Any thoughts about this? 😞 Curious to hear everyone's thoughts.
Here's the link: https://x.com/MattZirwas/status/2058891205845397856?s=20
Sometimes residency right now feels like learning celestial navigation right as GPS satellites are being launched into orbit.
The people who mastered the stars were incredibly skilled. For thousands of years society needed them. Then suddenly it didn’t. Not because humans became less intelligent, but because the system became easier, cheaper, scalable, and “good enough.”
That’s the part people in medicine do not want to confront.
Everyone keeps framing AI as “can ChatGPT pass Step exams?” That’s missing the point entirely. The real disruption is what happens when AI merges with robotics, sensors, imaging, continuous monitoring, automated documentation, and physical infrastructure.
Medicine has always been protected by the idea that healthcare is fundamentally human and hands-on. But what if that stops being true?
A lot of modern medicine is already algorithmic. Gather symptoms. Recognize patterns. Stratify risk. Order tests. Apply guidelines. Adjust medications. Document for billing and liability. Escalate edge cases upward.
That is exactly the kind of environment modern AI thrives in.
And the scary part is healthcare systems do not need AI to be better than the best physician on earth. They just need it to be statistically comparable to the average clinician while being dramatically cheaper, available 24/7, impossible to burn out, and infinitely scalable.
That economic pressure matters more than almost anything else.
People say “patients want a human.” Maybe. But patients also wanted travel agents, bank tellers, and cashiers until systems became more convenient. Most patients already spend huge portions of their appointments interacting with screens, portals, kiosks, automated messages, and doctors typing into Epic.
Now add robotics.
A decade ago humanoid robots looked like a joke. Now they walk warehouses, manipulate fragile objects, learn tasks from demonstrations, and improve every single year. Surgical robots are already more stable than human hands. AI systems are getting better at image interpretation faster than training pipelines can adapt. Physical exam hardware is becoming automated. Wearables continuously monitor physiologic data in ways no human physician possibly could.
People imagine the future as “AI helps doctors.” That is probably true at first.
But eventually administrators and insurers are going to ask a much darker question:
“If one physician supervising AI systems and robotic infrastructure can safely oversee what previously required an entire clinic, why are we paying for the entire clinic?”
That is where this goes.
Not all at once. Slowly at first. Then suddenly.
Radiology. Pathology. Primary care triage. Routine follow-ups. Chronic disease management. Medication titration. Documentation. Preventive screening. Low-acuity urgent care. Remote monitoring.
One by one, pieces start disappearing into software.
The top experts will still exist. Elite surgeons will still exist. Complex diagnosticians will still exist.
But technology historically does not eliminate the top 1%.
It compresses the middle.
And honestly, I think med students should at least be asking themselves a serious question right now:
If you were an 18-year-old choosing a career today, knowing where AI and robotics are likely headed over the next 10–20 years, would you still confidently recommend taking on 10+ years of training and massive debt to enter medicine?
I genuinely do not know anymore.
