Psychiatrists

Tasks largely resist digitisation. A 45-minute diagnostic evaluation where the differential turns on flat affect, pressured speech, and whether the patient is minimizing — plus titrating clozapine against ANC counts and negotiating a treatment plan with a family that disagrees with it — sits at 14 rather than 18 because the surrounding PHQ-9/GAD-7 scoring, note generation, and interaction screening are already machine work.

Some physical or field component. An 8 reflects the physical minimum that remains: catatonia and EPS exams, AIMS scoring for tardive dyskinesia, IM long-acting injectable administration, ECT supervision under anesthesia, and being bodily present on a locked inpatient unit during a code — but a large share of outpatient med management now happens over video from a home office.

Licensed human required and personally liable. A 19 is set by the DEA registration required to write for buprenorphine, stimulants, and benzodiazepines, state medical licensure, and the fact that a psychiatrist's signature on a 5150/72-hour hold and on every prescription is the personal liability anchor in a wrongful-death or Tarasoff duty-to-warn suit.

The human relationship is the product. Disclosure of suicidal ideation, command hallucinations, or abuse history is contingent on the therapeutic alliance itself, and patients routinely stay with one psychiatrist for years across medication changes — 18 rather than 20 only because much med-management volume is short, interchangeable 15-minute follow-ups.

Exists to be accountable for ambiguous calls. Deciding to commit someone against their will, discontinuing lithium in a pregnant patient, or judging whether a threat to a third party breaches confidentiality are calls made on partial and often deliberately distorted information, with no protocol that resolves them and the psychiatrist's name on the order.