{
  "source": "Cooked Index — occupational AI risk register",
  "page": "https://cookedindex.com/jobs/pediatric-surgeons/",
  "methodology": "https://cookedindex.com/methodology",
  "notice": "Verdicts are re-examined as evidence accumulates. Re-fetch before relying on this; the page above always carries the current score.",
  "scored_at": "2026-08-11",
  "model": "claude-opus-5",
  "occupation": {
    "title": "Pediatric Surgeons",
    "soc_code": "29-1243",
    "category": "Healthcare",
    "us_employment": 1190,
    "median_annual_wage": 559030
  },
  "verdict": "SAFE",
  "risk_resistance": 96,
  "contested": false,
  "near_boundary": false,
  "dimensions": {
    "task_resistance": 19,
    "embodiment": 20,
    "liability_shield": 20,
    "trust_premium": 19,
    "judgment_accountability": 18
  },
  "reasoning": {
    "task_resistance": "Repairing a gastroschisis or dividing adhesions in a 3-kg neonate requires tissue-by-tissue tactile decisions no model can execute, and the residual point comes off only because chart review, coding, and imaging pre-reads that currently eat clinic hours will be handed off.",
    "embodiment": "You scrub in, retract, feel for a malrotation, and re-explore at 2 a.m. on a child who has decompensated — every core duty happens with gloved hands inside a live, bleeding, non-standard anatomy that no fixed workspace can approximate.",
    "liability_shield": "You hold an unrestricted state medical licence plus ABS pediatric surgery certification, you personally sign the consent and the operative report, and a wrong-site or retained-instrument case names you — not the hospital's software vendor — in the malpractice complaint.",
    "trust_premium": "Parents hand over a newborn on the strength of one conversation about survival odds and what the stoma will look like, and referring pediatricians and neonatologists send cases to a named surgeon they have watched operate, not to a department queue.",
    "judgment_accountability": "Deciding whether a preemie with NEC is stable enough for laparotomy or gets a bedside drain, whether to resect or wait, and how much bowel to leave is an irreversible call made with incomplete data; it sits at 18 rather than 20 because tumor protocols, ATLS algorithms, and multidisciplinary boards constrain part of the decision space."
  },
  "rationale": "The core of this job is operating on infants and children — neonatal bowel obstructions, congenital anomalies, trauma laparotomies — with hands inside a small, anatomically variable body, plus resuscitating unstable patients and telling parents what happens next. Surgical robots today are master-slave tools fully driven by the surgeon, not autonomous operators, and nothing about pediatric consent, staging decisions, or intraoperative improvisation is text work. AI will absorb the paperwork tier: op notes, discharge summaries, imaging pre-reads, prior-auth letters, and literature synthesis for tumor boards.",
  "outlook": "In ten years pediatric surgeons will spend meaningfully less time on documentation and imaging pre-reads and roughly the same time operating; the constraint on the field stays training pipeline and case volume, not automation.",
  "what_would_raise_it": {
    "levers": [
      {
        "dimension": "judgment_accountability",
        "change": "If ACS/APSA verification standards for Level I children's surgery centers formalize a named 'surgeon of record' for every intraoperative deviation and for goals-of-care calls in neonates with life-limiting anomalies — as the ACS Children's Surgery Verification program already does for case-volume and on-call attestation — the ambiguous-call ownership becomes an audited, individually attributed duty rather than a team-diffused one",
        "plausibility": "plausible",
        "would_add": 2
      },
      {
        "dimension": "trust_premium",
        "change": "If hospital consent forms begin disclosing AI involvement in surgical planning (as some state AI-in-healthcare disclosure bills, e.g. California AB 3030 for clinical communications, foreshadow), parents choosing a named human operator becomes an explicit, priced choice rather than an assumption",
        "plausibility": "plausible",
        "would_add": 1
      },
      {
        "dimension": "task_resistance",
        "change": "As AI absorbs op notes, prior-auth letters, imaging pre-reads and tumor-board literature synthesis, the residual day shifts almost entirely to intraoperative improvisation, resuscitation and parent conversations — the two-tier split here is real and the routine tier is already thin",
        "plausibility": "already happening",
        "would_add": 1
      }
    ],
    "ceiling_note": "At 96 the occupation is effectively at the register's ceiling; embodiment and liability_shield are already maxed and nothing plausible moves them. Any remaining headroom is 4 points of measurement noise, not a meaningful change in security."
  },
  "adjudication": null,
  "employment_history": {
    "points": [
      {
        "y": 2021,
        "emp": 820,
        "wage": 239200
      },
      {
        "y": 2022,
        "emp": 780,
        "wage": 239200
      },
      {
        "y": 2023,
        "emp": 1180,
        "wage": 239200
      },
      {
        "y": 2024,
        "emp": 1050,
        "wage": 239200
      },
      {
        "y": 2025,
        "emp": 1190,
        "wage": 559030
      }
    ],
    "from": 2021,
    "to": 2025,
    "change_pct": 45.1,
    "comparable_from": 2021,
    "spans_soc_revision": false
  },
  "pivots": [],
  "license": "https://cookedindex.com/terms"
}