What career/ industry do you believe will become more in demand in Australia in the coming years, and would be wise for a school graduate to study?
Also what career do you believe will become redundant in the coming years due to the way the worlds changing?
thanks for you opinions :)
If you aren't academically smart I've always suggested trades + learning about running a business for a student to study. It's unlikely that those will disappear in the foreseeable (though who knows) and the business part means you can set up your own entity when you spot a hole in the market.
And at the moment the biggest hole is a tradie that actually provides decent customer service and a sane price.
I think even if you are academically smart, this advice still applies. Regards, an accountant who would have become a builder if there had been demand at the time.
If you are smart, then I think there is good reason to get that university degree (entrance level for so much), however I would concentrate far more on business and entrepreneurship - both to make money before/during college, and to give you viable directions going forward.
Not sure what the fastest trade to learn is, but if I knew then what I know now I might well of tried to pick one up as a backstop. Part of the reason for the business part you you don't want to be doing the same old trade for the rest of your life, but it certainly makes for a transferable skill.
Oh, and picking up sales is a valuable skill. Shit job, but the openings are everywhere and the skill is useful across your whole life (eg lying convincingly).
As a software engineer, I've always wondered about taking a 4 year apprenticeship & 'becoming' a tradie. Love cars, and it would be fun to be able to 'engineer' a car.
But the thing that gets you is that as a white collar worker, I could potentially work up until I'm 70 if I wanted, with physical work I think I'd start getting problems and would have stop earlier. Granted both can probably financially retire much earlier if they financially planned for it.
I used to believe the "Fire older engineers and hire young ones" would happen to me eventually, but that's happening less & less. I think that was valid in the old days, when SW was extremely limited by the HW. But today SW engineering evolves so fast, the work is more about design & risk management -> no-way a graduate can do that as well as a 10 year veteran with equal intelligence. Also salaries are capped now based on rank as the HR industry has moved in, so a 50 y.o doesn't cost more than a 30 y.o. engineer.
But you do cost significantly more than someone from India or China.
Bikies!
Security guards for sure. As jobs are lost people will get desperate and resort to theft to feed their families because the trend is away from dole or a social wage.
Pretty low rate of pay. Might as well join the army and become a merc after a couple of years..
What's merc?
maybe we need a poll about this!
As long as OzB keep growing, the demand for bikies would be strong
Do software engineering and you'll never worry about being unemployed. Just remember to study hard
Please respond to my comment instead of negatively voting.
Software engineering is the most in-demand engineering discipline and will continue to be for the next 100 years.
I work in the industry. We hire these people more than any other job.
The software industry employs mostly software people? Wow!
(I mean, you could be right, but also aren't a lot of those jobs being outsourced overseas?)
The software industry employs mostly software people?
Do you know how many people work in the tech. industry? All large corporations need software engineers. It doesn't matter if their primary product is not a piece of software.
Try reading the title of this thread
(I mean, you could be right, but also aren't a lot of those jobs being outsourced overseas?)
I am right. Ask any engineer.
No, that's nonsense. Governments, Telcos and advanced manufacturing companies are reluctant to outsource jobs which require security clearance. Software engineering and IT security is the most in-demand technical field in Australia.
I'm not really looking to convince people who aren't engineers or school children.
Programming jobs, yes - other IT jobs such as Management and Product Design, not so much.
It doesn't matter if their primary product is not a piece of software.
I was just joking about your tautology. You work in "the" (implying software, no other field was mentioned prior) industry, so of course you hire "these" people. If you meant "tech" more broadly, well, I hope your software isn't as vaguely written as your forum postings ;)
I don't know many engineers that are impressed by name-calling, appeal to authority, and a lack of data to back up claims…
@noey: > No, that's nonsense. Governments, Telcos and advanced manufacturing companies are reluctant to outsource jobs which require security clearance.
Only certain sectors, and even then it's areas within them, will not outsource. Heck our bank details and transactions are outsourced overseas already.
I used to think like you with this but I'm seeing it transition first hand, not to mention the overall numbers employed locally will continue to dwindle and if not already be a pretty small minority compared to other industries/careers being discussed here.
@dufflover:
Actually there's a good reason as to why there's two distinct observations on 'SW' out-sourcing & not out-sourcing. (I'm not using the term 'Tech' as most people think I'm as easily out-sourced as a Telemarketer)
Some SW departments are a cost centre - SW engineers exist to make the efficiency of the company 'better'. Cost cutting is also a diminishing returns exercise, so you can't always out-do yourself from previous years. SW engineers are then perceived as a 'cost' that must be reduced, and well for day-to-day running tasks, yes you can find engineers overseas for that.
