In the afternoon, I have a scheduled meeting with my boss, Ai. It’s another virtual meeting, so I’ll be tied to my screen, sitting in my windowless office, which has started to feel more and more like a box. I’m in a box talking to a screen with another person in box talking to a screen. We both suspend disbelief that it is normal to talk to inanimate objects.
Ai starts by telling me that I’ve been doing a wonderful job. Patient reviews look great. I’m consistently meeting my quotas, and in fact I’m actually in the top percentiles for efficiency.
“It’s been a heavy workload, and I feel overwhelmed at times.” I tell him.
“Have you been using the Ai button? It can write messages for you, report out labs, and even scribe the encounter note.”
“I suppose I could give it another try…” I let my voice trail. In fact, I had used it for a couple weeks, and I found that it left me feeling icky. I wasn’t sure how my boss would respond to the technical term, “icky,” so I stop myself. Instead, I said, “I found that it made a few errors. After the visit, I noticed that it would scribe something that the patient didn’t say.”
“Did you use the thumbs down button? It’s supposed to learn from you.”
“Yeah, and it took longer for me to edit the note than to just write it right the first time.”
“The code is updated regularly, so hopefully that will help.”
“I’m also concerned about all the ethical considerations of using artificial intelligence. What about patient consent? Many of my patients wouldn’t want the confessions of their private lives recorded. I also have concerns that we’re losing touch with our patients. Sometimes the only therapeutic remedy I have to offer are words of compassion. If I give that privilege up to a computer, then I wonder what that says about us.”
“I’m sorry, it looks like there is a delay in our video, and your audio cut out for a little bit. Can you repeat?”
“Oh, sure. I just said that it’s a privilege to use a computer.” I lost energy to argue further.
“Excellent. Now that we’ve got that solved. I’ve been meaning to ask you if you’d be interested in applying for a leadership summit. Now, it doesn’t commit you to anything, but it would give you the training you needed to be a medical director.”
Recently Ai has been encouraging me to apply for a promotion. The position would be the next logical step in the hierarchy of the medical profession. In addition to my current duties of providing direct patient care, I would take on the responsibility of managing my peers’ performance, training new hires, formalizing feedback, attend daily leadership meetings over lunch, and pacifying the disgruntled patients of my colleagues. Ai explains to me that I am already doing many aspects of the job already, which is why I am a prime candidate.
“Oh, that sounds…” My mind races to fill in the blank: exhausting, awful, stressful. Today, I listened to over a dozen people tell me their biggest complaints. I was caught in a web of lies between two bickering ex-boyfriends. I said goodbye to a patient pursuing hospice. I looked at one man’s hemorrhoids and then swabbed his throat for strep. I diagnosed someone with hypertension, which lead to a long conversation about stress and insomnia. I do this job because I have to believe that I am making a positive impact on my community, even on the days that I have a hard time seeing it. I give and give and give. “Exciting,” I finally say.
“Yes! I knew you would be up for it.” Ai says. “I’ll send you an e-mail with the details later this afternoon.”
“Sounds good. Thank you.” I smile and raise my voice to try to sound cheerful. I think I get away with it, but I can hear the tone of inauthenticity in my voice. I shall not tell lies.
“Oh, and one more thing, the powers above me said that they’re trialing this exciting new initiative to help expand patient access. To do this, physicians will work an additional weekend each month. Plus, you even get to choose which weekend you want to work, so be on the lookout for the sign up sheets. I’ll talk to you next month. Bye for now.” Just like that, Ai’s box disappears from my screen, and I’m left staring at myself.
Once again, I stand at a crossroads of what is expected of me and what I desire. Perhaps it would be easiest to accept the promotion, work the extra shift, and play the part. I am sure I would grow from the experience, and Ai thinks I would be good at it. Though somewhere in the back of my mind, I hear a quiet voice ask, Can I say no?
Writer Body and Soul 