9780198713395

By Jason Worth

(Note: If not specified otherwise, any quotations in this book review refer to text by the authors from the book being reviewed.)

Think about how much the Internet and technology have changed your life in the past 10 or 20 years. I could begin to recount countless examples, from the ease of pricing and purchasing airline tickets to automobiles, and the ability to research esoteric and specialized topics through Google. But no matter how many examples I give, it would only scratch the surface and be incomplete. And, you’d think of countless more.

Now, think about your last doctor’s visit. Or the last time you consulted with a lawyer. Or any of the interactions you’ve had with other knowledge-based and highly-trained professionals such as architects, psychiatrists, ministers, tax preparers and accountants. Most likely, you set up an appointment in advance, cleared your calendar for a time that was convenient as much for your service provider as for you, drove to his or her office and met with him or her face-to-face. Right? How much different was that interaction with your professional from what you might have done in 1980 or 1990, LONG BEFORE the Internet was a household term? Probably not much at all. Sure, these professionals are using technology themselves, to keep track of their appointments online, to automate their billing procedures, to dictate their findings and reports and to conduct medical or other professional research via the Internet. But how much did technology or the Internet change the way in which you actually received the professional advice or consultation from what you would have received 20 or so years ago? Not very much, if at all, based upon the analysis of father and son duo Richard and Daniel Susskind in their book The Future of the Professions.

The Susskinds say that the delivery of knowledge-based professional consultations and services will change dramatically in the coming years. It has to. Because high-priced, expert professionals have not significantly changed their service delivery models from before the Internet era (and there are many reasons why this has not yet happened), they have stifled access to their services and over-priced themselves. Insisting on face-to-face meetings, usually conducted in their offices, limits the reach of these experts to serve larger and growing client audiences. After all, the number of hours per day have not increased during this time. And insisting on a billing model that is largely by the hour (or perhaps a masquerading fixed-fee model that essentially represents their hourly rate times anticipated hours), with increases for inflation and escalating higher education costs, this has pushed their billing rates to the point at which small and medium-sized businesses and individuals can no longer afford their services. In fact, to save costs, small businesses and individuals often do not hire expert talent at the first signs of trouble (such as threatened lawsuits, discrepancies with the IRS, product failures, etc.) And, after things progress (i.e. “worsen”) to the point that they definitely feel the pressure to hire professional help, too often their situations are much worse than if they had turned to the professionals from the outset. And, with how complex and litigious the world has gotten, you need today a certain amount of expert professional knowledge to know when you need to hire the expert professional talent.

Why these professional experts have not deviated from their time-tested delivery models is understandable. For the most part, professionals have not historically wanted to change. On the one hand, you have pyramid-based legal, accounting and architectural partnerships where junior employees who slaved long hours to finally “make partner” have little incentive at that point to modify a model that now serves to pay them handsomely. There is also the fact that as members of self-regulating associations, entrance into these fields is carefully controlled and this limits competition to their established delivery models. And, even when a professional, such as a lawyer, agrees that service delivery could be improved in various professions, such as with accountants or tax preparers, that professional will invariably claim his own profession is somehow unique and change is not required there.

Regardless of the rationale from the professionals for not changing, there is consumer demand for a new paradigm. Evidence of this can be found in consumers increasingly turning to self-help and self-empowering solutions in the face of unavailable or unaffordable professionals. This self-empowerment can be seen in the fact that:

  • individuals and small businesses used tax preparation software to file 48 million tax returns in the US in 2014, rather than opting for involvement of CPA or accountant professionals.

 

  • there are more unique visitors (190 million) to WebMD’s family of medical information sites each month than there are doctor visits to all of the doctors in the United States in that same period;

 

  • three times more online dispute resolutions are resolved among eBay traders than there are lawsuits filed in the entire U.S. court system each year; and

 

  • consumers are increasingly using do-it-yourself legal software packages which, after asking a series of questions regarding the consumer’s needs and goals (not unlike TurboTax’s interview process), can craft pretty reliable and accurate legal contracts.

 

Consumers of professional services are ready to move beyond the traditional hourly-fee, face-to-face, in-office meetings that are the hallmark of professional experts. Even the consumers most likely to need and afford the high-priced talents of lawyers and accountants, namely multi-national corporations, have for several years received increasing pressure from boards of directors and shareholders to reign in and slash large fees paid to these providers. The professional service delivery model is changing, and it will dramatically change in the years to come. As the Susskinds state on the first page of the introduction, “…in the long run, we will neither need nor want professionals to work in the way that they did in the twentieth century and before.” “Technology will be the main driver of this change.”

