The other night, I curled up in bed with my favorite late-night reading: a copy of the most recent The Hospitalist and Today’s Hospitalist. (I can’t get enough of that guy who writes their commentary.)
I noted that both magazines featured a potential new trend in hospitalist medicine: the “RoboHospitalist.” Telemedicine via a robot that can actually enter a patient’s room and interact with patients, even listen to their heart and lungs! What could possibly go wrong with this type of creative outsourcing? I drifted off slowly and peacefully to sleep …
I awoke in my CEO’s office. Looking agitated, he barked, “DeLue! It pains me to say this, but you were right. We have reconsidered your request for two more human FTE hospitalists. Approved. This RoboHospitalist thing has not exactly worked out as planned.”
I replied, “I don’t doubt I was right, but what made you change your mind?” He swiveled his computer monitor so I could see it, and the following video played out:
Nurse to patient: “You have chest pain? I will call the RoboHospitalist.”
RoboHospitalist to nurse: “Thank you for calling me at 3 a.m. It would be my distinct pleasure to provide care to Ms. Smith. I will arrive in T-minus 2 minutes and 17 seconds. In the interim, I will make contact with the telehospitalist in Cancun.”
The following was observed and recorded from RoboHospitalist’s videocam: The patient, a sweet elderly woman in her late 80s, stares wide-eyed at the RoboHospitalist as it wheels itself into the room. The RoboHospitalist introduces itself. The patient turns white and goes into cardiac arrest. The RoboHospitalist runs code using flawless ACLS protocol. More impressively, the RoboHospitalist completes the death certificate without making a single error.
CEO: “That’s the third time this has happened in a week. I guess I learned my lesson: Nothing beats a real live hospitalist.”
I awoke with a smile on my face; it was only 3 a.m., and it was only a dream. After a quick trip to the bathroom, I was again blissfully drifting off, knowing I still had three more hours of sleep…
Again, I awoke in my CEO’s office. This time he had a big smile on his face as he barked, “DeLue! It gives me great pleasure to inform you that not only were you wrong, but you have been terminated!”
Sitting next to me was a near exact-replica of George Clooney in his early 40s, attired in physician garb and wearing a badge that read, “Hospitalist Medical Director–Department of RoboHospitalist Medicine.”
CEO: “RoboHospitalist version 4.0 has been the answer to my prayers. Unlike the prototype version 20 years ago, these are fully lifelike. We opted to order the entire cast of “ER,” you probably remember that TV show from when you were a young doctor. Unfortunately, Noah Wiley is still on back order.
“Anyway, George here will be replacing you, effective today. Unlike you, he works nights and is programmed never to complain. Needless to say, the higher utility bill is easily offset by taking your group’s salary off the books. And no more malpractice insurance either: Every decision it makes is based on the latest evidence-based guidelines. In fact, it is board certified in every medical specialty except psychiatry. We understand we will have to wait for version 5.0 before they can incorporate empathy into this unit–but we can wait.”
Me: “Can I at least keep my lab coat as a memento?”
CEO: “No.” He pressed a button and yelled, “RoboSecurity!”
I suddenly woke up, diaphoretic and tachycardic. The clock read 5:45 a.m. It was time to go to work. I showered and shaved with a smile on my face. What a relief–It was only a nightmare, and there is no way I could be that replaceable.
As I walked downstairs, I encountered my ROOMBA, our robotic vacuum cleaner. I gave it two swift kicks, tossed it into the garbage can, grabbed my stethoscope and headed out the door.