could be a useful assistant; this positive attitude is perceptible both in France [14] and abroad [28]. The general practitioners' (GPs) view of AI may be more skeptical, as suggested by a UK study in which GPs claimed they would only expect AI to improve the efficiency of their work and reduce the administrative burden [29].…”

“…Indeed, despite a rapidly increasing number of scientific publications related to this topic, none have focused on and compared the various interests and points of view of the main actors about the role of AI in medicine and healthcare. This is the first qualitative research which gathers and cross-references these different points of view [7,[25][26][27][28][29].…”

Vol 10 No 2 (2020)

“…In complex meaningful work, including "ethical decision-making, artistic, philosophical, therapeutic and caring tasks" (Nokelainen et al, 2018, p. 21), intrinsic value is provided by the activities being carried out by people, making it relatively resistant to automation or substitution; ultimately, the potential for displacement is not principally a factor of technological capability. Nokelainen et al's conceptualisation has the benefit of building on the work of Autor, Levy and Murnane (2003), while avoiding the latter's assumptions about technological limitations based on complexity; it offers a more resilient model in the light of subsequent discussions such as those of Susskind and Susskind (2015), Crookes and Conway (2018), and Blease et al (2019).…”

“…On balance, it is likely that a significant proportion of professional tasks will become susceptible to automation or substitution, and as Susskind and Susskind argue, some will be done more effectively, efficiently and consistently by machines. Areas such as medical diagnosis (Blease et al, 2019), legal drafting (Susskind & Susskind, 2015), routine research and data analysis (Pandit, 2018), and the assembly and auditing of accounts (Conway, 2018) are obvious examples, but in principle any activity that follows an operational logic is susceptible-over time, anything that can be described as "complex-but-routine," which may increasingly approximate to Nokelainen and colleagues' (2018) complex and instrumental work. This kind of work is likely to become increasingly commodified, with the likelihood of practitioners becoming displaced in one way or another.…”

Yonder: Obesity communication, opioid deprescribing, actinic keratosis, and artificial intelligence

“…I like to think that GPs are (rightly) some of the most sceptical of all healthcare workers, so I was interested to read a survey of UK GPs' opinions about the likelihood of future technology to fully replace GPs in performing six key primary care tasks. 4 Perceived limitations included the beliefs that communication and empathy are exclusively human competencies; many GPs also considered clinical reasoning and the ability to provide value-based care as necessitating physicians' judgements. Perceived benefits of technology included expectations about improved efficiencies, in particular with respect to the reduction of administrative burdens on physicians.…”