{
  "source": "Cooked Index — occupational AI risk register",
  "page": "https://cookedindex.com/jobs/surgical-technologists/",
  "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": "Surgical Technologists",
    "soc_code": "29-2055",
    "category": "Healthcare",
    "us_employment": 117460,
    "median_annual_wage": 64650
  },
  "verdict": "SAFE",
  "risk_resistance": 67,
  "contested": false,
  "near_boundary": true,
  "dimensions": {
    "task_resistance": 17,
    "embodiment": 20,
    "liability_shield": 8,
    "trust_premium": 10,
    "judgment_accountability": 12
  },
  "reasoning": {
    "task_resistance": "Anticipating the surgeon's next instrument before it's asked for, adjusting a retractor's angle by feel while tissue shifts, and reconciling a sponge and needle count under AORN protocol while a case runs long are tasks with no digital surface at all — the 17 rather than 20 reflects that preference cards, implant-log documentation, and case-cart pulling are already software-assisted and eating into the periphery of the role.",
    "embodiment": "The entire shift is inside a draped sterile field: gowning and gloving the team, passing loaded needle drivers hand-to-hand, holding a limb during positioning, suctioning blood out of a cavity, transferring specimens into formalin — an unpredictable, fluid-filled, time-pressured environment with a live patient, which is the ceiling case for physical embodiment.",
    "liability_shield": "CST or TS-C certification is demanded by most hospital ORs and mandated by statute in a handful of states (Texas, Indiana, South Carolina among them), but the surgeon and circulating RN own the chart entries and the legal consequences of a retained item — an 8 credits the real credential barrier without pretending you carry personal malpractice exposure.",
    "trust_premium": "The 10 is not about patients, who never learn your name; it is about the specific surgeon who requests you by name for a Whipple or a revision arthroplasty because you know their sequence, their preferred loaded sutures, and when to stay silent — that team-level reputation is real and portable, but it lives with a handful of attendings, not with a caseload of clients.",
    "judgment_accountability": "You call a break in sterility that stops a case, decide whether a discrepant count means an X-ray, and choose which instrument to load when the plan changes mid-dissection — real discretion within AORN and facility protocol, capped at 12 because the surgeon makes the clinical call and the circulator escalates it."
  },
  "rationale": "Almost nothing a surgical tech does happens on a screen: setting up sterile fields, passing instruments and sutures on anticipation rather than request, holding retractors, counting sponges and needles, prepping patients, and managing specimens. Today's robotics cannot manage a draped, bloody, time-compressed sterile field alongside a surgical team, and the tasks AI does well — inventory tracking, preference-card generation, case documentation — are the small administrative slice of the job. The weak spots are credentialing (CST certification is employer-required in many hospitals but not state-licensed everywhere) and the fact that patients don't choose their scrub tech, so there is no direct trust premium.",
  "outlook": "Employment keeps growing with surgical volume from an aging population; the job's administrative edges get software-assisted while the sterile-field work stays firmly human for the next decade.",
  "what_would_raise_it": {
    "levers": [
      {
        "dimension": "liability_shield",
        "change": "State-level surgical technologist licensure or mandatory certification statutes — already enacted in a subset of states (e.g., Indiana, Texas, South Carolina, Washington, Oregon, Nevada, New Jersey) requiring CST/NBSTSA credential or state registration to work in an OR. If AST's model bill spreads to the remaining majority of states, or CMS conditions-of-participation language requires credentialed scrub personnel for reimbursement, the role acquires a legal gatekeeping function it now largely lacks.",
        "plausibility": "already happening",
        "would_add": 5
      },
      {
        "dimension": "liability_shield",
        "change": "Joint Commission or AORN standard making the named scrub person's signature on the surgical count sheet (sponges, sharps, instruments) a required, individually attributable attestation — with retained-surgical-item events (a reportable Never Event under CMS) traced to that signature. Some hospital policies already do this; codifying it in accreditation standards makes the countersignature non-delegable to an RFID/AI counting system.",
        "plausibility": "plausible",
        "would_add": 3
      },
      {
        "dimension": "judgment_accountability",
        "change": "Formalized authority to halt the case: hospital policy or accreditation language giving the scrub tech explicit stop-the-line authority for sterile-field breaks and count discrepancies, mirroring the WHO Surgical Safety Checklist's 'any team member may stop' language, with documented escalation duty. This converts informal vigilance into an owned, consequential call under ambiguity.",
        "plausibility": "plausible",
        "would_add": 3
      },
      {
        "dimension": "task_resistance",
        "change": "Task-mix shift as instrument inventory, preference cards, tray assembly and case documentation move to automated CSSD and RFID systems — the residual job becomes anticipation, sterile-field management, and first-assist-adjacent work. Growth of the Certified Surgical First Assistant (CSFA) pathway pulls the top tier of the occupation further from anything automatable.",
        "plausibility": "already happening",
        "would_add": 2
      }
    ],
    "ceiling_note": "Trust premium has no realistic route: patients cannot and do not select the scrub tech, and no plausible market mechanism gives them that choice. Embodiment is already at ceiling. The real displacement risk here is not AI but headcount pressure — RN circulator/tech role consolidation and robotic-surgery case mixes that need fewer hands at the table — which this register does not score."
  },
  "adjudication": {
    "method": "two independent runs agreed on the verdict",
    "outcome": "corroborated",
    "run_totals": [
      67,
      68
    ],
    "run_verdicts": [
      "SAFE",
      "SAFE"
    ]
  },
  "employment_history": {
    "points": [
      {
        "y": 2017,
        "emp": 106470,
        "wage": 46310
      },
      {
        "y": 2018,
        "emp": 110160,
        "wage": 47300
      },
      {
        "y": 2019,
        "emp": 109000,
        "wage": 48300
      },
      {
        "y": 2020,
        "emp": 107400,
        "wage": 49710
      },
      {
        "y": 2021,
        "emp": 109060,
        "wage": 48530
      },
      {
        "y": 2022,
        "emp": 107400,
        "wage": 55960
      },
      {
        "y": 2023,
        "emp": 110320,
        "wage": 60610
      },
      {
        "y": 2024,
        "emp": 113890,
        "wage": 62830
      },
      {
        "y": 2025,
        "emp": 117460,
        "wage": 64650
      }
    ],
    "from": 2017,
    "to": 2025,
    "change_pct": 10.3,
    "comparable_from": 2019,
    "spans_soc_revision": true
  },
  "pivots": [],
  "license": "https://cookedindex.com/terms"
}