The diagnosis is becoming free, the operation is not

Artificial intelligence will transform medicine, but not in the way many assume. While AI provides affordable medical advice, it does not equate to affordable treatment. Free information does not guarantee quicker surgeries, more intensive care beds, or readily available organs. AI can explain why a blocked artery is dangerous, warn of a tumor's need for assessment, and suggest urgent questions, but it cannot perform the necessary procedures.

AI is making medical knowledge widely accessible, while the physical aspect of healthcare remains scarce. A top doctor's value was once a bundle of reasoning, advocacy, access, coordination, authority, and execution. AI affects the reasoning portion of this bundle, making it more affordable through software. However, this does not impact the scarce elements like MRI scanners, operating theatres, surgeons, ICUs, or transplantable organs.

The distinction becomes clear when comparing information to outcomes. More information does not always translate to better health results. Lifestyle programs, for example, prevent diabetes only if people actually follow through with the advice. Similarly, quitting smoking can significantly improve life expectancy only if the individual actually stops and stays stopped.

In severe cases, the gap between AI's impact and the scarcity of physical resources is stark. Early detection of localized colorectal cancer leads to better survival rates, but only through surgery, chemotherapy, and access to treatment. In heart attacks, quick action is crucial to reopen blocked arteries. In appendicitis, time is of the essence as the patient needs an operating theatre, not just a diagnosis.

While cheap advice benefits those already in the healthcare system, it also reaches those unaware of their symptoms' significance. This influx of informed demand could exacerbate existing bottlenecks. Those who can afford private treatment, faster imaging, or out-of-network care will still move ahead, creating a new form of medical inequality. This inequality, though less visible, may not be smaller.

The impact on general practice mirrors this shift. The reasoning-heavy, transactional part of primary care may lose value as machines excel in diagnosis and explanation. However, the remaining human role remains vital: physical examination, understanding the patient's context, trust building, medication judgment, safeguarding, accountability, and legal authority to prescribe or refer.

The implications of this AI-driven transformation vary across healthcare systems, especially those that are free at the point of use. In such systems, free advice can more easily convert into treatment due to the absence of a direct price at the next step.