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UC Berkeley researcher Mishal Khan warned at the Association of Health Care Journalists Fall Summit that AI in healthcare can affect workers even when it does not eliminate jobs. She cited risks including loss of skills and autonomy, surveillance, lower wages and weakened patient relationships; the scale of those effects remains unclear.
AI can harm healthcare workers even when it does not replace their jobs, UC Berkeley labor researcher Mishal Khan said at the Association of Health Care Journalists Fall Summit in Los Angeles. Khan pointed to risks including workplace monitoring, loss of professional skills and control over work, as well as possible effects on patient relationships.
Khan, a senior researcher with the Technology and Work Program at the UC Berkeley Labor Center, grouped workplace AI into three categories: electronic monitoring, algorithmic management and task automation. These can include systems that track workers, software that analyzes customer calls and coaches staff, or tools that take over selected job tasks.
In healthcare, Khan said de-skilling is a particular concern: when automated systems perform tasks, workers may lose the specialized skills needed to do them independently. She said this could affect healthcare workers’ scope of practice. Tina Hernandez-Boussard, a Stanford University professor of biomedical informatics who spoke in another summit session, described medical residents in Uganda who were unable to confidently interpret electrocardiograms after losing access to electricity and AI support.
Khan also raised concerns about ambient scribes, which record or document clinical encounters. Workers, she said, want to know what data these systems collect about them and whether that information could later be used in employment decisions. She also questioned who would be liable if a clinician followed an AI recommendation that led to an error.
How AI Could Change Healthcare Work
The concerns reach beyond whether AI eliminates positions. Khan said the technology can alter how work is monitored, divided and paid, potentially affecting worker autonomy and the skills clinicians use in practice. She listed possible harms such as job loss, theft of work product, lower wages or wage theft, faster work pace and injuries, discrimination, and restrictions on labor organizing.
These are risks identified by Khan, not findings that every healthcare AI system produces those outcomes. But they matter to patients as well as workers: if clinicians become less confident performing tasks without automated support, or if automated handoffs weaken relationships with patients, care may be affected. Khan said workers have raised concerns about what automation is doing to those relationships.
Algorithmically managed nursing platforms could also change how shifts are assigned, she warned. In one possible model, nurses would bid for shifts and algorithms could estimate the lowest wage a nurse might accept. The report did not establish that this approach is in widespread use; it was presented as a potential form of the “gigification” of healthcare jobs.
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Three Workplace Uses of AI
Khan’s framework distinguishes between tools that observe workers, tools that direct or evaluate their work, and tools that automate parts of a job. Electronic monitoring includes tracking activity or safety. Algorithmic management can involve software analyzing conversations and prompting workers to change how they respond. Task automation transfers specific work to an AI system.
Khan said technology can benefit workers, but argued that outcomes depend partly on how much power workers have in decisions about its use. She described potential harms including reduced autonomy, job de-skilling and work intensification. The summit report did not provide measurements of how common these practices are across healthcare or quantify their effects.
Khan also pointed to policy responses in several states. She said Illinois and Vermont had passed bills prohibiting replacement of mental health workers with AI, while a California law bars companies from advertising an AI chatbot as a health professional. A separate California bill under consideration would prevent workers from being required to train their replacements, including AI systems.
“Even if they don’t lose a single job to AI, it doesn’t mean there are no harms to workers.”
— Mishal Khan, senior researcher at the UC Berkeley Labor Center
How Widespread Are These Risks?
The summit report does not quantify how often healthcare employers use the practices Khan described, or how many workers have experienced the listed harms. It also does not establish that AI caused the residents’ difficulties in Uganda; the account describes a loss of electricity and lack of AI access alongside their difficulty interpreting EKGs.
It remains unclear how ambient-scribe data are handled across different products and employers, whether information about workers is used in employment decisions, and how liability would be assigned when AI contributes to a clinical error. The report also does not say whether the California proposal concerning replacement training has advanced beyond consideration.
Policy and Workplace Decisions Ahead
State-level rules and proposed legislation are among the next developments to watch. Khan said Illinois and Vermont had passed restrictions concerning replacement of mental health workers by AI, while a California proposal on training replacements was still being considered at the time of the report. Its status and any later legislative action were not provided.
Healthcare employers’ choices about monitoring, documentation tools and automated work allocation will also determine how the concerns play out. Khan’s comments call for attention to worker input and safeguards, but the report did not announce a new policy, study result or industry-wide agreement. Further information is needed on adoption rates, effects on clinical skills and patient care, and how employers govern data collected by workplace AI.
Key Questions
What did Mishal Khan warn about?
Khan said AI may harm healthcare workers through monitoring, de-skilling, lower wages, faster work and reduced autonomy, even if it does not eliminate jobs.
Does the report show that AI is already replacing healthcare workers?
No. Khan discussed job loss as one possible harm, but the report does not provide evidence that AI is replacing healthcare workers at a particular rate.
What is de-skilling in this discussion?
It refers to workers losing specialized skills when automated systems take over tasks they previously performed. Khan said it could affect healthcare workers’ scope of practice.
What concerns were raised about ambient scribes?
Khan said workers want clarity about what information these systems collect and whether it could be used to make decisions about them. The report did not detail the data practices of specific products.
What policy actions did Khan cite?
Khan said bills passed in Illinois and Vermont prohibit replacing mental health workers with AI, and that a California law bars marketing an AI chatbot as a health professional. She also described a California bill on requiring workers to train their replacements as under consideration.
Source: rss
