The Cauldron: Overcoming Obsolescence (Abstract)

Journal of the Intensive Care Society

A growing, increasingly comorbid population, living longer and undergoing ever expansive procedures and treatments provides a burgeoning demand for critical care. A demand that can only be expected to increase. As a new and progressive specialty, much has been made of technological advancements in powering our collective ability to cope with such challenges.

With big data analytics and artificial intelligence already providing the minority report-esque ability to predict crime ‘before it happens’, one can imagine it will be not long until these technologies are re-purposed, providing advanced Early Warning Systems and illness modelling. Breaking down institutional boundaries, uniting hospitals, regions, even entire countries, serves to create a pool of data infinitely surpassing the darkest recesses of even the most experienced professor’s mind. Each and every intervention becomes a trial, constantly refining the predictive capabilities of the AI system.

Such developments may provide coping strategies on a system level – but what about for individual doctors? With AI able to predict when (or perhaps more pertinently, when not) to intervene, with what intervention and in whom, one may begin to question what will be the role for the intensivists of the future?

Acute proceduralists inserting lines, performing scans and managing airways? Perhaps roles that could be better served by dedicated technicians, other specialties, or the growing number of Advanced Critical Care Practitioners? Data gatherers and sign hunters meticulously taking histories and elucidating examination findings only to present them to an online data collection form? Perhaps as diplomats, updating patients and relatives, translating the system’s probabilistic prognoses into plain English and providing that often cited ‘human touch’?

Undoubtedly these elements are all encompassed within the intensivist’s current role, providing their own synergistic satisfaction. It is hard to imagine that they would have the same appeal when performed in isolation, with integrative decision-making surrendered to the system. Clearly, then, our role must be updated and redefined, abreast of technological advances.

In such an exciting era of change, rhetoric ought not to centre on the adequacy of coping, but have more aspirational aims of capitalising on opportunities to thrive. Engagement in the process of progression, be it through research, at an organisational level, through education or diversification and sub-specialisation, could allow us to seize control of our professional destiny and create a system in which we not only cope, but may thrive.

Dr Chris Tomlinson
Dr Chris Tomlinson
👨‍⚕️ Critical Care Doctor | 🎓 PhD @ UCL CDT in AI-enabled Healthcare