Will AI Take My Job?

Otolaryngologists Are Insulated from AI Takeover, but Change Is Coming

Most otolaryngologists interviewed for this series agree that AI is unlikely to take jobs from otolaryngologists, particularly given that otolaryngology is a surgical specialty. Image-intensive specialties, such as radiology, pathology, and dermatology, are expected to face greater AI takeover (Mohta A. These 7 specialties may be obsolete in the next decade. MDLinx. October 23, 2023). But, as described in this article series, AI is very likely to augment tasks that currently bog clinicians down in time-consuming requirements that detract from patient care and can lead to burnout.

Alfred-Marc Iloreta, MD, assistant professor in AI and emerging technologies in the Graduate School of Biomedical Sciences at Icahn School of Medicine at Mount Sinai Hospital in New York, said that there’s potential for AI to take on repetitive tasks such as scheduling patients, dictating notes, and compiling billing. “I think the best way to view AI is that it represents an incredibly powerful tool that places a broad amount of expertise at our fingertips in a very immediate and convenient fashion,” he added.

But, like any tool, he said, AI is limited by the person using it. “It will not transform a novice surgeon into a master surgeon but, more likely, will improve the learning curve and, at the same time, make that transformation safer, [more] well-rounded, and alleviate some of the collateral damage that comes with the journey, such as burnout and sacrificing extensive amounts of time,” he added.

Anais Rameau, MD, MSc, MPhil, assistant professor and the director of new technologies in the department of otolaryngology–head and neck surgery at Weill Cornell Medical College in New York, also thinks otolaryngology will face a lower threat from AI than some other specialties might, because it is a surgical specialty and she doesn’t see the technology taking over the procedural skill set. “These tools are definitely not here to replace us right now,” she said. “We want to have humans work alongside AI and not have AI make autonomous decisions.”

We are behind in our understanding of AI and, unfortunately, we have a lot of catching up to do as a community in understanding what machine learning is, what large language models are, how we can benefit from these technologies, incorporate them, and evaluate them critically.” — Anais Rameau, MD

In otolaryngology, Dr. Rameau, who is also associate editor of machine learning for Laryngoscope and a member of the AI Task Force of the American Academy of Otolaryngology-Head and Neck Surgeons (AAO-HNS), sees AI as augmenting some tasks, like documentation, that clinicians find burdensome, as well as being used as decision support tools to assist clinicians in refining their differential diagnoses or specific diagnoses of patients. “There might be predictions and assessments that AI is able to create that an individual physician will not be able to do as well—such as incorporating complex patient data, such as genetic or socio-demographic information—to arrive at a more precise diagnosis,” she said.

Vijay R. Ramakrishnan, MD, professor of otolaryngology–head and neck surgery and director of rhinology research at Indiana University School of Medicine in Indianapolis, said the surgical aspect of otolaryngology may account for why otolaryngologists should not be particularly worried about AI taking over their jobs.

In a survey on physician views of AI in otolaryngology and rhinology published last year in Laryngocope Investigative Otolaryngology, Dr. Ramakrishnan and his colleagues found that otolaryngologists were primarily concerned about whether they could trust AI to be accurate and unbiased (particularly when AI disagreed with their clinical judgment), what their medicolegal exposure might be if they disagreed with AI and followed their own clinical judgment, and the possibility of third-party payers creating or using AI systems to deny or limit care recommendations or create roadblocks for reimbursement (2023;8:1468-1475).

Despite these concerns, the survey showed that most otolaryngologists were very receptive to AI for clinical use and particularly excited about using it for clinical decision support, for personalized medicine, or potentially for the diagnostic or therapeutic management of patients. “The otolaryngologists we interviewed were all very hopeful that these uses will enhance patient care rather than replacing our roles,” said Dr. Ramakrishnan.

The most striking finding of the study, he said, was that most of the otolaryngologists surveyed had very limited understanding or hands-on experience with AI applications. The survey was conducted prior to the release of ChatGPT and, since then, Dr. Ramakrishnan said he thinks most people have some awareness of the basics of AI and its developments in healthcare.

Practicing Medicine in the Age of AI

For Dr. Rameau, who is board certified in clinical informatics, it’s critical that otolaryngologists become familiar with, educated about, and unafraid of AI to prepare for the inevitable integration of AI applications into their practices. “We are behind in our understanding of AI, and, unfortunately, we have a lot of catching up to do as a community in understanding what machine learning is, what large language models are, how we can benefit from these technologies, incorporate them, and evaluate them critically,” she said.

Her colleagues in radiology are saying that those who are using AI will have jobs, while those not using AI may not. “This could be true for otolaryngologists,”