We are in the midst of a secular shift in labor which is being driven by both rising interest rates and technology.  As I’ve already shared, physicians are not immune to either of these forces.  Envision has recently filed for bankruptcy and ChatGPT is going to have a profound impact on radiologist certification and value (coauthor Lincoln Berland).  The era of the “knowledge worker”, promoted by the 1960’s leadership guru Peter Drucker, is likely dead.  As physicians are largely knowledge workers (radiologists particularly so) is time to reinforce how we can create value.  My niece is a perfect case study.    

When I finished high school in 1990, public school superintendents trumpeted their college acceptance rates (with no follow-up on how many actually finished).  The message was if you didn’t go to college then you were a second-class member, you didn’t belong, you were a failure.  Today, not a moment too soon, this perception is changing.  

My niece Libby, for whom the traditional classroom was never attractive, has been fortunate enough to have the option to obtain her EMT certification during her last two years of high school.  She will graduate with a tangible skill which is desperately in need within our communities, a strategic long-term win-win deal for taxpayers.  During a recent practical ride-along with a local EMT squad she helped pick a woman off the floor and place her broken arm in a sling.  The feedback of “Oh, this is the first time I haven’t been in pain in hours,” is invaluable to a student like Libby.  For someone like myself who tries to help faceless patients at the edge of K-space and immunotherapy, it is also a lesson in humility.

As Libby graduates, she reached out to me to learn where she could buy a stethoscope.  Having two that haven’t been touched in 20 years, I offered her the one given to me at my medical school matriculation.  It will be infinitely more useful in her hands than it ever was in mine.  

This tangible tool being passed through the generations is also a signpost for our changing labor markets.  It will anchor Libby to a sustainable career by physically attaching her to the human beings who need her help.  Because of this tangible tether, she cannot be outsourced to AI nor is she at risk of being seen as too expensive as the cost of capital rises and some white-collar knowledge workers can no longer generate marginal value.  Her EMT certification is a gateway to future certifications as a medic or registered nurse, levering her value in our community for the taxpayers who have helped educate her.  Her certification is more valuable today than some bachelor degrees being handed out four years into the future. 

The labor teaching our children, responding to emergencies in our communities, fixing our plumbing and building homes, supplying our food, and working in recently onshored factories will be in demand.  Their jobs won’t be static, but will be there.  The rest of us, like Libby’s college bound twin, need to embrace the fact that the knowledge worker is dead.  We must become more strategic in our approach to our future careers.  We need to understand value, and iteratively ask ourselves whether we are delivering value.  In other words, we need to develop the professional sustainability skills that Libby is launching with.  

The knowledge worker is dead, long live the strategic worker.  There are several ways to be strategic in our workplaces, and one is our human networks.  Tangible tethers to other humans, like the stethoscope or a physical product delivered to a neighbor, will be difficult for either technology or rising capital costs to displace.  Strategic workers will recognize this fact and actively strengthen those networks.