Frederick Taylor was a pioneer in taking work apart and putting it together in a more efficient, cost-effective way. His Principles of scientific management altered the way work was done and effectively moved control from workers to producers, the latter determining not only what should be done but how it should be done. 

The idea of disaggregating and reassembling work can be a powerful way of improving outcomes. The knowledge holders of his initial targets were relatively powerless. Over time, various professions have suffered similar scientific management incursions. But the most powerful professions in our society remain above such threats. For now. 

But when resources are pressed and better outcomes are much needed, should they be? Just as Taylor disaggregated industrial production as a way of freeing up efficiencies, should we now look at the medical profession in a similar way? 

The BMA and existing practice, coupled with the latent threat of industrial action, keeps such pressures at bay for now. But as we expect more from medics and as there are fewer to go around, should we now consider reconfiguring their professional activity to increase clinical supply? Take the work of GPs. In some parts of the country, it is virtually impossible to get an appointment in less than two weeks, a situation unlikely to improve any time soon. This can drive worried patients to A&E. 

At present, the medical receptionist is the first line of defence - fiercely protective of doctors' time but who offers no clinical input at all (though it may feel like one is being diagnosed on the phone). 

What if this work was given to diagnosticians, doctors whose sole job is to manage this interaction? This happened to a degree during the pandemic. Medics' ability to not only diagnose but to read between the lines, to hear what's not being said as much as what is, would make this a powerful frontline, enabling them to triage quickly and ensuring patients were directed to the right clinical next stop. 

This could be a wide range of clinical offers: preconsultation tests; nurse practitioners; other health professionals; and, in some instances, further face-to-face GP or hospital time. 

These new diagnosticians would work alongside AI to consider the range of symptoms reported to ensure nothing was missed. Enter AI: the average GP will struggle to keep abreast of potentially useful research. Some 19 medical papers are produced every day offering potential new insights. 

Alongside this, citizens could log key health indicators on a quarterly basis – blood pressure, heart rate, weight, recent injuries – and make regular submissions to their GP. Such data could enable patterns and potential emerging risks to be screened by AI, allowing proactive contact by the practice rather than waiting for something untoward to emerge. 

The fact is that even these initial sketchy ideas are unlikely to be adopted – or even considered. Our top professions are fiercely protective of their boundaries, knowledge, methods and entry requirements. The BMA has large well-defended battlements. It's one of the reasons, one suspects, why disruptor change models are so favoured by politicians; it's easier for computers and algorithms to go to battle rather than ministers. 

But doctors are not alone. Most professions that can resist change, will. Protecting knowledge and method boundaries helps them to retain both their place in the market and their rate for the job. But all that is changing; virtually any work that is algorithmic in nature could in time be done by a computer. Ironically, those commanding the lowest rewards, care and other hands-on professions, are virtually immune to this kind of disruption. 

Of course, it would mean loss of professional autonomy. Doctors and other professionals enjoy considerable method latitude at present, just as workers did before Frederick Taylor started meddling in their work. And change will certainly affect how they see their work and themselves. 

But over time, if it could produce better clinical outcomes at lower cost, then this kind of disruption might merit serious attention. Professions matter. But where they are means of resisting much needed change, then they will, in time, go the way of the crafts. Clue: it doesn't end well. 

If you would like to respond to this article or have a radical solution of your own, contact l.peart@hgluk.com