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May 23, 1977

The Post-Physician Era: Medicine in the 21st Century

JAMA. 1977;237(21):2336-2337. doi:10.1001/jama.1977.03270480076033

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Even the monthly science fiction magazines demand more intellectual insight, a more mature viewpoint, and a better logical projection than this tiresome offering. Reviving a discussion popular 20 years ago, Maxmen predicts that physicians soon will become extinct, to be replaced by a giant system of computers assisted by inexpensive medics who can solve the enormous and ugly problems of the present-day medical system. If Maxmen understood these enormous problems and could show sympathy and much more humor, then the book might have become a pleasant fantasy or even a satire, but he achieves much less impact with this unsubstantiated, cultish forecast.

A more sophisticated intellect could scald present-day politicians, consumers, and medical leaders with criticism based on the methods of forecasting and analysis and could include some useful understanding of incentives, governmental authority, comparable projected costs, alternative futures, and workable methods of implementation or control. A valid tradition of