A Lesson Doctors Must Learn From Lawyers!

The contemporary world is in the midst of technological upheaval. Millennials' reliance on the tech industry is overwhelmingly liberating to those doubling down on technocrats. The latter sets up the best environment for corporate powers clenching on all enterprise sectors one by one, from agriculture to Healthcare. For close to a century, corporations have gained control over small businesses and scholars through fiscal control and kickback exercises. With the advancement of artificial intelligence, access to big data and the concept of their conquest over various industries is well corroborated, describing how organizations are representing their behavior today. While seizing all industry sectors, Healthcare is surely enduring that peril and Legal technology system seem to be the next profitable frontier. The tech industry is shifting from being a subsector of frugality by evolving into an open economy. Every enterprise lives along the spectrum of mighty evolution. Some speculate they will be apt to build sustainable companies amidst businesses for which the move toward technology is substantiating transformation. Although with the advent of software as a service (SAAS) entities such as legal zoom and rocket lawyer, we all must be familiar with the technological advances within the legal domain. However, the expanse of the industry take over had recently gotten further possessive. In contrast, the tech industry, through its non-domain ownership, is contemplating extending artificial intelligence and deep learning technology to solidify more significant technology-driven legal assistance. While well known to our healthcare system, the law industry comes across to be no match for the prevailing corporate feudalism. Nevertheless, the latest attempt to conquer the system stands not without antagonism, yet it is much better than what medical counterpart can observe. To administer some control, just like states boards of medical specialties and American Medical Association (AMA), California Bar Associations is among the first entities that have formulated a Taskforce on Access Through Innovations of Legal Services" (ATILS). The organization has drafted plans to fix legislation of the state's legal marketplace that has led to harsh criticism from the lawyers who reckon some of the committee members assessing whether to expose the legitimate endeavor to non-lawyer holding, exposing vaster technology-driven legal services to conflicts of interest. The State Bar of California has already put in place thresholds on arising legal technologies prohibiting non-lawyers from owning legal service technology firms; nonetheless, the landscape is shifting as we speak. In a recent interview, Professor William Henderson of Indiana University's Maurer School of Law tallied that the California State’s regulatory status has been constraining many of its citizens of reasonable passage to rectitude, hence to address the issue the state bar recently organized the Task Force on Access Through Innovation of Legal Services. The new committee was ratified in 2018 to observe feasible regulatory upheavals to improve the delivery and access to legal assistance through the technology, including but not limited to artificial intelligence and online legal service delivery measures." The ATLIS presently marks twenty members with at least ten of whom are attorneys with a widespread conception of current technologies. Among board members are six with current or preceding high-level expertise at legal tech or platform. Some names to recall among them are Andrew Arruda, CEO, and co-founder of ROSS Intelligence; Dan Rubins, CEO and co-founder of Legal Robot; Joshua Walker, co-founder of Lex Machina and author of On Legal AI; Simon Boehme, co-founder and COO of Dispute; Johann Drolshagen, CTO/CIO at Level Playing Field Solutions; and Allen Rodriguez, former director of attorney services at LegalZoom. Recently ATLIS published sixteen tentative proposals, comprising authorization of non-attorneys to acquire or retain economic interests in legal entities. Within the context, the task force approved licensing technology-driven legal services delivery systems to engage in particular legal actions without perpetuating the illicit practice of law. The distinctions of the tentative proposals attracted influential tension from California's attorneys in September 2019 on every proposition received. However, some lawyers have also put forward skepticisms about the task force's enrollment, utterly opposing the proposal on the potentiality of the panelists holding technology associations. All Attorneys, unanimously argued that the possible conflict of interest threatening the legal system by way of financial benefit through allowing "non-lawyers" to own or invest in law firms. In technical terms, the opponents of the measure are strongly concerned about the method of validation of their technology. Improper validation and oversight would give rise to more effortless undertaking certain legal activities by non-attorneys. The legal community also called for transparency on what businesses community would possess in the prospect relating to the function they intend to facilitate on the task force. Despite the overwhelming opposition California bar, task force panelists were not expected to consent that they wouldn't gain financially from entities arising from the panel's capacity. The ATLIS also waves the members from being subjected to any state bar conflict-of-interest prerequisites. The agency's reason behind such controversy; is because unlike other state bar councils that render particular conclusions esteeming fund allocation, the access task force would merely be furnishing guidance and advice to the judiciary's board of trustees. The task force elected members with diverse backgrounds and interests with intend to maximize their bottom line on various aspects of the technology, disciplines, and science. For instance, panel members who function or specialize on legal tech can provide crucial advice of related topics of that expertise. Hence, their perspective is balanced and rounded out by members of varied experiences. Interestingly, it was also emphasized; it's a conflict of interest for lawyers to regulate themselves. Hadfield, one of the working members at Utah Bar Association, who also served at LegalZoom's legal advisory board, spent time on occasional meetings, says she has no economic involvement in the company and has not directly operated in the legal tech industry. In August, the Utah group put forward a series of reform recommendations, including advocating for the creation of a regulatory sandbox in which non-traditional legal services providers could test out inventions to assist legal clients without concern of standing arraign of the unauthorized practice of law. The Utah Supreme Court adopted the recommendations soon after and created a task force to implement them. Himonas, the co-chairperson of the implementation task force, tells this panel also does not encompass anyone who is directly working at legal tech industries. Instead, there will be several advisory panels to the task force, entailing one headlining partner with legal technology experiences. At the other end of the spectrum, in October, the Arizona task force released its report and recommendations, including proposing to eliminate the constraint to non-lawyers co-owning companies that employ in the practice of law. The proposals are headed to the Arizona Judicial Council for approval.