Some SW departments are the revenue stream - SW engineers build the product that bring in the dosh. It is extremely difficult to 'out-source' SW that you have a competitive advantage on -> you're generally the market leader, so only your own staff are the best at it. In these scenarios, knowledge & pro-activeness is valued, and it is bloody hard to hire these types of engineers. Hell we don't out-source, we additionally hire people from overseas cos we need 'talent' & 'proactiveness'.
IF you can become pro-active as well as demonstrate that you are an effective engineer. I guarantee you will always find a job in the latter SW departments (assuming the market hasn't crashed).
Grammar is a general term referring to the set of rules in a given language which also includes syntax. Software does have grammar.
Always a good chuckle when a person has the highest and lowest voted comment in a single comment thread.
Eh I beg to differ about security clearances. They are not that difficult to obtain.
As an example, Defence is spending almost $1-2b in outsourcing their basic infrastructure and have already done so, with Leidos (nee Lockheed Martin). As well as the big juicy $1b contract with Telstra for fixed networking across Aus.
Once this gets down the subby level, you will find that these big companies are further outsourcing and getting in a range of companies. Security clearances cost a few thousand dollars and if the company needs the skill and a progress payment is in line, they will spend the money, and the speed of a clearance has dramatically improved. Clearances aren't that coveted today as they once were a decade or so ago, especially for 'basic' level skills. It's not up to government at this level. It's the industry partner who sponsors their employees and can effectively get a clearance for, well, anyone and have the Department sign off on any 'risk' - even a risk of a subject not having citizenship in Aus!
When you said outsourcing, perhaps you are thinking of the kind where you utilise 'globalisation' and get a second or third world country involved to avoid labour costs of a developed nation - security clearances and basic security policy about having things based in Aus aren't compatible with this so there will always be a technology provider ecosystem to support government, I will concede that.
Cloud is another example where government is relaxing. There are Australia Signals Directorate (ASD) endorsed cloud hosting environments, including Azure. Government departments love the low stand up time of these environments and SaaS and PaaS is effectively a glossy version of the managed environments (also known as outsourced) of the last decade. It's nothing new, just the marketing changed.
I will agree that some functions will remain in australia no matter what and even in the public service - as an example, the ASD is constantly recruiting (publicly) for a range of technical skillsets with a positive vetting clearance. This will never leave the country.
You also mentioned advanced manafacturing - patently incorrect. As an example, Applied Materials who make all the fabrication equipment for the likes of Intel and other big boys who are doing this advanced manafacturing (more advanced than most of the STEM jobs in Aus) outsources so much of their supply chain and IT jobs overseas to India and Phillipines.
@togaboyau: I think that was meant to be "@noey"because yes I agree; security clearances are just paper work, no different to some employer doing basic police checks on you.
And yep you also mentioned the outsourcing to companies which is probably what I should've said more specifically; Government outsources a job to a private company; who then is able to get government approval to outsource some (and try to maximise that proportion) to cheaper offshore development.
It is slightly safer, but not by as much as noey thinks …
I'm a software engineer/developer too. I had the same concerns almost a decade ago when I graduated from university, eg that my job would be outsourced, etc. Yes, there is a lot of outsourcing to overseas that happens, especially among larger organisations. But, at least from my perspective, there still seems to be plenty of jobs, and, thankfully, I've never really had any trouble getting any relatively highly paid work.
My advice would be: try not to be a dime a dozen php programmer (or whatever happens to be tomorrow's "commodity programmer" that could easily be outsourced or is not valued). Have a look at the specific skills being asked for in highly paid job advertisements that interest you and try to work towards building those skills.
As with anything, make friends, build your network, and eventually you'll find out about some of the best jobs before they're even advertised.
I agree with this. I have a very small IT company and it is very hard to find good programmers and extremely easy to find bad ones. The good ones get paid $120k+ p.a. and the bad ones don't get hired because you may as well outsource there work overseas instead. So if you're going to be a programmer make sure you are good.
The reality is only about 10% of the population have the intelligence and skill-awareness to become a good programmer and many of those people choose other professions, hence the shortage.
Australia is still a bit behind the rest of the world in this area. Countries like the US/uk etc it can be incredibly hard to find a software engineering/developer job. I would expect we will hit a similar slump over the next decade as more of this work is sent to countries that do it just as well but at lower costs. This industry isn't going to disappear anytime soon but easy street is not going to remain, only the top end devs will continue to thrive in the future. You want job security and high wages then be a plumber.
