As Scotland embraces its own digital revolution, are we accidentally deskilling our doctors?

Across the NHS, a new authority is emerging: the algorithm.

As Scotland pushes forward with its “Digital Front Door”, the direction is clear: faster triage, advanced diagnostics and more streamlined care.

In our drive to modernise healthcare services, however, we risk overlooking a quieter, more human consequence: the gradual erosion of clinical judgment, the very skill that has historically defined safe medical practice. Research into clinical decision-making shows that medicine is not just procedural, it’s fundamentally cognitive work, centred on how doctors think.

This is not a hypothetical concern. A recent warning from the Royal College of Physicians found that 73% of doctors fear algorithmic error. The issue is not whether artificial intelligence (AI) has a role in healthcare (it clearly does), but what happens when it begins to shape, and subtly replace, the reasoning of clinicians. Misdiagnosis is already a significant contributor to patient harm, and improving thinking—not just tools—is central to safer care.

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At its best, medicine is not simply the application of clinical guidelines or protocols, It’s a complex and interpretive practice. Clinical intuition – the ability to recognise patterns, detect anomalies, and sense when something doesn’t quite fit – is not guesswork. It’s built over years of training and experience, grounded in evidence, and refined through........

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