Why humans will always be the most important asset in health care

Health care is an expensive industry. Most successful hospitals started as non-profit endeavors with financial backing from religious or governmental institutions to serve the public. Older hospitals have an advantage of evolving over time and benefiting from such angel investors to create infrastructures that don't have to be part of the investment model.

More modern hospitals, especially in the Gulf region, require a much larger capital investment for construction and purchasing of medical equipment and materials, often in the order of millions of dollars. Investment models thus focus on the physical assets of hospitals and treat staff as an operations issue rather than a core asset related to the "raison d'être" of a hospital in the first place.

Trust in their care is not generated by the million dollar MRI machine, but by the sense of safety, competence and attention to their needs that is provided by their interaction with medical personnel.

When a patient enters a health care institution their entire experience is defined by their interactions with hospital staff. Patients are by definition in a vulnerable position and likely feeling quite unwell and their families or companions likely quite worried and distraught. Trust in their care is not generated by the million dollar MRI machine, but by the sense of safety, competence and attention to their needs that is provided by their interaction with medical personnel.

A common pitfall for hospitals is to assume that physicians, nurses and technical staff are entirely replaceable. To cut costs due to salaries, hospitals push for inadequate staffing while continuing to work at ever increasing capacity. This has led to health care workers "quitting in droves" according to several news report world-wide since 2021. Have hospital systems adjusted how they think about their most important asset - health care workers - since then? Evidence points to no.

Although artificial intelligence promises to be an excellent tool to support physicians and nurses do their increasingly more complicated jobs, to pretend that it can actually replace health care workers demonstrates a complete lack of understanding of what the job description is.

Health care management forums today seem to focus on technological solutions, artificial intelligence being commonly cited as the savior to the "doctor and nurses shortage problem". Although artificial intelligence promises to be an excellent tool to support physicians and nurses do their increasingly more complicated jobs, to pretend that it can actually replace health care workers demonstrates a complete lack of understanding of what the job description is.

In theory, a lay person should be able to input a list of symptoms into an algorithm and get a useful differential diagnosis.

An illustrative example would be looking at artificial intelligence (AI) as a diagnostic aid. Google Health has become a punch line for jokes about how it diagnosis everyone with cancer. In theory, a lay person should be able to input a list of symptoms into an algorithm and get a useful differential diagnosis. In practice, good diagnosticians can filter out the list of symptoms and prioritize them by profiling the patient and asking for detailed questions about each symptom to determine if it is related to the main issue or a possible peripheral issue that a patient may have been dealing with for a while. There have not yet been useful AI simulations that can ask enough questions to replace an experienced physician's ability to prioritize symptoms and generate a differential diagnosis that is realistic and customized to the patient. Imaging and laboratory medicine, while greatly enhancing our capacity for accurate diagnosis, are not in fact a replacement for clinical reasoning and generating a pre-test probability for each differential diagnosis.

Humans who are ill do better in environments where they feel supported by trusted humans.

The gap in diagnostic potential has not even touched upon a patient's need for human interaction. Humans who are ill do better in environments where they feel supported by trusted humans. Taking the time to council a patient about their illness and the treatment plan, to answer all their questions and to relate to them and encourage them is just as important a part of the healing process as the medications or procedures. Beyond this, how can we expect someone who is ill to navigate an automated menu that even a well person struggles with when calling a company's auto-response system? If we continue to expect unreasonable things from both staff and patients then we will continue to blind ourselves to how our hospital systems are actually functioning.

It is time for the healthcare industry to course correct and understand that in order to give the best possible patient experience in a safe environment, the health care staff offering this experience need to have their own well-being and safety prioritized.

It is time healthcare administrators prioritized creating a supportive environment for their staff. It is time for the healthcare industry to course correct and understand that in order to give the best possible patient experience in a safe environment, the health care staff offering this experience need to have their own well-being and safety prioritized. Unless honest conversations about staff turnover or attrition take place that examine the working environment, conversations about patient experience and patient safety will be missing the most important piece.