Also true because skilled immigration brings more and more resources to Australia every year, probably far more than number of additional jobs created. Not sure why govt isn't looking at reducing the numbers/caps though.
Yep Software all the way. Plenty of internships and grad positions.
This, but go into Security. That's where the $$$/Demand will be at I reckon.
Software engineering is one of the most easily outsourced and offshored jobs. In the future I would expect this to be a relatively low paid profession with only the very top end continuing to do well, Australia cannot compete on a world scale here due to our conditions. offshoring will only get easier and more viable in this sector making it gradually harder and harder to justify the very high pay we get in this industry in Australia at the moment. many projects even in Australian government are seeing ever increasing use of offshore developer resources to reduce cost
Professional Bargain Hunters.
Gerry Harvey better watch out!
Anything to do with renewable energy.
Silly Forum Question Answerers
IOT
Self-driving car-tech
Renewable Energy
Any job that is involved in making and/or maintaining robots and automated systems that would be used to make other manual jobs and trades redundant.
That is what I tell everyone. Current jobs will have the same fate as Kodak!
Don't you think it would be relatively niche though? It's not going to be as popular a job as say your enterprise programmer or something like that.
Centrelink.
Aged care.
Or funeral director.
Grave digger?
Too much labor. I was being semi-facetious, but also alluding to the fact that death is a certainty.
In the past, yes, but with land being so expensive I reckon more and more people will choose cremation
All Blackz Grave Digger Co: We dig em, you fill em!!
Agree x 1000
And occupational therapy / physiotherapy especially in the context of the aged care boom
Also geriatricians. Geriatrics is one of the least competitive specialties to get into, with one of the most relaxing lifestyles/workloads but you can bet your ass there's a boom coming.
if you still want to be employed and earn a decent wage beyond the next 15 years don't study now to become a diesel or a patrol engine mechanic.
Dunno, the Nissan Patrol engine is sure to need constant maintenance!
Lol
Not when driverless cars arrives and hardly anyone needs to own a car when a car arrives and takes u wherever.
Some people love driving. The guys who buy fun expensive cars.
Even the driverless cars will need maintenance and R&D.
Finally made a username just to respond to this…
I actually think that these roles will be hard to fill. There will still be plenty of demand that will be filled by geriatrics earning big dollars to keep equipment online and producing.
Tho would not steer my kids this way
robot programmer, then a few years later when skynet takes over, robot killer
nah still robot programmer, only you get to program obsolete robots, but at least you can send back in time.
Mate, don't be silly - they will have robots programming robots.
Health and age care will be the core industry as more people aged.
Yep, this will be the biggest growth sector as its very hard to automate.
Actually you can automate much of the rote GP work - it's just they have a good/bad union to jump up and down on any innovations in that area. Only a matter of time though.
No you can't. You really can't. That 'rote' GP work that you see about script dispensing and treating coughs and colds and what have you is just the surface. I have countless stories from my GP friends about people who come in for that simple thing, and hand on the door, on the way out, will say "by the way", and a much more complex problem will present. Or, the person who comes in for the simple thing but the GP has known them for 20 years and knows just the right thing to say to get the true problem out of them. GP's don't exist to give medical certificates and dispense scripts, that is a millionth of the work they do. The breadth of knowledge and the relationship management skills required to do that job, not to mention the resilience required to put up with the deterioriating levels of respect for them in the community, requires a very special and skilled person.
/rant.
Yeah you can (and they will). Think assistant, with you all the time, knowing everything about you and able to respond to any query at any time. It would wipe the floor with any GP - no appointments, no spilling privacy to another human (although that's another issue) and much more up to date and connected.
Now nurses, that's harder to automate …
@sane: You can't replace the therapeutic relationship with a computer, there's a lot of EQ involved. And I don't think a lot of people would be very comfortable with a computer knowing everything about you and dictating your care. There's a very very human element involved with being a doctor, and when done well, requires a great deal of trust developed over time. Illness isn't just about medical condition —> treatment. There's an emotional component to it as well and having a computer solely focus on the protocolised problem and fix would be incredibly isolating for most people. People like to be listened to and sympathised with as well. The problem with the routine stuff, like vaccinations, pap smears, prostate checks etc is that a lot of people use them as a pretext to talk about something else that's been bothering them. So much more goes on in that office than people realise.