Change is underway, and beginning to accelerate. The Susskinds give a myriad of examples across various professional disciplines to demonstrate this. Such as:

Healthcare

  • Artificial intelligence algorithms, and AI systems like IBM’s Watson, are helping doctors diagnose illnesses and evaluate X-rays and CT scans.

 

  • New medical papers are published, on average, every 41 seconds. If only 2% of the new medical literature is relevant for any given doctor, it would still require 21 hours of each day, every day, just for that doctor to keep up-to-date on new discoveries and theories. AI systems are increasingly screening the new medical literature to provide support for doctors not able to keep abreast of the proliferating studies.

 

  • Real-time medical sensors which monitor the performance of pacemakers and blood chemistries, for example, are providing guidance for insulin and other drug and chemical delivery machines, so patients receive customized treatment regimens without nurse or doctor intervention.

 

  • Autonomous robots are being used in more than 140 hospitals to deliver supplies from bed linens to medicine, totaling as many as 50,000 deliveries each week. A robot in the pharmacy at the University of California San Francisco has completed more than 2 million prescriptions without error.

 

  • Telemedicine, telehealth, e-health and telesurgery are on the rise. A surgical team in the United States, manipulating robotic agents remotely, removed the gallbladder from a woman in France.

 

  • 3D printers are being used to construct patient-specific items such as casts, prosthetics and dental crowns and caps. Human skin cells are now being “printed” onto burn victims, and it is foreseeable that entire human organs will be printed in the not-too-distant future to be used in organ replacement surgeries.

Education

  • The role of teachers is being integrated with computers to develop ‘adaptive’ and ‘personalized’ lesson plans tailored for each individual student. As computers take the lead in teaching and testing students, teachers can assume the role, considered by many to me more effective, of counselling and coaching students who need additional help in areas of difficulty. Teachers are increasingly becoming a “guide on the side” rather than their more traditional role of a “sage on the stage” in front of a packed classroom.

 

  • Although the success of these initiatives is debatable, college professors are experimenting with MOOCS (massive open online courses) which teach hundreds, thousands or tens of thousands of students simultaneously through the Internet.

Law

  • Lawyers are increasingly breaking down their work processes into discrete tasks and outsourcing or subcontracting functions such as document review, due diligence, routine contract drafting and rudimentary legal research.

 

  • As previously mentioned, software tools “can generate high-quality documents after straightforward interactive consultations with their users.”

 

  • Lawyers are routinely setting up “online deal rooms” where clients and lawyers share documents related to deals and disputes and collaborate on their progress.

Journalism

  • “The traditional newspaper model is in crisis” and publishers are increasingly exploring new digital offerings and pricing models to survive.

 

  • Wikileaks “is a not-for-profit organization, financed by donations, that provides an online platform to publish private, secret, and classified material.” Anyone can submit articles for publication on the for-profit Huffington Post.

The authors go on to recount numerous more examples for these and other professions, including the management consulting, tax and audit, divinity and architectural professions. The point is clearly made through these examples that various professions are deviating, sometimes radically, from business practices that in many cases did not change much over the preceding 200 years.
As interesting as these anecdotes are, they still don’t clearly demonstrate the totality of how professional work processes and procedures will likely change over the coming years. In fact, one of the authors of this book, Richard Susskind, believes that “over the next two decades… the legal world will change more radically than it has over the last two centuries.” And Richard has a track record of correctly calling changes in the legal profession, having predicted in the mid-1990s that email would become the dominant form of communication between lawyers and their clients. At the time, his prediction was scoffed at, with many in the profession believing that issues requiring confidentiality and privacy, combined with the severity of the matters discussed, would dictate that email not be an appropriate communication method. But, over time, Richard has been proven correct.

In anticipating how professions will change in the future, the Susskinds look to the following:

