Value

You may argue we still need a good doctor to make the decision that a CT scan is needed, to interpret the result when it's available, and to give the appropriate treatment.

I must say I am not put at ease with these answers.

My worry is simple: When a previously expensive and sophisticated technology becomes cheap and easily available, there is no need to make that very first decision. For example, a patient with tummy ache will just go for a CT scan before consulting anyone. That's exactly what happened in VW's story.

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You may think the lack of added value only affects the lot of brainless doctors who think by only one synapse before ordering all tests and investigations.

The sobering truth is: Good doctors (in our traditional sense) are not spared.

The explanation could be put simply: The lay public could not discern good clinicians from lousy ones easily, and, therefore, they have to compete by their price. (The traditional scenario used in game theory is taxi driver: You cannot tell a good driver from a bad one before taking the ride. As a result, no taxi driver could mark up their own price - otherwise, any potential passenger would choose a cheaper one. The more important implication is: No taxi driver would have the incentive to improve their service!)

There is a more convoluted and elaborated way to give the explanation. It goes like this: The public is not only incapable of discerning good and bad doctors. Lay people are tempted to make the wrong judgment in this matter. For example, does a doctor - when every other aspects are equal - appear more reassuring if he send a patient with tummy ache home after a normal CT scan, as compared to another who just palpate the patients abdomen and send the latter home? In the matter of diagnosis, the lay public is most unforgiving. You score no point by making a diagnosis of normal abdomen in one thousand patients (in fact, patients like normal study results), but your name would be condemned if you miss a single case of, say, Merkel's diverticulum. In other words, it is for sure a losing battle to compete the diagnostic yield of our clinical skill to the advancing technology.