I don't think either profession should be automated. People need people, especially when they're vulnerable. I think computers are exceptionally useful for quality control and keeping the rogue practitioners in check though, and asking them to justify decisions that are well outside the bounds of the standard of care.
In part why I suggest nurses are going to be more in demand.
Have a read of : http://fortune.com/2012/12/04/technology-will-replace-80-of-…
https://news.usc.edu/65051/patients-are-more-willing-to-conf…
In the end, time will tell - but my bet is on the automation.
@MissG: I can guarantee it will happen. It will happen first with clinicians then possibly with surgeons.
The most difficult jobs to automate are the ones that require creative thought and inspiration. For the most part, GPs are walking medical libraries with a pinch of connecting the dots.
There have already been many attempts to "help" clinicians which have been quashed and ridiculed by those affected by it for obvious reasons.
My masters research program is in machine learning and honestly the leaps and bounds in AI is amazing.
@darkzen15: You guys do realise there are a few GP's on Ozbargain who are staying politely quiet right now. Devaluing their job to being walking libraries able to connect the job is actually pretty insulting. They're so much more than that.
Forget about the clinicians for a minute though and tell me what you really think an 80 year old woman would want. As time goes on, this age group is going to be the highest proportion of patients (and already is in the hospital system). As perfect as a computer might be able to get diagnostics and treatment, the intangible human element that people need will always be there. Medicine is as much an art as a science but the art side of it is invisible unless you're in it.
@MissG: and who would want to trust their health with a robot vs a person? And in particular with mental health, how could anything ever understand a person better than another person.
Some people don't realise the difference between a proper GP and a medical graduate working in a clinic
So, because I'm bored and I feel that people should read another one of my pointless diatribes, below are some personal reflections on why I think automated GP is unlikely.
We're a long way off of artificial intelligence that has the fleshed out capability to replace a human GP in a practice setting let alone anything mobile (home visit/flying doctor/field etc); optimistic estimates for a completely functional AI is 2050 and more realistic estimates put it around 2070 if not the end of the century. (I think this is relevant because it relates to immediacy of potential redundancies).
Even the optimistic estimate for fully fledged AI wouldn't necessarily translate to a walking/talking humanoid style platform/robot. Resolving that conundrum is a whole different can of worms. For instance, resolving issues with a reliable/stable power supply and implementing extremely sophisticated motion tracking/sensitivity; I.E: think of something mundane like flipping customer's eyelid to remove a rogue eyelash. I'm not an artificial intelligence expert by any means, but even I can recognise that the level of technical sophistication involved in accomplishing something like that would be enormous.
As would seem to be the flavour of the month/year/whatever you'd need to factor in whether or not the automated health care provider is 100% completely immune to being compromised via hacking (there's probably a more descriptive term for that). Can an outside quantity disrupt or corrupt a device to malfunction?
What about legal ramifications? I can guarantee that any hospital or surgery will want to be completely insured against possible liability if something goes wrong? But who is responsible? The hardware manufacturer or maybe the software developer? What about the operator? Or if we're talking about AI, are they then held liable? Do you then destroy that AI because it malfunctioned? What if the machine misses a cancer diagnosis? Or misdiagnoses a condition which is more serious? Could you get a second opinion if the robots are all running the same software?
Then, on top of all of this you'd need a public willing to support automated primary healthcare.
I mean you could just go on and on.. which as you can see I've done. I think the most likely reality we'll see if humans augmenting their skills/abilities/referencing with degrees of artificial intelligence, but artificial intelligence never completely replacing the original human operator.
@sane: honestly I do not like automation for the ethical dilemmas present. For example look at the self driving car dilemma. You are driving on a highway, there is a wall to your left, a bus full of children on the right and a truck in front of you. The truck hits a stopped truck and comes to a sudden halt. The computer is going to have to decide between swerving right and possibly killing a bus load of children, and swerving left and killing the driver. Things are binary to a computer based on how things are programmed. Would you want a computer making that decision for you? Comparatively, if the driver has been trained to drive defensively, they could think of ways out of the situation that haven't been programmed into the computer, ie. Hard brake into handbrake swinging the tail to wipe off more speed and lessen the impact and force a rear impact instead of a head on impact.
Whilst health is different, there will still be similar dilemmas. If the automation is programmed based on cost vs risk, then they will refuse treatment to minimise costs because of a high risk situation whereas a surgeon knows that a family would rather gamble on the 1% chance of success for a positive outcome for a family member.
@darkzen15: lol leaps and bounds are amazing. AI has been around for yonks, especially for ECG machines. Yet cardiologists are always consulted regarding an ECG reading. Automation in medicine will not become a reality anytime soon with the current "leaps and bounds".