How does Healthcare task force align with its legal counterpart?

Healthcare is a vast opportunity for the tech industry. U.S. health care spending increased by 3.9 percent in 2017 reaching $3.5 trillion, or $10,739 per person! It serves as a perfect seedbed for corporate entities to reign on! Many technologies that inundate physicians, often useful but some impetus for complete burnout, all justified under the physician scarcity. Industries pivot to maintain financially prosperous deed versus sustaining their promised vision and mission. Henceforth, they will do all they can to reduce the friction from the medical community. The consequence of which implicates physician burnout and the nihilistic attitude of the patients. That is the least we can appreciate from the current industry trends. As of today, the state bar association counterpart in medicine, the state medical boards do not have a well-recognized task force committee in place to address the related categories of issues as described for ATLIS. The majority of existing organization plunge under general healthcare transformation task forces, focusing merely on value-based clinical care delivery model and physician burnout prevention, as it will be shortly discerned with the Healthcare Transformation Task Force ( HTTF) and The Connected Health Initiative's Health artificial intelligence (AI) Task Force. Even then, they are far from proven unbiased; or have little or no direct relationship to the state medical boards or any other regulations agencies. In February 2019, healthcare dive published an article about healthcare task forces asking for reforms in its policies towards making Artificial Intelligence (AI) algorithms in line with real-world workflow. The title of the article stunned me, as it seemed well descriptive of how shaky the foundation of the intention, despite painting the legitimate intent. That word was" real world with the flow"! The Connected Health Initiative's Health artificial intelligence (AI) Task Force has recently published a set of policies to regulate the usage of artificial intelligence systems in Healthcare. Accordingly, the recommendations utilize risk-based strategies to assure AI used to be aligned with proper safety, efficacy, and ethical standards, as mentioned earlier, to be compatible with real-world workflow impacting Healthcare by enhancing diagnosis and treatment and curtailing administrative impediment. Concomitantly parallel with the evolution of AI and the urgent need for regulations to ensure proper algorithm validation towards fulfilling their promised patient empowerment as well as a secure passport to care, the system needs rules making sure they are sufficiently robust to protect patients and ensure their data. According to market intelligence firm Tractica, AI's need is estimated to reach $34 billion by 2025, from $2.1billion in 2018. But interestingly, Dominant industry entities, including Optum and Anthem, as well as other disruptors like Google, CVS are all exploring partnerships and projects using AI and machine learning technology. Healthcare Transformation Task Force ( HTTF) is a group of Executive Committee members that provides recommendations on the strategic direction of the Task Force and is known to attend to it as the "north star" for organizational priorities. The Executive Committee is chaired by the President of Government Services at Aetna. Other members include Blair Childs; Task Force Chair; the Senior Vice President of Public Affairs, Premier Healthcare Alliance; Mary Beth Kuderik, Task Force Treasurer/Secretary, Chief Strategy and Financial, UAW Retiree Medical Benefits Trust; Emily Brower, Senior Vice President, Clinical Integration and Physician Services, Trinity Health; Angela R. Meoli, Senior Vice President, Network Strategy and Provider Experience, Aetna, A CVS Health Company; Hoangmai (Mai) Pham, MD, Vice President of Provider Alignment Solutions, Anthem; Shelly Schlenker, Vice President of Public Policy, Advocacy and Government Relations, Dignity Health; Susan Sherry, Deputy Director, Community Catalyst; Jim Sinkoff, Deputy Executive Officer and Chief Financial Officer, Hudson River Health Care; Todd Van Tol, Senior Vice President, Health Care Value, Blue Cross Blue Shield of Michigan. As we can unfailingly point out from the list, there is only one physician in the community while rest holding an overwhelming conflict of interest; and possible no technology experience.

