Healthcare Automation Strips Away Human Infrastructure

When a physician recently spent 30 minutes on hold trying to refer a complex patient to a specialist, only to be routed to a chatbot and then voicemail that was never returned, the experience captured a fundamental problem in American healthcare. Medical offices have systematically removed people from the system in pursuit of efficiency—and discovered too late that many of those people were not inefficiencies at all.

According to reporting by Dr. Robert Glatter in Forbes, healthcare organizations have spent years stripping away front-office staff, experienced receptionists, and administrative nurses, replacing them with centralized call centers, automated phone systems, and patient portals. The result looks efficient on spreadsheets while functioning poorly in practice.

The hidden cost of automation

Healthcare embraced automation for understandable reasons: labor costs are high, physician practices operate on narrow margins, and software promises to process more calls with fewer employees. For predictable tasks like appointment reminders or routine prescription refills, automation works well.

The critical mistake, Glatter notes, is assuming that because automation handles simple transactions effectively, medicine itself can be organized as a series of simple transactions. A patient calling about an elderly parent discharged from the hospital without necessary medications, or a primary care physician needing to discuss a CT finding that doesn't fit electronic referral forms, requires judgment, context, and sometimes compassion—none of which navigate well through "Press 1 for appointments" menus.

Experienced receptionists once recognized which patients sounded unusually short of breath on the phone. Nurses knew which messages needed immediate physician attention rather than sitting in electronic inboxes. Administrative staff understood when another doctor calling personally signaled genuine urgency. These employees functioned as connective tissue, solving problems before they escalated and understanding the human context behind each interaction.

Many healthcare systems have consolidated or eliminated these positions entirely. When physicians spend 10 minutes navigating phone trees to reach colleagues, or nurses spend shifts responding to messages that trained clerical staff could have resolved, automation hasn't eliminated work—it has redistributed it to the most expensive and overextended people in the system.

Why it matters

Patients judge healthcare systems primarily through a deceptively simple metric: Can I reach someone when I need help? A world-class specialist who cannot be reached is functionally unavailable. For older patients, those with disabilities, or people managing multiple illnesses, forcing all interactions through apps and portals creates barriers rather than convenience. The lack of complaints doesn't indicate satisfaction—many patients and physicians simply give up, leading to delayed care, emergency department overcrowding, and adverse outcomes that never appear in quarterly reports.

The path forward

The solution is not abandoning technology but implementing human-centered automation—systems that automate repetitive work while preserving rapid access to people when situations become complicated. Healthcare organizations should restore adequately staffed front desks, maintain clear physician-to-physician communication pathways, and design phone systems that offer straightforward routes to human assistance rather than burying them beneath menu layers.

As healthcare enters an era of increasingly sophisticated AI, the lesson from current automation failures should be clear: technology should augment healthcare, not serve primarily as another mechanism for removing humans from patient care. The objective should be the most effective combination of humans and machines, not the smallest possible workforce overseeing the largest patient population.

Healthcare needs more people—people answering phones, coordinating referrals, and helping patients navigate complexities that automated systems cannot solve. Sometimes the most advanced thing a healthcare system can do is remarkably old-fashioned: have a knowledgeable person answer the phone.

These details were first reported by Dr. Robert Glatter, writing for Forbes, with contributions from Dr. Peter Papadakos of the University of Rochester Medical Center.