For years, the narrative of modern medicine has been one of increasing distance. The space between a physician and a patient is now frequently filled by electronic health records, standardized guidelines, and a relentless pressure to optimize “throughput.” In the pursuit of evidence-based precision, the individual—the person with a name, a family, and a specific set of fears—can sometimes feel like a secondary detail to the pathology they carry.
Dr. Ann O’Hare, a professor of medicine at the University of Washington and the VA Puget Sound Health Care System, spent much of her early career feeling like an outsider in her own field. A nephrologist by training, she found herself drawn to the sensibilities of geriatrics: a focus on the whole person, the prioritization of quality of life, and the courage to navigate the complex, often messy transition toward the end of life.
Now the recipient of the Shaul G. Massry Distinguished Lecture Award, O’Hare is sounding a cautionary note about the latest promise in healthcare: artificial intelligence. While AI is being marketed as the tool that will finally “free” doctors from administrative burdens to spend more time with patients, O’Hare argues that the humanization of medicine cannot be outsourced to an algorithm. It is a choice that clinicians must make every time they enter a room.
The Migration Toward Person-Centered Care
Nephrology, the study of kidney function, has traditionally been a field of aggressive intervention and rigid protocols. However, O’Hare observes a gradual shift. The values of palliative care and geriatrics are beginning to permeate the specialty, moving away from a paternalistic “physician knows best” model toward a partnership with the patient.
This evolution is driven by a growing number of clinicians who are dually boarded in both nephrology and palliative care, as well as a broader cultural movement toward patient advocacy and consumer rights. The goal is to move beyond the strictly medical to uphold who the patient is and what actually matters to them—whether that is staying home for a grandchild’s birthday or avoiding a specific side effect of a life-extending drug.
This shift is not merely a matter of kindness; it is a clinical necessity. In complex chronic illnesses, the most effective treatment plan is the one the patient is actually willing and able to follow, which requires a deep understanding of their unique life constraints.
The AI Paradox: Efficiency vs. Empathy
The current excitement surrounding AI in medicine often centers on “AI scribes”—tools that listen to a patient encounter and automatically generate a clinical note. The selling point is efficiency: the machine filters out the “extraneous” information to leave a clean, professional medical record.
To O’Hare, this “filtering” is exactly where the danger lies. She recalls being horrified by the idea of a tool that would remove a mention of a patient’s dog or a detail about their home life from a note. In her practice, those details are not noise; they are the anchors that allow her to conjure a unique image of the patient during their next visit.
This creates a fundamental tension in the “Deep Medicine” philosophy—a term coined by Dr. Eric Topol—which suggests that by automating the humdrum, AI will give doctors more time to be empathic. O’Hare remains skeptical of the idea that time is the only barrier to compassion.
“I’ve always been skeptical of people who say they don’t have time to listen to the patient… It’s still up to us how we spend the time we are granted and what we choose to prioritize,” O’Hare says.
The risk, she argues, is that if clinicians view the “boring” parts of the job as something to be automated away, they may miss the very moments where the most significant healing happens.
The Value of the ‘Meaningful Mundane’
Humanizing medicine often happens in the gaps—the moments that don’t fit into a billing code or a clinical guideline. O’Hare describes these as the “meaningful mundane.” For a patient with kidney disease, the greatest obstacle to their health might not be the glomerular filtration rate, but a glitch in transportation or a confusing conflict between two different doctors’ instructions.
When a physician takes the time to solve a transportation issue or clarify a medication mix-up, they are exercising a form of compassion that no AI can replicate. These tasks may seem like administrative annoyances, but they are often the most direct way to make a tangible difference in a patient’s life.
| Robotic Medicine Approach | Humanized Medicine Approach |
|---|---|
| Prioritizes population-based guidelines | Prioritizes the individual’s unique experience |
| Filters out “extraneous” personal details | Uses personal details to build a patient profile |
| Views administrative hurdles as noise | Views social hurdles as clinical priorities |
| Physician as the sole expert | Shared decision-making partnership |
Navigating Uncertainty in the Age of New Drugs
As nephrology enters a new era of pharmaceutical innovation, the need for human-centered care becomes even more acute. A pipeline of new drugs is emerging that can slow disease progression or prevent end-stage kidney disease. While these are scientific triumphs, they introduce new layers of uncertainty for the individual patient.
Many of these are “forever drugs” with potential long-term side effects. Determining whether a specific drug will be helpful or harmful for one specific person requires more than a clinical trial average; it requires a true partnership. Bill Wang, a lawyer and dual kidney-liver transplant recipient, has highlighted the immense “homework” patients must do to engage in their own care—a burden that clinicians rarely acknowledge.
The challenge for the next decade of medicine will be to integrate these powerful new tools without losing the person in the process. If the medical community relies solely on standardized boxes, O’Hare warns that they risk becoming robotic themselves, making them easily replaceable by the very AI they are implementing.
Disclaimer: This article is for informational purposes only and does not constitute medical advice. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding a medical condition.
As the National Kidney Foundation and other medical bodies continue to integrate AI into clinical workflows, the next critical checkpoint will be the evaluation of “human-in-the-loop” systems to ensure that automation supports, rather than replaces, the clinician-patient bond.
Do you feel the human element is disappearing from your healthcare experiences? Share your thoughts in the comments or share this article with your provider.