But what is a Task Force?

In general terms, a task force (TF) is a unit formation organized to carry out on a single well-defined assignment to make the right decision or make appropriate advice of a matter of the topic. The Task Force was primarily utilized by the United States Navy; however, it was later adapted for widespread usage and since has been the formal component of the NATO vocabulary. Various non-military institutions have been implementing TFA for transient functioning that once was performed for an ultimate purpose by the councils. One would assume the members of a given task force comprise of those members well versed in the core subject of the tasks and duties of the discipline they tackle. For example, to ensure optimal alignment of AI in the healthcare arena, it is yet necessary to engage physicians with particular functional knowledge on information technology and machine learning. It is furthermore imperative to acknowledge the fact that although the legal community has at least illustrated itself heading towards accomplishing that mission, the medical community is not even close to doing the same. The structure of task force by nature is deemed to be susceptible to bias and monopoly commenced by business elements for the motive of fiscal warranty, as we can discern from ATLIS and HTTF proceedings.

Between the line

Let's consider the fact that the millennial over-reliance on technology is inevitable, as they are willing to put their complete faith in technological initiatives driven by various industries. They often believe in a technocratic approach to the collective efforts of their respective countries. Enterprises are well aware and hence rush to make the big bucks with innovations faster than some other industries can keep up with; creating a vacuum drawing in changes that may or may not be in line with the mission of the users of those technologies. The technological gold rush is undermining the physicians being in touch with their domain, just with regards to legal tech and lawyers. Healthcare and law industries share the common challenges of dealing with complications of technological rush that are imminently threatening two of the most critical sectors of our time while being flooded by the players from other domains with pure financial inducements. Nevertheless, the legal community seems to be more adjusted to resist such a radical move by their sphere towards fiscal monopoly. Corporatism, Millennials' attitude, and technocracy are three of the catalysts for the latest information technology and digital trends.

Take home message

Bias and conflict of interest are a potential threat for all scenarios, but what make Healthcare more vulnerable are the ordinary physician's attitude as well as the aptitude to acknowledge the severity of the issue and prevent abuse. To implement the action of the given task force is not sufficient enough to fully halt the corporate invasion of what would otherwise be considered sacred to their respective initiative, but having formed with the right participants in the panel is a notch in the right direction by attorney community is contemplating. Lawyers are changing, and Physicians need to do the same by relishing of the basic concept behind technologies and the path of their continual evolution; a process that should start in medical schools so that doctors become adept in handling the technologies straight from the outset of their practice. The contemporary techniques must be handled in the same manner as a stethoscope was perceived by René Laennec at the Necker-Enfants Malades Hospital in Paris, France, during 1816. Rene invented the first stethoscope prototype because he was not comfortable placing his ear directly onto a woman's chest to listen to her heart. What makes today's artificial intelligence technology similar and different at the same time is its tactical use just like the stethoscope but strategically deviated by none-physicians unlike the "chest" and "explore" tool as ancient Greek says the stethoscope.