My wife was trained as a medical family therapist, and her research is helping to scale a model of healthcare delivery called integrated care, a team-based medical approach that brings together physical health, mental health, and social support services.
Rather than patients setting up individual meetings with all of their healthcare providers (ex. physician, pharmacist, cardiologist, oncologist, psychologist, psychotherapist, social worker, nurse, medical assistant), their entire care team would meet together as a group to share context and coordinate care for that one patient across all of the relevant domains.
The traditional healthcare system is not set up to operate in this team-based model, so her research focuses on unlocking the financial, regulatory, operational, and workforce barriers to adoption.
Technology has helped some, but recently, we talked about how the future of integrated care may not be providers working more closely together, such as meeting at the same time in-person or digitally, but rather the agents from their various departments working together to coordinate care. AI won’t just change how many providers get hired, it could fundamentally change the entire structure of the operation.
Past technological shifts like the industrial revolution, electricity, the internet, the personal computer, and the smart phone caused similar transformations at the structural level. AI does more than just automate the past; it unlocks a completely different future. Jack Dorsey’s essay, From Hierarchy to Intelligence, explores how AI-native companies won’t just hire less, their organizational charts will not look anything like companies of the past. Rather than bureaucracy and middle management being the center of a corporation, it’ll be its own AI model.
Regardless of whether AI ultimately leads to more or less hiring, the more interesting dynamic to me is how it will change the structure of the labor market itself.
Forsaking the “J” Word by Wingham Rowan explores this restructuring:
When we think of jobs, we normally think of people working 40 hours every week for one single employer in one specific capacity. Rowan argues that this industrial form of work is precisely where digital and physical AI will always be better, faster, and cheaper than the average human worker. While technology is better at the vertical, human beings are better at the horizontal. They possess a lot more skillsets and ambitions than one job can maximize. People are multi-faceted and will need a way to monetize their versatility of skill and availability throughout the day and week in order to survive in an increasingly competitive economy.
“Like it or not, this is probably the future; regular jobs will be a subset of work still available to the unusually skilled, or people in pastoral roles (robo-priests probably won’t become a thing anytime soon), plus a few lucky blue-collar workers. For the rest of the economy, humans will have to compete against the economics of automation. That’s why helping anyone wanting to unlock their multi-faceted potential becomes vital.”
“But if employment policy just focuses on getting everyone into a job you are concentrating on where we are weakest.”
Wingham Rowan
Rather than politicians obsessing over the “J” word, we should focus on the “W” word, work, and structure the growing gig economy in a way that plays to human strengths, not exploit them. His “Modern Markets for All” thesis presents a compelling solution to this challenge.
What excites me about Open Work is that portable performance is extremely adaptable. It can leverage data for a 1099 contractor on DoorDash or Uber just as well as it can a W2 employee that works on a factory floor or medical clinic, especially when the same person performs both types of work.
Because Open Work can evolve as the labor market evolves, it helps give workers the leverage and resilience they need to evolve, too. Wherever and however people are creating value that they should take credit for, and in whatever capacity they do so, whether it’s called a job or a gig, Open Work will be there to ensure they can own their hard work, not just rent it out with nothing to show for it.