Can't upvote this enough. I review medical records in my line of work and there are definitely some very challenging scenarios that come about.
One can tell you have absolutely no clue about the field of Medicine. You should stop talking to your robots.
You probably don't want to look at how such health questions are currently handled then. Or, indeed, the error rates associated with such medical decisions when humans are making them.
Frankly I'm not surprised at the type of comments (and downvotes) that have come out. It's kind of usual that people say "but not me, I'm special" and that particularly goes for medicos. Problem is, when you actually look into it - it just doesn't stack up. There can be particular edge cases, sure. But those are exactly the cases where you keep a few humans around anyway. And on the flip side, you do have to take into account the number of errors made by humans in medical situations. And finally, you couple in the access to such advice and the depth of the information that automation can be party to, that your GP isn't.
It ends up not being close.
Much of healthcare is rote; the vast majority. And if there is one thing that deep learning excels at, it's 'smart' pattern matching of cause and effect/input and output. Rule of thumb is that it can do that at least as well as a human, 24 hours a day, 7 days a week, with no errors/fatigue.
For however much those in the trade don't want to think things will change, it really is only a matter of time. Rough guess, you could cut 30-50% from healthcare costs by plucking the low hanging fruit, at the same time as improving quality - and sooner or later the politicians will recognise that.
May I ask your experience? Are you a doctor, a healthcare/allied health specialist? Do you work in the healthcare department for the government? Are you a software engineer specialising in biotech? Are you a University lecturer in health and human sciences? That is by no means an exhaustive list, and while I understand qualifications don't count for everything, they count for a lot more than if you were to say "I don't need qualifications for what I say to be true".
Yes I read both of these articles. The first one is written by a venture capitalist who only speaks of dreams with no concrete frame of mind of how to get there. He speaks of computer pattern recognition as if that's the only thing that's required to diagnose and treat a patient. Provides no evidence and no actual solutions to how a computer would be able to diagnose a patient from a bio-pyscho-social point of view just because it knows 10,000+ illnesses, of which the human brain could not possibly comprehend. With the amount of overlap, as well as the inability for a computer system to calculate for systematic errors as well as human errors (did you know muscle movement/twitches on an ECG can create artefactual spikes currently not discernible by longstanding ECG AI's?) not to mention having to screen for other possible conditions and manage concurrent diseases, a computer is far and beyond from ever coming into play to replacing triage nurses, let alone ED doctors, let alone physician and surgeon consultants. The VERY BEST it could ever do, is provide a percentage likelihood of a diagnosis (how many years will it take to get there? And when it does, how accurate will it be? How many deaths will it cause before it would be more accurate than a physician? Is it worth the cost, time and effort through all the forms of government, public etc.?), and again, we wouldn't even have touched upon the part where it has to deal with the psychological variants of different patients and the social aspects that may be causing their illness in the first place.
The second is about to be published into a journal with an impact factor so low it's laughable. But let's talk about the study, which recruited 239 participants from craigslist. Need I go on? Sure. The "patients" were not stratified for some of the most obvious confounders including age and gender. They had been recruited not as patients, but as participants for the study with full knowledge that they would be asked questions with the expectations that they would be answered. So right there both these articles you have posted are utter rubbish.
You don't only have no idea what you are talking about, you are grossly misrepresenting little silicon valley venture bubbles, and I suggest you stop lest you continue embarrassing yourself with your misinformed, inane opinions.
@sane: Hi Sane, I appreciate your enthusiasm and I understand why you might feel medicine is done by rote. There certainly is a pattern to many presentations and a pathway for treatment for many of them. Heck we even have the pathways printed out on the walls in ED/Operating theatres for things like sepsis or cardiac arrests.
I'm not sure you appreciate the human and emotional element of medicine, nor the factors outside of the what is objectively measurable disease - patient preference, social factors - that anything but a fictional science fiction level AI would be unable to interpret. There are also a lot less yes/no problems in medicine than you may imagine. If a patient presents with sepsis, but has metastatic cancer, what should the AI do? Palliate? Send to ICU? My colleagues in ED and GPs face decisions far more complex than this every day.
When you say the vast majority of healthcare is rote, you should probably cite a source or at least have some experience in the field. Otherwise it comes across as rather ignorant*. Particularly your view that our union is somehow blocking progress. I assume you mean the AMA, did you have any examples of this?
