A growing concern in the healthcare field is the pace at which information about diseases and treatments is expanding. Termed the “information explosion,” this phenomenon has led to an expectation that physicians have command over an ever-growing body of scientific knowledge 1, 2. Despite the benefits of the high rate of scientific discovery – most notably new treatment options and higher success rates – the amount of information required for a physician to do their job is quickly becoming untenable. As this problem deepens, multiple suggestions for better managing the myriad information available to medical professional have been made. One such idea is the creation of para-professionals who can review research and make recommendations for physicians 1.
The Information Explosion
Underlying the “information explosion” is a more general trend that has been referred to as a “publication explosion.” At present, 2.5 million new scientific papers are published each year, which has led to difficulties in all scientific disciplines, with fewer papers being cited and reviewed by scientists 3. In the medical field, specialization used to be the answer to this problem: although it was not possible for one physician to be abreast of all the developments in the field of medicine, specialization allowed a physician to focus on a specific area of expertise and be responsible for a much smaller area of the literature. There was little reason for an oncologist to stay up to date on the newest medical treatments for depression, and likewise, a psychiatrist did not need to know the most current protocols for chemotherapy. This specialization began in the 1940s and has accelerated since with a greater number of subspecialties being recognized 4. This strategy, however, is nearing the end of its ability to enable specialist physicians to fully grasp the developments in their area of the medical field. Furthermore, physicians are often under pressure from the public to be at the cutting edge of medical knowledge, which is becoming increasingly unfeasible 2.
Are “Para-Medicals” the Answer?
Borrowing from the legal filed, which has long suffered from the same information overload, some have suggested the creation of an analog to the paralegal 1, 2. The paralegal profession started in the 1960s as a cost-saving measure: paralegals are able to do research and other tasks for lawyers but are not able to take on clients or provide representation in court 5. Such a role in the medical field makes some logical sense. A “para-medical” could be trained to review and synthesize scientific literature in a specific area and provide summaries and recommendations to physicians who are providing care. Like a paralegal, they would not be involved in the direct provision of clinical care, such as examining patients, developing diagnoses, and providing treatment. There is a precedent for the use of non-physicians in limited roles in the healthcare field as well: physician’s assistants and advanced practice nurses provide routine direct patient care, often under the supervision of a physician who consults on their cases and provides care for less routine issues.
Paralegals are generally educated at the associate’s degree level. Although this provides adequate preparation for conducting legal research and reading and summarizing case law, a greater level of training would likely be needed to fully understand the complex scientific literature that exists in medicine. If this training becomes too long or challenging, the likelihood that a large number of people will flock to this career field is diminished. Paralegals take on tasks from higher-paid lawyers, and their work still results in billable hours to clients 5. A similar system for healthcare is not likely to catch on unless similar cost savings can be found.
What About AI?
Another potential solution, which is becoming more feasible, is the use of artificial intelligence to collect and summarize information, and even provide treatment recommendations 2. It is possible that such technology could be brought to bear on the ever-growing database of medical literature to provide intelligent summaries to physicians which are specifically related to areas of practice, or even individual cases. Artificial intelligence is already used by news outlets such as The Washington Post and the Associated Press to generate articles based on specific information inputs 6. Although it would take significantly more sophistication to analyze scientific literature, such an application seems possible given the ability of current artificial intelligence to generate readable and accurate content. Of course, these recommendations would need to be interpreted and decisions made by a trained medical professional, so WebMD is not likely to take over for your GP any time soon.
- Chin, L., & Satell, G. (2016, December 16). How physicians can keep up with the knowledge explosion in medicine. Harvard Business Review.
- Foo, A. (2017, January 4). Helping doctors keep up with the medical knowledge explosion. MIMS Today.
- Boon, S. (2016, January 7). 21st century science overload. The CSP Blog.
- Cassel, C. K., & Reuben, D. B. (2011). Specialization, subspecialization, and subsubspecialization in internal medicine. The New England Journal of Medicine, 364, 1169-1173. doi:10.1056/NEJMsb1012647
- Law Crossing. (n.d.). The evolution of the paralegal profession. Law Crossing.
- Moses, L. (2017, September 14). The Washington Post’s robot reporter has published 850 articles in the past year. Digday.