“Our positioning should not be to seek to stop the rise of technology but to seek to influence and control its use”
The AOP’s chief executive, Adam Sampson, on how the advancement of developing technology could change the profession, and the AOP
13 June 2023
As regular readers of this column will know, I am not the most sociable of individuals. So given that I tend to avoid unnecessary chat with other people whenever possible, it will not surprise you to learn that I have yet to engage in merry banter with any of the new Chatbot functions which are being rolled out by the titans of the software industry. Someone who insists on dialing his own telephone numbers and selecting his own music rather than asking Siri or Alexa to do it for him is scarcely going to rush to talk to Bard or ChatGPT.
And the public mea culpa of the former “godfather of AI,” Geoffrey Hinton, for his role in leading Google’s charge toward the new technology, is not exactly an encouragement for old farts like me to change our ways.
But that’s me as a private individual.
Professionally, I am excited to see what new technology can bring to our organisation and our sector. As an organisation, we are already using chatbot functions to improve our service to members. How far can we use artificial intelligence (AI) functionality to provide advice to members, enabling our in-house experts to concentrate on nuanced and specialist cases? And will AI reduce clinical risk and defray the number of potential insurance claims?
For the sector, and especially for patients, the possibilities are even more enticing. Improved technology should allow for a reduction in the administrative burden of practice (better transfer of data, automation of recording etc). More profoundly, the ability of new technology increasingly to perform some of the basic repetitive optometric tasks (particularly in the area of refraction) and, over time, to move slowly into diagnosis, will transform optometrists’ day-to-day activities. For patients, the ability for new technology to allow images to be reviewed remotely allows them to potentially access services in areas where there is a shortage of optometrists or, in time, even from the comfort of their own homes.
Yet there is no question that technology carries with it substantial risk. Not only is there the threat to optometry jobs represented by increasing automation of eye care work – to say nothing of the existential risk to the financing of the High Street opticians model represented by any unchecked rise in online sales – but there is an ongoing danger that AI models developed in response to data gathered about eye conditions among predominantly white, western patients may fail to deliver to the needs of an increasingly diverse population.
Equally profound is the risk arising from the fact that our existing regulatory models, bound by national boundaries and aimed primarily at monitoring the behaviour of individual medical professionals, are profoundly ill-equipped to control the growth of AI-enabled offerings by providers based outside the UK. When I was legal ombudsman, we knew that one of the online automated will-writing programmes had a technical flaw which rendered the wills it created unenforceable. But since the provider was a shadowy entity offering a virtual service based somewhere outside the UK, there was nothing we could do to respond. Even now, if someone were to offer a virtual refraction and sales model from abroad, it is difficult to see what powers the General Optical Council has or could be given to prevent it.
Faced with these risks, there are those in the profession who believe that the AOP should be campaigning against the rise of technology in the optics sector. Much as I quite fancy being a modern-day Ned Ludd, as Geoffrey Hinton himself has argued, it is too late for that. As King Cnut was trying to show to his courtiers (note to readers: the moral of the original Canute story was not about the arrogance of ruler but the obsequiousness of the ruled), not even the most powerful of us can turn back the tide.
Our positioning should not be to seek to stop the rise of technology but to seek to influence and control its use. Just like the questions we are asking about its use in the AOP, there are questions we need to ask as a sector. What are the areas where it will be most useful? Where are we most worried? In the world that is to come, how can we try to ensure that control of this technology remains in the hands of people who know optics and care about patients rather than people who are just motivated by short term gain at whatever price? What are the risks and how can we mitigate them? And, above all else, how can we ensure that in the world that is to come, optometrists continue to survive and thrive?