In the real world many Australian hospitals haven't even moved to a completely electronic medical record system, so yeah my interns still write in the notes. I can't even open a CT scan done outside the hospital on any of the computers in the hospital because they won't allow the imaging software to open. So much room for advancement before we even think about replacing doctors/nurses with AIs.
Also to the OP - healthcare is only going to get bigger. So big in fact it may blow out the budget not that far into the future. Still a good field for job security.
*Coming from a doctor/surgeon who looks forward to every technological advancement in out field (that ideally doesn't send the health system bankrupt)
Did a good few years on high level shape of eHealth, scale, and the troubles in trying to get any change. So contact with people from top to bottom, across many countries, high profile centres of excellence, etc. Eventually suggested the company drop the area, since although the demand and need for change was well recognised, the obstacles put up to prevent it were many. In short, failure had been engineered in.
Your responses are kind of typical of the type of thing I've seen many times. People who see a small amount of the picture and say "but you don't understand X, so I won't listen" all the while sitting on an avoidable death toll only rivalled by car accidents.
As I say, I don't think reform from within is possible because of the lack of interest in the types of change needed. It's a change that will have to come from without - probably shortly following the system collapsing because the money isn't there to pay for the baby boomers reaching end of life.
PS if you think I'm harsh on the future prospects of GPs, you should hear what the consultants think…
@sane: I'm not a GP and I'm not defending GPs per se. I'm targeting the crux of your comments. Your history and experience would suggest that you should know that the issue lies in within the technology (as thetownfool points out) in the hospital system. But you don't, so I don't think you have an authority to speak on this issue not because you don't understand, but because you literally have no idea what the issue even is. So i'm not listening not because your opinion doesn't matter, but because it's so wrong it's frustrating. It's like if i were to talk about how coding when i don't even know what HTML even stands for. In much the same way, i've given your opinion respect and looked up the research you have presented and come to the conclusion that you not only have no idea, you basically spout nonsense.
And you, by your words, demonstrate that you are an example of the problem - ignorant of the key factors, but too arrogant to consider the possibility. You'll note that I remained pleasant until you started lashing out - it's you that have been talking nonsense, I assure you.
And as I say, change will come, one way or the other. The attitude you betray can only hold out for so long. When it does, you might like to remember what you said here. Few will be indispensable once automation comes calling.
PS although I can talk tech, I'm a systems person, with a particular emphasis on the whole system - humans included. I think you might find patients have a different view of GPs to the one they themselves have.
@sane: Sane I don't want to add to the myriad of excellent points made except to say this. The lens through which you view the field has also been shaped to a certain viewpoint by the work you have done. At a systems level medicine is ALL error rates and pattern matching. And I agree in that there IS a lot of failure built in and trying to automate it at such a high level (i.e. ehealth) at this stage is not going work for the reasons you described - there is too much of the 'old guard' present for it to work, there is a lot of people unwilling to accept change - I agree with that.
However when you view things at a systems level, when you see error rates, and medicine as a list of diagnoses to be solved, of course you see it the way you do. There are some horrible stories out there. But no one is measuring the positive intangible outcomes that doesn't represent itself in the data. There is a very invisible side to the field, measured in tears shared by doctor and patient together when there is tragedy, numbers of boxes of Favourites given to the nursing staff from very grateful families, numbers of senior consultants supporting maternity leave and a positive workplace culture, of cheers from the whole ward and an honor guard formed by doctors, nurses and allied health, when a person whose had a really rough ride and been in hospital for months gets to go home, and comes back to that ward for years afterward. None of these wins are measured, they can't be. Medicine has huge systemic and cultural issues but computerising isn't the answer. It's an easy, blunt tool - replace the doctors with computers, problems solved! But I think the real answer lies in ongoing quality control at the ground level up. Change is hard and the problem is that no two doctors are the same. There are terrible ones. There are super impressive professor of everything ones. They are average ones. But the invisible majority that no one ever talks about, are the kind ones. No one notices them and certainly kindness is never measured as an outcome and yet it's probably the most important tool there is.
Then with computerising medicine is the cost, the stakeholders, the privacy, the data ownership, the ethics of even doing it - as you would have seen with ehealth, no one is going to let it be replaced in the next century, even if it could happen. I still don't think it should though.
Hi Sane,
This has been an interesting discussion on here and I thought I might just comment as I am a newly minted GP who is interested in technology and systems. What you say about the difficulties in pushing through change in Medicine is by and large true. However the crux of your argument that GPs will be replaced first and foremost I would argue is misplaced.
