The connective cure 

Many healthcare professionals know that connecting with patients is an important part of giving excellent care—even a brief conversation can help a patient share vulnerable truths and absorb clinical advice, especially when they feel “seen” by a clinician. Yet contemporary medicine shows how much it values those conversations when it asks clinicians to have them at the same time as entering data, gamely trying to hold eye contact while typing furiously on the computer. Tensions between the importance of “connective labor” and the pressure to measure, control, and systematize it aren’t limited to medical staff: they’re shared by teachers, therapists, and a host of other workers. I wrote my recent book, “The Last Human Job: The Work of Connecting in a Disconnected World,” to highlight the importance of “seeing the other” in all kinds of fields at a time when they’re under siege by data analytics and threatened by automation and AI.   

After five years of talking to 100+ practitioners and observing for 300+ hours, I found that connective labor is widely understood by practitioners as the catalyst for important outcomes: clinicians often appreciate that “feeling seen” is the crucial factor that helps patients talk to them, hear them, and want to get better. But connective labor is important for so much more: for generating shared dignity, purpose and understanding, for making clinical work meaningful, and for knitting communities together.   

Nonetheless, we treat connective labor as if it’s not very important, because it eludes easy measurement, and measurement is dictating value. In my book, I tell the stories of many clinicians who shared the compromises they found themselves making, and the heartbreak they faced as a result. Data imperatives and efficiency campaigns are leading organizations to prioritize the counting and scripting of this work, with time constraints and burdensome rosters generating less seeing and more misrecognition. The resultant ruptures in patient-doctor relationships are damaging trust and contributing to a depersonalization crisis, where people feel increasingly invisible in commerce and civic life.   

And standardization is a slippery slope to automation, as anyone who has encountered a call-center bot or a grocery self-checkout aisle can attest. When connective labor is degraded to the point where interactions are homogenized by checklists and scripts, it becomes even more vulnerable to automation. This was evidenced by the engineers I spoke to who were designing AI intake nurses and virtual discharge nurses. “The Last Human Job” argues that only by identifying connective labor and articulating its value can we protect and preserve it from the threats posed by the industrial model.  

This piece expresses the views solely of the author. It does not necessarily represent the views of any organization, including Johns Hopkins Medicine.