Goodness gracious. I NEVER said that all doctors will be replaced. I NEVER said that they would be the first sector fully automized. In fact, I NEVER said any industry would be completely automized.
And no, I'm talking about shifts at the hospital level, not specific practice areas. Let's use your fiancée for an example. Where a dermatologist might have spent 20 minutes diagnosing a patient, that meant 3 patients per hour. But if technology shortens that time to 12 minutes then it's 5 patients per hour. Assuming an 8 hour shift, your dermatologist will go from 24 patients to 40 patients in the same time frame. A hospital, which knows approximately how many people come in to see dermatologists (again technology), will reduce the dermatologists on staff accordingly. That means that instead of 8 derm's, the hospital only needs 5. The derm's will make less money because they are now competing for fewer job openings. As technology reduces the time needed to complete the physician only tasks, the productivity increases will allow the hospitals to cut the number of doctors.
In a parallel to this, hospitals are buying up practice groups and moving them in house. They're doing this because doctors on staff are cheaper and can be managed like regular employees. The technology has moved in such a way that power is shifting away from the physicians and most of them don't realize it because they've bought into the idea that what they do is so special that tech couldn't replace it. They're mostly wrong. You don't need to replace a derm's specialized skills, you need to increase her productivity enough that you don't need a 2nd derm.
This is a bottom line problem. By controlling and limiting the amount of doctors needed to see X number of patients, hospitals strengthen their profit margin. They have every incentive to gradually shift doctors into standard employee roles and are doing so.
