Technological advances have ushered in an era where many AI models outperform specialists on specific tasks, but AI still lags far behind experts in less controlled settings.
That’s the Generalist-Specialist Paradox of Medical AI laid out in a recent NEJM AI editorial, which paints a picture of a world where AI might soon start redrawing the boundaries of medical specialties as they exist today.
- AI is already delivering great results on well-defined tasks like interpreting EEGs or CT scans, but it’s still consistently struggling on generalist tasks with less clear boundaries.
- If that trend continues, the article argues that tasks that used to be in the hands of specialists will be at the fingertips of primary care (just as tasks that used to belong to primary care will now belong to patients).
LLMs don’t care what specialty a case belongs to. They can ingest the full clinical context across visit notes, labs, and imaging to come up with the most probable diagnosis.
- Breyer Capital Partner Dr. Morgan Cheatham recently made the case that this feature of AI could lead to the collapse of traditional medical specialties as we know them.
- “Some domains will converge. Others will splinter into new subspecialties defined not by organ systems, but by data fluency, workflow design, or model supervision.”
Not so fast. There’s no doubt that AI will reshape roles, but that doesn’t mean that specialists are about to start offloading everything onto generalists.
- High-quality care requires more than following AI-friendly guidelines, and specialists incorporate judgment earned through years of experience to deliver effective treatments. LLMs are also still a ways away from replacing anyone’s hip.
- Primary care providers also aren’t exactly sitting around looking for extra work, and it’s far-fetched to think that they can start taking on specialty care for their ever-growing patient panels.
The Takeaway
AI might be great at well-defined tasks like many seen in specialty care, but we’re still a ways away from having primary care physicians replacing cardiologists.