  • The Old Era is Ending – The traditional (i.e. “old”) model of professional service delivery is ending. This was an era characterized by “reactive” and “bespoke” work done by “gatekeeper” experts. A good example of this is a large manufacturing firm, for example Boeing, calling in a strategy consulting firm to evaluate their production line methodologies to identify areas for cost savings and process improvement. In this case, the consulting firm represents the access point to specialized knowledge (they are “gatekeepers”), Boeing’s need for the analysis is reactive in that they’ve identified a need to cut costs or improve processes, and the consulting firm performs a highly customized “bespoke” work process that typically leads to a single report or presentation outlining their conclusions and recommendations at the conclusion of their engagement. The Susskind’s foresee a transition from bespoke, one-off work to a methodology yielding more reusable content. They foresee the gatekeepers will be increasingly “by-passed,” in which case new competition for these expert services will come from non-traditional firms (accountants and consultants being the more versatile in branching into new areas not previously served) or from former “gatekeepers” who have left traditional service firms to go in-house and perform their services within a single corporate infrastructure. And, a shift is increasingly taking place from “reactive” to “proactive” engagements, where corporations don’t wait for an area to be identified in need of improvement and instead proactively mine production and other operational data to increasingly improve things incrementally rather than in one big step. McKinsey’s decision to create and offer a suite of data analysis tools called McKinsey Solutions, and Deloitte’s similar decision to offer Deloitte Managed Analytics, which enable clients to harvest and analyze reams of data on their business processes in the absence of formalized, bespoke consulting reports, demonstrate this trend very well. This example also demonstrates the bypassing of the gatekeepers as a once-traditional consulting firm and a once-traditional accounting firm are now in competition against once-traditional analytical software providers.

 

  • Automation versus Innovation – Technology has historically been used to automate routine and repetitive tasks. This is important and will certainly continue, but firms are increasingly looking to use technology to revolutionize and innovate their business processes. In the former case, the same way of working continues, but in a more cost-effective and efficient manner. In the latter case, new ways of operating are undertaken. Cash machines which replace human tellers, robotic arms that assemble cars on assembly lines, and “blended learning” classrooms where students interact with computerized lesson plans while receiving one-on-one teacher assistance in areas where they need additional help are all good examples of innovation.

 

  • New Skills and Competences Required – In addition to face-to-face, written and telephone communications of old, new professional services firms will need to communicate in new ways, including social media, Skype calls and the emerging “telepresence” of remote workers. Professionals will need to increasingly master large data sets and be proficient at mining big data for answers. They will need to interact and manipulate technology in entirely new ways to accomplish new feats. It is no longer sufficient to have the attitude “my kid knows more about computers than I do,” and it should be the case that even retired octogenarians are considered “power users.” Furthermore, professionals will need to diversify their talents such that they can increasingly provide their skills and knowledge online, and the firms they work for will need to offer an array of multi-discipline services as well.

 

  • Professional Work Will Be Reconfigured – It used to be the case that knowledge-based professionals considered their work a craft which could not be reduced to checklists or pre-articulated procedures. But this thinking is incorrect and outdated. The Susskinds believe that professional services work can be subject to “routinization,” “distintermediation and reintermediation” and “decomposition.” These are various buzzwords relating to breaking down and analyzing every step of what the professional does. Those tasks which can be delegated to another person or machine more capable to do them will/should be reassigned. Those tasks which are being done by a middleman, intermediary or broker, should be reassigned, if doing so saves time and money. In order to make the professional more productive and able to channel his or her specialized knowledge in a manner that serves more clients, it is very likely that a professional in the future will no longer do many of the things he/she has been doing historically.

 

  • New Labor Models Will Flourish – As tasks are “decomposed” from larger projects and reassigned to workers best able to execute them, this will change the manner in which work is performed. For one thing, now possible in our globalized and interconnected world, some tasks will be sent to offshore facilities, such as in India and China, where they can be done at lower cost. A new category of employee will increasingly be deployed, which the Susskinds call “process analyst,” whose job function will be to decompose the production steps required for a given work project and assign them to various offices and personnel for execution. The application of technology and checklists will also enable less senior professionals (known as “para-professionals”) to take on certain tasks historically reserved for more senior or more experienced professionals. A good example of this is nurse practitioners increasingly empowered to dispense medications with the oversight of artificial intelligence serving as a safeguard against mistaken dosages or unforeseen drug interactions. Decomposition and reassignment of tasks will also enable professionals to increasingly pursue self-employment and contract labor work styles. This will provide them with greater flexibility, better work-life balance and possibly greater income, while better enabling businesses to ramp up and down their labor obligations as their workflow needs change. The Susskinds also see new specialist positions arising, especially at the intersection of expert services and technology. For example, computer programmers need to really understand tax procedures to develop cutting edge tax preparation software packages, and CPAs cannot do this alone when their work activities and training don’t lend themselves to proficiently programming computer software.

