Join Farhad Manjoo in Washington, D.C., on Thursday, Sept. 29, for a Future Tense event on robots and the workforce. Manjoo will be joined by Tyler Cowen, author of The Great Stagnation and blogger at Marginal Revolution; Robbie Allen, whose company StatSheet could put sportswriters on unemployment lines; and others. To RSVP for a free ticket, click here.
The first computer I ever saw was the one my dad bought to manage prescriptions in his pharmacy. This was in the early 1980s, in South Africa, and my dad was an early adopter. Back then almost none of the country's other pharmacies were computerized. The idea that a pharmacy, of all places, would ever need a computer seemed bizarre. Computers were for calculations, and pharmacists didn't calculate. My dad, who was then just a few years into his practice, spent his days counting pills, mixing compounds, and counseling patients who looked to the local pharmacist as a kind of always-on-call pseudo-doctor. All these tasks were beyond the capabilities of early computers—which also tended to be unreliable, difficult to use, and expensive. "Some of the other pharmacists thought I was crazy," my dad recalls. "Why spend so much money on this?"
But pharmacy was changing. More and more medicines required little intervention by pharmacists—they didn't need to be mixed, diluted, or otherwise prepared. These medications just needed to be counted, bottled, labeled, dispensed to the customer, and then billed to insurance companies. The tasks that now consumed a pharmacist's day—customer management, inventory control, and invoicing—weren't taught in pharmacy school. They were, however, perfectly suited to a new breed of software being developed to manage retail businesses.
The computer that my dad installed was primitive, but it streamlined the most-onerous processes in his pharmacy. Before the computer, my dad spent three hours every day on billing, pricing, patient management, and all the associated paperwork. The new machine handled all of that. In an instant, he had three free hours per day.
Within a few years, every pharmacy in South Africa used computers to manage its operations. My family moved to the United States in the late 1980s and my dad started working at an American chain pharmacy. The technology he encountered there was even more amazing. By the 1990s, most American pharmacies were equipped with electronic connections to doctors' offices and insurance companies, allowing them to receive prescriptions and check a patient's coverage. The typical retail pharmacy also has systems to warn against potential medical errors—it flags drug interactions, for instance, and warns if a prescription doesn't fit a patient's demographic characteristics.
In the three decades since my dad installed that underpowered PC in his store, computers have helped pharmacists do their jobs better and faster. Unfortunately for the field's human practitioners, these once-helpful machines can now do the job on their own. Over the next 10 to 15 years, increasingly intelligent robots, computers, and software package will invade a wide variety of American workplaces. Pharmacists will be some of the first highly skilled professionals who'll lose their jobs to machines. Today's pharmacy robots can look up patient records, count out pills, label vials, and bill insurance companies. Some of these systems are buggy, and several pharmacists I spoke to complained that they needed constant human supervision. But they concede that the computers keep getting better, and that today's best robotic pharmacists are faster and less prone to error than the best human pharmacists.
Not long ago, I visited the Mission Bay campus of University of California-San Francisco and met my father's successor face-to-face. It was a staggering site: The hulking room-sized machine was festooned with Rube Goldberg-ian appendages—a labyrinth of rubber conveyor belts, miles of pneumatic pipes, and finely calibrated, suction-powered, pill-picking arms. Here's a video of the robot at work:
UCSF's robot is called PillPick, and it was developed by a company called Swisslog. The machine is so big, with so many different moving parts, that (unlike most robots) it's difficult to anthropomorphize. There's nothing playfully human about it. It's all business.
The machine begins by picking individual pills from large boxes that humans insert into the machine. Filling these stock boxes with the correct medication is the only role humans fill in the process. I spent a few minutes watching this step, and I was struck by how lazy the machine appeared. (OK, I guess anthropomorphizing machines is impossible to resist.) It took a second or two for its suction-powered arm to push down into box, grab on to a pill, and pull it up. Once in a while, the arm would miss and come up empty. But it was never fazed; the bot kept going, picking and picking and picking. After getting each pill, the robot packages it into a plastic bag that contains a barcode identifying the drug. Then, for each patient in the hospital, it selects the appropriate number of pill-containing bags and binds them together on a plastic ring. These rings are transported to the patient's bedside. When they're administered, a nurse scans the barcode on the pill ring, tracking the path of every drug to every patient.
Before installing the robot, UCSF needed about half of its more than 100 on-staff pharmacists to administer and check the drugs going out to patients on the floor; now nearly all have been reassigned to different parts of the hospital, where they make IVs, help adjust patients' drug regimens, and perform other tasks that had been neglected when they were simply filling prescriptions The robotic pharmacy cost $7 million to install—less than one year's salary for all those pharmacists—and when it's running at full capacity, it can dispense more than 10,000 doses a day. After it became operational last year, the robot filled 350,000 prescriptions without making a single error. (The first error it did encounter was a printer problem that was quickly caught by its human operators.)
Why are pharmacists so vulnerable to automation, and what can those of us who work in other fields learn from their plight? Over the last few months, I've spoken to several pharmacists and makers of pharmacy robots about how automation has changed the industry. These were grim conversations. Medicine is a growth industry; as the nation ages, we'll all need more drugs. Citing this demand, the Bureau of Labor Statistics projects a 17 percent increase in the need for pharmacists over the next decade. The high demand for pharmacists has also led to steady wage growth—in 2010, the median salary for an American pharmacist was $111,000, almost 70 percent more than what he earned in 1999.