tymshft

You will still take a cab to the doctor’s office. For a while.

In May of 2003, Edith was a 75 year old widow. Though she missed her husband terribly, she still maintained an active life. This was complicated by the fact that she never learned to drive, but what are friends – and cab companies – for?

Being somewhat set in her habits, she would always have her medical checkup on the first Tuesday in May. The routine never varied. An hour before her appointment, Edith would go to the living room, pick up the phone, and call the cab company. The cab driver would arrive half an hour later and take her to the doctor’s office. Edith would pay the cab driver with a credit card – she didn’t like using the cabs that required cash – and then go into the doctor’s office, see the receptionist, and wait. She’d then spend some time with a nurse, and toward the end of the appointment would spend some time with the doctor. Edith was amused by the fact that she was now older than her doctor.

Edith remained in remarkably good health, so she continued to visit the doctor every year. And even in 2013, when she was 85 years old, the routine never varied – or it didn’t vary much. She still scheduled her doctor’s appointments for the first Tuesday in May, and she still took a cab to the doctor’s office. She still went to the living room to call the cab – not because the phone was there, but because she always liked to make her calls from the living room. It was easier to make the call to the cab company, because she had the number pre-programmed into her Jitterbug phone. And her daughter had set things up so that she could pay the cab driver in advance, through her computer. Edith could have booked the cab through the computer also, but that just didn’t feel right. She did appreciate the safety of paying online, though. The cab driver took her to the doctor’s office, just as before, and she had to wait in the waiting room, just as before (well, maybe a little bit longer). These days she spent much more time with the nurses than she did with the doctor, but the doctor always made sure to spend a few minutes with Edith. The doctor actually liked to spend time with Edith; some of his patients would probably just as soon have the doctor email his findings to them, and skip that whole “discussion” bit.

Time continued, and while Edith slowed down a bit, she was still able to maintain her independence. So in May 2023, when Edith was 95 years old, she still scheduled her doctor appointment for the first Tuesday in May, and she still took a cab to the doctor’s office. The routine never varied – well, maybe a little bit. Edith had booked and paid for the cab a month before the appointment, using the online Gacepple Calendar service. (Gacepple, of course, was the company that resulted from the merger of Google, Facebook, and Apple – the important merger that saved the tech industry in the United States from extinction. But I digress.) An hour before the appointment, Gacepple Calendar reminded Edith of her appointment, and five minutes later the Toyota in the street let her know that it had arrived. No, not the driver – there was no driver – but the Toyota itself.

Edith was the expert on driverless cars. Outside of the techie circles, most individuals didn’t own driverless cars. But the cab companies that Edith used sure did. While some cabdrivers protested over their job losses, many of them got jobs with churches, nursing homes, and other groups that didn’t have the money – yet – to afford a driverless car. Edith was secretly pleased with the elimination of cab drivers – all of the cab drivers in the past had listened to that horrid country music, and Edith liked the freedom to choose her own music on the way to the doctor’s office. Edith, of course, usually listened to oldies music – early Katy Perry was her current favorite.

After the Toyota delivered Edith to the doctor’s office, she went to the front door, was identified by the multi-biometric reader, and walked in. She announced her presence in the waiting room. “We’re ready for you, Edith,” said the friendly voice. “Would you like someone to guide you through the examination?”

“Yes,” replied Edith. “I’m not that good with all of this electronic stuff. Yesterday I set my alarm for seven o’clock PM instead of seven o’clock AM! Not that I need an alarm to wake up.”

The friendly person opened the door for Edith and told her to go to Examination Room C.

“So do you still need people to perform some of the tests?” asked Edith as she sat in the comfortable chair.

“Actually,” replied the friendly voice, “none of the tests requires human intervention. In fact” – the voice paused for a bit – “we’re already done.”

“Wow, that was quick!” replied Edith. “And I didn’t even have to get poked or take any clothes off.”

“We try to make the experience as comfortable as possible for all of our patients,” said the friendly voice. “We know that medical appointments in the past used to be very uncomfortable for some people, but with today’s scanners and medical reading devices, we can complete the examination without laying a hand – or sensor – on you. We’ll mail the results to Edith Smith at Gacepple dot com. Did you have any questions?”

“Actually, I had two,” replied Edith. “First, will there ever be a time when me – or my children – won’t have to come down to the office for the examination?”

The friendly voice replied. “Actually, we offer this service right now, and some of our REALLY elderly patients prefer it, because it allows more constant monitoring of their medical condition. Unfortunately, insurance doesn’t cover the cost, but – just a moment – I’ll mail you the information on our home service.”

“Thank you,” said Edith. “And if you have a minute, I do have one more question for you.”

“I have the time,” replied the friendly voice.

“I have to admit that I was unnerved a couple of years ago when I came to the medical office and no one was here. I had been warned that this would happen, but was told that a person would guide me by voice to the office and conduct the exam. After a while, I’ve gotten used to the idea of talking to you, even though you’re not here.”

“Well, I’m glad you’ve gotten used to the procedure,” replied the friendly voice. “I hope you like me!”

“I do,” said Edith. “You’ve been very helpful. But I’ve always wondered exactly WHERE you were. If you were in Los Angeles, or in Mississippi, or perhaps in India or China, or perhaps even in one of the low-cost places such as Chad. If you don’t mind my asking, exactly where ARE you?”

“I don’t mind answering the question,” replied the friendly voice, “and I hope you don’t take my response the wrong way, but I’m not really a person as you understand the term. I’m actually an application within the software package that runs the medical center. But my programmers want me to tell you that they’re really happy to serve you, and that Stanford sucks.” The voice paused for a moment. “I’m sorry, Edith. You have to forgive the programmers – they’re Berkeley grads.”

“Oh,” said Edith after a moment. “This is something new. I’m used to it in banking, but I didn’t realize that a computer program could run an entire medical center. Well…who picks up the trash?”

“That’s an extra question! Just kidding,” replied the friendly voice. “Much of the trash pickup is automated, but we do have a person to supervise the operation. Ron Hussein. You actually know him – he was your cab driver in 2018 when you came here.”

(DISCLOSURE: I am employed in the biometrics industry.)

For further information, see this discussion of Vinod Khosla’s views on the future of medicine, and this discussion of the future of driverless cars. And it shouldn’t surprise you to know that Tad Donaghe has commented on both of these stories.