The Death of Medicine or the Birth of Something New?

A critical look at the rise of Physician Associates, AI-driven healthcare, and the future of the medical profession.

Dear readers

There’s been a growing drive in recent years to employ Physician Associates (PAs) and Anaesthetic Associates (AAs) in the healthcare system. On the surface, this seems like a brilliant idea, help relieve the pressure on doctors by handing over routine, mundane tasks that don’t require years of specialised training to capable, but less experienced professionals. Who would argue against that?

Well, let’s look a bit deeper. That may be the noble intention, but it’s not what’s really happening.

What we are witnessing is an explosion in the hiring of Physician Associates, individuals who, while often hardworking and well-meaning, are less experienced, less qualified, and less confident than trained medical doctors. These new professionals will be more likely to obey authority, follow management protocols without question, and be entirely beholden to their employers. They won't have an independent skill set or an alternative career path, their entire profession will be based on rule-following, box-checking, and protocol adherence.

In other words, they’ll be technicians, not clinicians.

And that’s interesting, because 30 years ago, as a medical student and junior doctor, I was repeatedly warned by consultants, physicians, and surgeons never to consider myself a technician. I was told to think critically, independently, and always act in the best interest of my patient, even if it meant going against management’s dictates. Yet here we are. In the last few decades, a managerial class, both clinical and non-clinical, has taken control. And yes, some of these managers are doctors.

How did this happen?

It began with the introduction of centralised guidelines and policies, produced by a small cohort of management staff and select clinicians. Many of them have glaring conflicts of interest, financial ties to big pharma, academic institutions, or consultancy firms. These guidelines are often built on flawed studies, large population-based data, and other shaky foundations. Most importantly, they are not based on the needs of individual patients.

While guidelines can be helpful, they are no longer guides. They are now strict rules enforced upon practicing doctors. And if a doctor dares to stray from a protocol, even if doing so is in the best interest of a patient, they may face investigations, disciplinary action, or even loss of their licence.

This has led to an insidious culture of conformity within medicine. Doctors follow rules. They tick boxes. They do what they’re told.

But here’s the catch: if all a doctor is doing is following a flowchart, why go through 6 years of medical school and several more years of postgraduate training? Anyone can follow a protocol. So, we’ve created a system where doctors, highly trained professionals, are essentially being replaced by less expensive rule-followers.

Even worse, many doctors have accepted this fate. They've not just dug the grave of their own profession, they’ve jumped in headfirst, mocking and ridiculing those of us who have raised concerns and try to lift them back out of the hole they have climbed into.

The COVID years made this painfully obvious. Doctors were quick to abandon face-to-face consultations, opting instead for teleconsultations and computer-screen diagnoses. Even now, across the UK, patients are asked to submit symptoms online or over the phone, minimising direct human contact.

And now, on the horizon, we have AI-based healthcare, systems trained during the plandemic to diagnose, manage, and produce treatment plans. Unsurprisingly, many of these treatment plans end with a prescription, a pill, a shot, or some supposed therapeutic substance. And who benefits most from that?

Not the patient. But big pharma. The government. The system.

And with AI dictating diagnosis and treatment, we won’t need doctors anymore. Just technicians, professionals who say “yes,” tick the right box, and dispense the pill or administer the injection. This is exactly where Physician Associates come in. Grateful for their job, deeply indebted, and eager to follow rules, they will fulfill this role perfectly.

Even though most doctors today are highly compliant, diligent rule-followers, the profession still occasionally produces independently minded troublemakers like myself. Think of Anne McCloskey, Gerard Waters, Jayne Donegan, Sarah Myhill, David Cartland, Sam White, Mohamed Adil, Mary Bowden, My Le Trinh, the late Jackie Stone (RIP), and yes, even Billy “Big Balls” Bay. While doctors like us may represent less than 1% of the medical profession, don’t expect even that sliver of dissent to survive in a system dominated by Physician Associates. With PAs, that figure will almost certainly drop to zero.

So yes, on one level, this is incredibly sad. I do mourn the slow death of the medical profession.

But I’m also hopeful.

Because with every crisis comes an opportunity.

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Perspective & Reflection

Let’s zoom out for a moment.

There are benefits to using Physician Associates, they can reduce waiting times, support multidisciplinary teams, and alleviate workforce pressures. And AI, when used ethically and transparently, can enhance diagnostic accuracy and streamline care.

But my core argument rings true for many: the soul of medicine is at risk.

Medicine is not just about following rules or protocols. It's about human connection, listening, and individualised care. It's about knowing when to follow a guideline, and when to break it, because the patient in front of you doesn’t always fit the algorithm.

I predict that people will ultimately reject impersonal, AI-led, pharma-driven healthcare. I foresee a new generation of doctors, or perhaps healers by another name, rising from the ashes. They will take the time to listen, think critically, and treat people as human beings, not data sets.

This is a powerful vision. And one worth fighting for.

Let’s see what happens.

In the meantime I will be launching my consultation service next week. Due to my time constraints I have only a limited number of slots every week.

With over 25 years of experience as a doctor and orthopaedic surgeon, both in the public and private healthcare systems, I will now work independently to support people navigating the sick healthcare system.

If you’re facing uncertainty about your health, struggling to make sense of conflicting advice, or simply want clarity before making a medical decision, this is for you.

I will offer non-medical, educational consultations to help you:

• Understand your current diagnosis and treatment plan

• Learn how to obtain informed consent

• Make sense of medical jargon and test results

• Decide which type of practitioner to see (GP, specialist, osteopath, etc.)

• Prepare for and recover from surgery as well as reducing risks for complications

• Manage chronic conditions with lifestyle and diet changes

• Explore holistic approaches to support your well-being

• Learn practical strategies for long-term health optimisation

• Implement lifestyle changes such as intermittent fasting

These sessions are educational and informative only, and do not replace formal medical care and advice. They are designed to empower you with clarity, confidence, and practical next steps.

Much Love

Doc x

Ps Don’t forget my Summer retreat and an opportunity to spend a whole weekend with me and other beautiful souls

Set in a peaceful, natural setting, this retreat is designed to help you reset, restore, and reconnect with your true self — physically, emotionally, and spiritually.

✨ What to Expect:

• Healing workshops with me (Doc Malik) and a special guest

• Daily yoga, meditation, and breathwork sessions

• Deeply restorative sound baths

• MELT Method bodywork for pain relief and nervous system balance

• Cold plunges and sauna experiences to awaken your vitality

• Firepit reflections beneath the stars

• Delicious organic meals, shared with laughter and soul-nourishing conversation

• Therapeutic massage to gently close your journey

This is more than just a weekend — it’s a sacred space for transformation, held with care and intention.

🔥 A Note on Availability:

There are only a few spaces left, and we’re keeping the group intentionally small to preserve intimacy and depth. If you feel called to join, now’s the time. Email retreats@docmalik.com or visit the link below.

👉 Reserve your place:
https://docmalik.com/retreats/summer-retreat/

🎁 Special Gift:

As a thank-you, those who register within the next week will receive a complimentary 1-hour consultation with me.

I look forward to sharing this powerful experience with you.

With warmth,
Doc Malik

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I hope you enjoy this episode.

YOU ARE BEAUTIFUL AND AWESOME

Much love Ahmad

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I Ahmad Malik: am a private civilian, protected by the Geneva Convention.

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