AI Scribes and Hidden Costs

How could AI shift medical value toward primary care relationships if pattern-recognition specialties are more automatable? What would people prefer if given the choice between discussing their problems with a human or with non-judgmental empathic AI?

Allison J. Pugh is a Professor of Sociology at Johns Hopkins University and the author of several books. Her most recent works are The Last Human Job: The Work of Connecting in a Disconnected World and The Tumbleweed Society: Working and Caring in an Age of Insecurity.

Greg and Allison discuss Allison’s newest book and her concept of “connective labor,” defined as the relational practice of seeing another person and having them feel seen. They also contrast this idea with more individual-centered ideas like EQ. Allison argues that this type of work is reciprocal, widespread across roles (therapists, teachers, chaplains, primary care, managers, service work), and increasingly important as the economy shifts toward requiring more “feeling.” Allison also talks about how AI is being used in new ways to help automate different aspects of different jobs, and along with that come connected effects like the rise of automated medical scribes amongst the medical community, but also the drastic reduction of interns and the near elimination of that valuable aspect of education and job training for an intern’s future professional life. They also discuss how the different efficiency tools can backfire because of the increased need to oversee and validate automated output.

*unSILOed Podcast is produced by University FM.*

Episode Quotes:

Why friction is essential to human connection

17:26: Part of the relationship with another human being involves the friction of not being able to control what they say, of running up against their disagreement or conflict or even tension, or they have their own ideas, their own desires. And that is part of making our way through this world, and it is a really important part of being in community, in relationship with other human beings. And that is what chatbots do not give us. They give us no friction.

AI is mirror, not a relationship

17:08: So with chatbots, you are not really experimenting how to be with another human being. You are instead experimenting with a mirror, and that is just not going to have the same powerful impact.

Who gets humans, and who gets machines?

12:27: The idea that technology will be better than nothing, I am afraid, will not lead to greater opportunities to be seen, for less advantaged people. Instead, they will just have machines seeing them, and the rich people get humans seeing them, and that is an inequality that I find kind of tragic.

Seeing people is a leadership skill

49:52: When people have a chance to kind of express their values at work, figure out who they are and have their values kind of enacted in their work and kind of basically attach a purpose to what they are doing, a more transcendent purpose than just kind of earning the paycheck, it translates into a kind of deep meaningfulness, and that is part of the outcome of connective labor. And so it is really worth it for managers to get good at this because it enables people, the people they are seeing, to figure out what matters to them and to find that in relationships at work. That is a path to meaningfulness that can be very important.

Show Links:

Recommended Resources:

• Moneyball: The Art of Winning an Unfair Game
• Automated Medical Scribe
• Chat Checkout Lanes
• Unsiloed 469: Matt Beane - The Importance of Learning by Doing

Guest Profile:

• Faculty Profile at Johns Hopkins
• AllisonPugh.com
• LinkedIn Profile
• Social Profile on X

Guest Work:

• Amazon Author Page
• The Last Human Job: The Work of Connecting in a Disconnected World
• The Tumbleweed Society: Working and Caring in an Age of Insecurity
• Beyond the Cubicle: Job Insecurity, Intimacy, and the Flexible Self
• Longing and Belonging: Parents, Children, and Consumer Culture
• Google Scholar Page

Hosted by Simplecast, an AdsWizz company. See pcm.adswizz.com for information about our collection and use of personal data for advertising.