It's really a sad state of affairs the general population view of GPs. I don't think any GP is under any illusion regarding patients general views of GPs - hence the low morale in the profession and the fact most capable medical graduates don't want to pursue it. I was one of these people until I saw the light! (The problem is with our system - I can make more money being a "bad GP" who sees lots of patients for "rote" stuff. In effect I am losing money practising the good medicine I try to practise now). If your view of GPs is so low, I would encourage you to seek out a good GP. They may save your life one day.
Back onto your main argument, I would argue that specialist physicians would probably be the first ones to go. This is because AI can basically assist a good GP in 20-30 years time to perform at the same level as a specialist physician would today without the GP having to learn absolutely the minute details of everything. People are people and will need human interaction, so those at the coal face (client facing role) will be the last to go.
By the time that AI can truly replace the cognitive functions of a GP, I would guess that many jobs would be long gone. True "Artificial Intelligence" I suspect will have arrived already. I have no doubt AI will help save lives. For simple, protocol driven problems this should be the way forward - because as you said, computers aren't affected by a bad day or being tired. But there are many new situations in medicine where you have to be able to piece together information and formulate a hypothesis which may have never occured before. By the time a computer can create a new solution or diagnosis based on no prior data, I think AI will have arrived.
@RJW:
In part that is why I said at the top that I think nurses have more a of role in future. The 'EQ' parts of the job are those which I think will naturally fall to nurses. Rather than AI taking a GP and making them a 'specialist', I think it will take over the expertise parts of the GP role, and allow nurses to do the rest (and frankly, they are usually better at it).
It will probably then work it's way up from there. I do wonder about automation of surgery. It's not an area I studied, but I can see there is scope for quite a bit there as well.
We obviously have a disagreement over the 'cognitive functions of a GP'. I think the majority of that role can be done by an AI, with only a few doctors left to do the 'formulating an hypothesis' type of role. Say 90% of doctors removed from the total, outside the hospitals. Don't discount the value of the AI having a view across large swathes of the population - it'll be able to spot connections far better than the lone GP.
What I was proposing is that the doctors left to do the "formulating hypothesis" part will be generalists - i.e. GPs, ED doctors, Intensivists, General Surgeons (as long as robotic surgery can be fine-tuned). You do realise that people who end up really sick in hospital once upon a time saw a GP? It's actually extremely taxing work as a GP to pick that 1 in 1000 that has something more sinister.
If you intend on just using statistics/algorithms/machine learning to pick the right diagnosis/treatment, then you will still need someone to elicit the information from patients - Nurses currently aren't trained to the same level for this, and maybe in the future they can, but then you're looking at a longer training time and as a result their salaries will also cost more.
If you don't ask the right questions then you don't get the right answers.
@sane: In these days of modern medical school selection, the EQ side of things does not naturally fall to nurses anymore at all. Doctors are selected for it now, in addition to test results.
Or, the person who comes in for the simple thing but the GP has known them for 20 years and knows just the right thing to say to get the true problem out of them.
Well, this is an ideal scenario. Are all our GPs so experienced, smart and intelligent? Ask this question to yourself and you will know the answer if you have ever visited 5 different medical centres in Sydney. Is there a QA check on their services and quality on a regular basis?
@sane: i can somewhat agree with your statement. not everyone in the healthcare system is perfect. I already have a list of hospitals i plan on avoiding in future simply due to the human error rate. in the pharmacy industry, automation has already taken shape. its still not perfect and it is expensive, but in the long run it can reduce costs. as long as there is still a human factor for some decisions.
@virhlpool: Like I said in an earlier post, no two doctors are the same and they are also all at varying points in their training. Some are highly experienced, some are not. And GP's often have special interest areas and it might take going to a few different ones to find the right ones for you. There are so many QA processes in medicine that they impede clinical work and make the whole system completely inefficient. Unfortunately those processes have a particular focus on political point scoring than they do patient care. As someone already mentioned, they get paid more to be a 'bad' GP because the lauded measure is most patients seen, not time taken with patient. You take too long, god forbid, talking to someone, you get penalised. This is system wide across the hospitals and the community. It's so cost-driven because it's public money and it's highly political that doctors are in a constant fight to get more time with their patients without being penalised for it. In the public hospital system, the clock starts ticking the minute you enter the door and the pressure to get people out before you're entirely comfortable with it is ridiculous. Departments get congratulated on having the shortest length-of-stay.
But finding the right GP and persisting with them, you'll find that you will get the experienced, smart, and intelligent one for you. They might be the worst choice for someone else.
