Artificial intelligence (AI) will play some role in helping deal with the primary care crisis in Canada and could even make it “the hottest” of specialties, according to a recent panel discussion held at Queen’s University.
The need for a regulatory environment specifically to monitor AI-based tools and protect patient privacy was also raised at the discussion as was the core issue of who would pay for using these tools in primary care.
Hosted by the law school at Queen’s University in advance of a one-day workshop on the topic, the one-hour panel discussion discussed whether AI could be the “cure” to the primary care crisis. While none of the speakers said use of AI tools alone would solve the current crisis with millions without family physicians, all said they felt AI could play some role.
The panel discussion started with Dr. Michael Green, a family physician on the faculty at Queen’s and current president of the College of Family Physicians of Canada.
He said recent government initiatives to increase enrolment in family medicine are welcomed but are not sufficient to address the current crisis and that “AI has the potential to make a difference.”
He talked about how the administrative burden on family physicians is a significant factor in causing burnout and seeing many family doctors either retire or cease to practice comprehensive care. The 2021 National Physician Health Survey prepared for the Canadian Medical Association (CMA) showed administrative burden as measured by managing electronic medical records at home was significantly higher for general practitioners than for other doctors.
Scribes who document and summarize patient visits can help relieve this burden but add more expense many practices cannot afford, Dr. Green said. However, he said ambient scribes using AI are seen as a definite option and are currently being evaluated in a pilot project involving 150 physicians in the Kingston area.
“AI doesn’t have to solve all our problems,” said Dr. Green, but he added a 10% increase in productivity that might result from using such tools could help relieve the burden on family doctors and allow them to regain the work/life balance they seek. In addition to ambient scribes, Dr. Green also referenced other AI-tools that provide clinical support.
“AI has some potential solutions that we could and should and must explore,” said Dr. Colleen Flood (SJD), dean of Queen’s Law, who spoke after Dr. Green adding later that she felt AI-based tools could be especially useful in helping primary care physicians working in rural and remote areas.
Dr. Flood discussed the challenges of using generative AI and the bias associated with using algorithms based on data from the Internet. Another panel speaker, law professor Samuel Dahan talked about the high incidence of “hallucinations” or errors associated with using generative AI to deal with complex issues in law and medicine.
Because family doctors don’t have the capacity or time to rigorously assess the work of generative AI tools “appropriate regulation is needed to make sure the tools that are there are reliable,” Dr. Flood said, specifically referencing the important role of Health Canada.
Dr. Devin Singh, an emergency physician and AI innovator at the Hospital for Sick Children in Toronto, talked about the potential for making family medicine “the hottest (most attractive)” of medical specialties by integrating AI into a number of the roles family doctors have in dealing with a broad spectrum of patients.
He raised the issue of cost and whether family doctors would be expected to pay for AI tools that might improve the quality of care and patient outcomes rather than improving their own workloads. As one audience member commented “If the economics don’t make sense adoption is not going to happen.”
Dr. Singh also said guidelines were needed to help family physicians use AI appropriately.
Based on his experience with legal applications of AI, Dahan said that medical associations need to put together consortiums to design their own domain specific tools to make sure those tools are appropriate for the profession.
The Queen’s discussion was just one of many recent fora in which the potential role for AI in Canadian medical practice has been discussed. Just days earlier, a conference at the University of Toronto held by the Institute of Health Policy, Management and Evaluation heard many speakers reference digital health technologies including AI has potential solutions for the primary care crisis.
The topic is also being explored currently on LinkedIn by Dr. Darren Larsen, a family physician and a former chief medical officer at OntarioMD, in a well-received series on the potential use of AI in medical practice. In his most recent post Dr. Larsen noted “as AI technology continues to mature and demonstrate its value in improving healthcare outcomes, its integration into primary and specialist care in the community will be more evident.”
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