 

  • More Options for Recipients – Consumers and recipients of professional and expert services should be able to receive these services in new ways in the future. Long gone will be the days when you have to set up an appointment and drive to your accountant or doctor’s offices. There should be new ways of receiving the services online and via remote conferencing. New self-help advice services will be deployed enabling customers to mine the expertise of professionals in their own Internet directed search efforts. The marriage of technology and expert knowledge will also lead to newfound levels of personalized service and mass customization. Automated document delivery systems which produce high-quality legal contracts or tax returns after answering a series of questions represent good examples of this. The collaboration of professionals online to tackle intractable projects will also enable professionals to raise their game and produce even higher qualities of output. In the same way that Linux is produced by an open source consortium of computer programmers, doctors and other professionals are forming “communities of experience,” sometimes with consumer and patient involvement, to share the experiences of their successes and failures for greater societal benefit. The Susskinds are confident that all of this will result in latent demand being unleashed for the services of professionals, especially as these new efficient models of operation enable professionals to charge less for their services.

 

  • Response from Professional Service Firms – Professional service firms will respond to all these changes in various ways. With greater flexibility in how they conducting their businesses, it is anticipated they become more liberalized. Namely, the professions as a whole will operate in a less monopolistic and closed manner. They will increasingly pursue globalization activities, since decomposed tasks shipped to lower cost locations will enable them to save labor costs. Professionals will become even more specialized. This is a mixed bag, because there is already concern about over-specialization. But professionals freed up from routine and mundane tasks to pursue their calling, combined with increased competition that will likely result from unleashed latent demand, will undoubted encourage or force even more professionals to specialize to a greater degree. It is also anticipated that the partnership ownership model, long an organizational choice for like-minded professionals to share risk, will no longer be the most appropriate corporate structure. And liberalization of activities and diversification of services offerings will undoubtedly lead to greater numbers of mergers and consolidation not unlike the how the “Big 8” became the “Big 4” in the accountancy/consulting world.

 

  • Demystification – Finally, honest and forthright professionals from within the closed ranks of their various professions will likely admit to having “mystified” their expertise at some points in the past in order to justify their high billing rates. This could take the form of using arcane professional jargon, “legalese,” tax technicalities or medical terminology to make their activities seem more esoteric or more complex. The liberalization of professional services should result in a “demystification” of these services, where the shroud of mystery is lifted and these services are made more readily available or understandable to the masses. (I confess that I’m a little skeptical on this point, and I’ll believe it when I see it.)

Conclusion: I found myself at times encouraged and at other times discouraged by what I read in The Future of the Professions.

  • Encouraged – On the one hand, I have myself felt at the mercy of professionals on numerous occasions. Specifically their high bill rates, their unnecessary mystification, their (dare I say…) self-important attitudes and their requirements that I fit my schedule around their availability. (Fun fact: my CPA is now close to 60-days beyond the date I thought he’d have a draft of my 2015 tax return and two weeks after the date he most recently promised it would be ready, with no new target deadline in sight; and my dermatologist’s office told me last week he couldn’t fit me in for two weeks even though an infection on my back had me concerned enough that I contemplated a visit to the emergency room. His office even informed me that I could call them every day at 10:30am to see if they had any last minute cancellations for that day. It’s all okay now, thankfully; but I never did meet with the doctor. ) To think that these, and other professionals, can develop new skills, new service delivery capabilities, more strongly adopt technology for my benefit which will make their services to me and others more timely and at a lower cost is unquestionably a good thing. I would look forward to that future.

 

  • Discouraged – The thought that our complex and highly-specialized world is going to get even more complex and specialized doesn’t sit well with me. I like to be self-sufficient, and it bothers me that you essentially can’t replace a set of spark plugs or change the oil on a modern car any longer without voiding the warranty or risking damage to it. (Fun fact: with autonomous driving vehicles, soon you won’t even be able to steer the car!) I long for the days of the Renaissance Man and Woman, and the Jack-Of-All-Trades, who were versatile, independent and could do anything. And the Susskinds just sounded a death knell over their legacies. I think it is healthy for humans to diversify their work activities. Is it really that wrong or inefficient for a doctor to sit behind a word processor and type up his notes, even though a college graduate in Mumbai can do that more quickly for one-fiftieth the cost? For that matter, in the Susskinds’ uber-efficient world of the future, with their “decomposed work tasks” and “labor arbitrage,” that doctor shouldn’t have a conversation over the water cooler with a colleague about last night’s NFL game. I’m being too dogmatic and harsh with that last point, but seriously, where will all this specialization and computerization end? How many more industries and jobs will we send off-shore? And how many more months will it before I am assigned to-do lists and checklists from AI computers on tasks they need me to execute, in order to make their jobs more efficient???

[CAF Note: Jason is being seriously polite in his excellent review. You and I need to become more resilient, not less. Having highly specialized skills in an area of your passion is great. However, it takes a character and versatility to successfully navigate the high friction, cyber insecure world emerging around us.]

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