To a level unimaginable years ago, almost all the activities of customer-facing workers are mandated: what to do, what to say, what not to say, what to do if, even how to speak.  Yes, robot-like but loved by HR, Legal, IT and Efficiency Experts everywhere.   Face-to-face, telephone or chat with almost any company and you will see it on display.  Check in for a flight – or hospital.

Institutions love it.  It’s like finding the perfect recipe and then have everybody follow it.  And now AI makes it even easier to implement.

There are unexpected benefits to such rigid mandates: you can now hire less-trained and less-competent workers because individual initiative and problem solving is not required.   We see that everywhere.

While accountants like the immediate bottom line, it has a deadly effect on industries that must change.  Those industries need to identify then adapt to new circumstances, and therefore need motivated workers capable of problem-solving and initiative-taking.

With highly-mandated work rules it is almost impossible to adapt to new circumstances or to problem-solve.  (Remember: AI provides old content, not new solutions.)  The only way to effect change in that kind of business is a tedious trip up the corporate ladder to the many groups involved, and have them agree to the changed circumstances.  Not a trip for the timid, so seldom done.

What does this have to do with the practice of medicine?  Because it is the industry that so desperately needs to change how it works.  It needs to act more like early Amazon and Netflix than like McDonald’s.

It’s time to modify the morale-killing rigidity of hospital work rules, and allow more bottom-up solutions to see the light of day.  And rethink the quality of front-line workers: perhaps fewer, but more capable, ones.