Unfortunately virhlpool - the answer is no, not all GPs are experienced or smart. But the key problem is not all GPs care. I really think we do need better systems in place to identify that sort of GP - the ones who don't give a damn except the financial side and offer absolutely zero value for money for our tax dollars.
Having said that, there are LOTS of good GPs as well. The fact that you haven't found one in Sydney may speak more to the fact that these GPs probably aren't taking many new patients, or that they may charge more for a consultation for those who can afford it. It really is sad that the bad GP ruins the reputation of the whole profession.
I can tell you I work for a mixed billing clinic (I charge people a gap fee) but earn less than I would at one of those massive super clinics run by corporates (at least at the pay rate they offered with their model of operations…i.e. churn through lots of patients). I work damn hard for my money and follow-up patients personally with phone calls, SMS, recall letters etc. It also means that by charging patients who can afford it, I can bulk bill my vulnerable patients and not have to feel the pressure of the clock.
I highly recommend anyone reading to seek out a good GP. Most importantly look for a GP who cares, who isn't brash and seems to know absolutely everything (couple of doctors I met who seemed very confident with EVERYTHING but subsequently I've found they had no clue). More is missed in medicine by not looking than not knowing.
Can't help but laugh at those ads! I can see the intention but really really poor execution from my point of view. Very cringeworthy.
@RJW: Is it the case then that full bulk billing medical centres are more likely to have not-so-good GPs? It is painful for the taxpayers and also our medical system then.
I prefer 100% bulk billed care for the tax money that I (and we all) pay - and if that is the reason I shouldn't have a great care, then it's not a good reason. Hoping to find some more, good bulk billing GPs.
I wouldn't say all bulk billing centres are bad. That would be really smearing a lot of good GPs names. There are definitely good and ethical practices. The closer you are to the CBD / richer area though the lesa likely that will be though (rent costs more after all).
It is indeed painful for our medical system. I understand the reasoning for bulk billing. I used to be a fierce opponent of Medicare Co-payment, until I actually worked in General Practice and saw the waste of our precious tax dollars.
The current fee for service model works well for good-hearted doctors - but is easily exploited for a fat paycheck. Quality assurance is hard, because invariably it will just penalise good doctors with more paperwork. The best quality assurance is the economy.
If you use food/restaurants as an analogy:
When people go to a restaurant, you pay however much you want for the quality you want. There are food safety officers checking in to make sure places are safe for consumption, but noone checks nutritional or taste quality because the economy self-audits (if you serve bad food noone will come back).
Now imagine one day the government decides to pay every citizen a set amount each meal. It doesn't matter how many meals you eat, as long as you walk in the door, the government pays the restaurant. The government pushes hard for all restaurants to accept the set fee and charge no more. Most restaurants agree as the initial payment is good and there are incentives to be free for the consumer (bulk-billing), plus 80-90% of all other restaurants are now free so everyone is worried of losing business.
Subsequently, you, a restauranteur, notice Joe Schmuck Burgers down the road has cottoned to a nifty trick. He feeds people fast food in smaller portions, and just invites them back more often. He starts making more money than you, even though you know its terrible food (but safe - so passes all audits). He draws people in by being available all the time, he will serve anyone that comes, and if you want a drive through for a sickie he'll serve it right up.
At the start you don't care and stick to your quality burgers. Customers love you and heap praise on you. Over the years though the government stops increasing their payments in line with inflation but still expect you to serve for set free. Joe Schmuck grows bigger with all their fat profits and starts expanding to a super sized chain fof Joe Schmucks. You notice all the franchisees (doctors) at Joe Schmucks are earning now 50% more than your quality burgers despite serving what you know to be absolute garbage. You still have a family to look after whilst Joe Schmucks and their franchisees seem to be living it up.
So what do you do.
Personally I join a classy establishment who charges the high flyers and with that money continue helping the needy with free quality meals. That way Joe Schmuck is only earning 30% more than me and I am happy with that difference. My customers also value me more, both for those who pay, as they feel they get value for money, and those who get it free are very grateful.
I grew up being a leftist but with ageing and wisdom comes the realisation that nothing is black and white. If only we could tweak in a bit of am economic factor into our health system, at least some inefficiencies will be eliminated (its not going to be perfect though and we definitely need some safety nets for the vulnerable!).
Rant over!
And Human Services & Social Work, too.
I'd love to see our games industry grow. It's slim pickings out there at the moment.
Trades are going to be further in demand soon.
There are substantially less apprentices currently in, taking up and even completing apprenticeships.