I appreciate it's a tough time for doctors, facing increased pressure and scrutiny, from both payers and patients. They work so hard and make so many sacrifices along the way in order to practice medicine. Add to the mix that outsiders are developing technologies which may impact the delivery of care. Rock Health estimates that people with doctoral or medical degrees make up fewer than 20 percent of all CEOs of funded digital health companies. How will the established healthcare system react to outsiders who are 'disrupting' existing processes and procedures? Will they protest on the streets in the same manner as the taxi drivers across Europe last week, who are upset about the impact of consumers using the Uber app on their industry?

The perceived threat

The relentless progress of technology can be frightening. When I have spoken before about the possibility that one day doctors could become unemployed due to advancing technology, I've observed a whole range of reactions. When I even discuss the possibility of doctors being replaced by robots powered by artificial intelligence, many take the view that this is a preposterous idea. How dare we imagine a world where human doctors are replaced by machines & algorithms?

Now, if this was such a preposterous idea, with zero chance of every occurring in the future, the system would just ignore it, right?

In the USA, National Nurses United launched a campaign to alert the public to the dangers of hospitals using algorithms and unproven medical technologies. The video [below] they have put together is actually very thought provoking. The fact that they've invested time, effort and money into this campaign suggests to me that do indeed feel threatened by the potential impact of advancing technology.

Depending upon how you view the future, robot nurses & doctors could be just a few decades away or unlikely to ever happen. Can we state with any certainty which path the development and adoption of robots will take in healthcare? I don't believe so. As AstraZeneca state on their website, "Predicting the future of healthcare is virtually impossible". It's sensible to consider all the possible future scenarios, not just the scenarios we feel comfortable with.

One of the drivers behind exploring robots in healthcare is to understand if it could reduce medical errors. A hospital in the UK has brought in a robot to combat "serious" human errors in handing out prescriptions.

Who is pushing the boundaries?

If you want to get a glimpse into the future of robots in healthcare, take a look at Japan. A country with the highest proportion of citizens aged over 65 on the planet. They are also leaders in robotic technology. For the Japanese government, their focus will be on the use of robots in nursing care. In 2020, Japan will host the Olympics, and is possibly going to host 'Robot Olympics' at the same time. Given that Dementia is increasingly challenging for healthcare systems globally, are robots the future of eldercare? Bristol Robotic Laboratory in the UK believe their robot, Molly could be part of that future. The video is truly eye opening.

Softbank in Japan plan to sell a robot called Pepper, which is claimed to be the first robot that can recognise human emotions and respond to them.

What does all of this mean?

The recent documentary, Power to the patient, opens with these sentences, "The relationship between doctors and patients is about to change dramatically. Modern technology enables patients to become their own personal healers, with the doctor as advisor".

Now, it may be the case that human doctors & nurses never become unemployed. However, if technology continues to advance at the same pace, what patients want from doctors & nurses may change. Even though the the United States’ National Robotics Initiative (NRI) seeks to integrate robotics to assist rather than replace nurses and physicians, the NRI’s language doesn’t specifically forbid healthcare organizations in the U.S. from seeking to completely replace nurses and doctors.

What will systems under extreme cost pressure do if one day robots can do much of what doctors & nurses do today? Will the doctors who refuse to work with new technology have fewer opportunities? Will the successful doctors & nurses of the future be the ones that can work with robots & algorithms to deliver the care which serves patients' needs? What would training at medical school look like? How might the relationship between patients, doctors and nurses change? How will the power dynamics change? If there is conflict in decision making, whose verdict will reign supreme? Human or Robot? What if patients get emotionally attached to a robot caring for them at home 24/7? Can robots truly care for us?

Whilst people happily buy modern cars which are assembled by robots, would those same people feel comfortable if some aspects of health & social care were delivered by robots? Do you agree with Peter Diamandis, who envisions a future where patients prefer a robot rather than a human surgeon to perform cardiac surgery? NASA are developing a robot which could one day perform life saving surgeries on astronauts in space.

Fact from fiction

I attended an event at Nesta in London last week, "Humanising the robot society", which I really enjoyed. In a few weeks, I'm attending an event at Policy Exchange in London, "Rise of the Robots: What skills will we need in the future economy and how do we get them?". What's fascinating is that the second event has David Willetts MP, Minister for Universities and Science as the first speaker. If robots truly aren't going to impact our lives, why would these two high profile organisations waste their time even discussing these possible scenarios?

We must be mindful that it's easy for scientists to make grand claims about the future of Artificial Intelligence and robots. It's hard for members of the public to distinguish facts from hype. How do we have informed discussion? Perhaps the events in London are the way forward?

Don't fear the robots, fear the monopolies behind them. Great piece on #nestarobots by @VickiTurk http://t.co/6RN0QgJNRZ cc @izakaminska
— Stian Westlake (@stianwestlake) June 19, 2014

Technology, as always, can serve to both improve and undermine the quality of our lives. I believe the development and adoption of robots could have serious ramifications for everyone in society over the next few decades, not just those in health & social care. For some the rise of the robots seems terrifying, for others it seems marvellous. What's your view?

[Disclosure: I have no commercial ties with the individuals and organisations mentioned in this post]