Call centers replaced many doctors' receptionists. Now, AI is coming for call centers
At one call center in the Philippines, workers help Americans with diabetes or neurological conditions troubleshoot devices that monitor their health. Sometimes they get pressing calls: elderly patients who are alone and experiencing a medical emergency.
'That's not part of the job of our employees or our tech supports,' said Ruth Elio, an occupational nurse who supervised the center's workers when she spoke with KFF Health News last year. 'Still, they're doing that because it is important.'
Elio also helped workers with their own health problems, most frequently headaches or back pains, borne of a life of sitting for hours on end.
In a different call center, Kevin Asuncion transcribed medical visits from half a world away, in the United States. You can get used to the hours, he said in an interview last year: 8 p.m. to 5 a.m. His breaks were mostly spent sleeping; not much is open then.
Health risks and night shifts aside, call center workers have a new concern: artificial intelligence.
Startups are marketing AI products with lifelike voices to schedule or cancel medical visits, refill prescriptions, and help triage patients. Soon, many patients might initiate contact with the health system not by speaking with a call center worker or receptionist, but with AI. Zocdoc, the appointment-booking company, has introduced an automated assistant it says can schedule visits without human intervention 70% of the time.
The medically focused call center workforce in the Philippines is a vast one: 200,000 at the end of 2024, estimates industry trade group leader Jack Madrid. That figure is more than the number of paramedics in the United States at the end of 2023, according to the Bureau of Labor Statistics. And some employers are opening outposts in other countries, like India, while using AI to reshape or replace their workforces.
Still, it's unclear whether AI's digital manipulations could match the proverbial human touch. For example, a recent study in Nature Medicine found that while some models can diagnose maladies when presented with a canned anecdote, as prospective doctors do in training, AI struggles to elicit information from simulated patients.
'The rapport, or the trust that we give, or the emotions that we have as humans cannot be replaced,' Elio said.
Sachin Jain, president and chief executive of Scan Health Plan, an insurer, said humans have context that AI doesn't have — at least for now. A receptionist at a small practice may know the patients well enough to pick up on subtle cues and communicate to the doctor that a particular caller is 'somebody that you should see, talk to, that day, that minute, or that week.'
The turn toward call centers, while creating more distance between a caller and a health provider, preserved the human touch. Yet some agents at call centers and their advocates say the ways they are monitored on the job undermine care. At one Kaiser Permanente location, it's a 'very micromanaging environment,' said one nurse who asked not to provide her name for fear of reprisal.
'From the beginning of the shift to your end, you're expected to take call after call after call from an open queue,' she said. Even when giving advice for complex cases, 'there's an unwritten rule on how long a nurse should take per call: 12 minutes.'
Meanwhile, the job is getting tougher, she said. 'We're the backup to the healthcare system. We're open 24/7,' she said. 'They're calling about their incision sites, which are bleeding. Their child has asthma, and the instructions for the medications are not clear.'
One nurses union is protesting a potential AI management tool in the call centers.
'AI tools don't make medical decisions,' Kaiser Permanente spokesperson Vincent Staupe told KFF Health News. 'Our physicians and care teams are always at the center of decision-making with our patients and in all our care settings, including call centers.'
Kaiser Permanente is not affiliated with KFF, a health information nonprofit that includes KFF Health News.
Some firms cite 30% to 50% turnover rates — stats that some say make a case for turning over the job to AI.
Call centers 'can't keep people, because it's just a really, really challenging job,' said Adnan Iqbal, co-founder and CEO of Luma Health, which creates AI products to automate some call center work. No wonder, 'if you're getting yelled at every 90 seconds by a patient, insurance company, a staff member, what have you.'
To hear business leaders tell it, their customers are frustrated: Instead of the human touch, patients get nothing at all, stymied by long wait times and harried, disempowered workers.
One time, Marissa Moore — an investor at OMERS Ventures — got a taste of patients' frustrations when trying to schedule a visit by phone at five doctors' offices. 'In every single one, I got a third party who had no intel on providers in the office, their availability, or anything.'
These types of gripes are increasingly common — and getting the attention of investors and businesses.
Customer complaints are hitting the bottom lines of businesses — like health insurers, which can be rewarded by the federal government's Medicare Advantage policies for better customer service.
When Scan noticed a drop in patient ratings for some of the medical providers in its insurance network, it learned those providers had switched to using centralized call centers. Customer service suffered, and the lower ratings translated into lower payments from the federal government, Jain said.
'There's a degree of dissatisfaction that's bubbling up among our patients,' he said.
So, for some businesses, the notion of a computer receptionist seems a welcome solution to the problem of ineffectual call centers. AI voices, which can convincingly mimic human voices, are 'beyond uncanny valley,' said Richie Cartwright, the founder of Fella, a weight loss startup that used one AI product to call pharmacies and ask if they had GLP-1s in stock.
Prices have dropped, too. Google AI's per-use price has dropped by 97%, company CEO Sundar Pichai claimed in a 2024 speech.
Some boosters are excited to put the vision of AI assistants into action. Since the second Trump administration took office, policy initiatives by the advisory group known as the Department of Government Efficiency, led by Elon Musk, have reportedly explored using artificial intelligence bots for customer service at the Department of Education.
Most executives interviewed by KFF Health News — in the hospital, insurance, tech, and consultancy fields — were keen to emphasize that AI would complement humans, not replace them. Some resorted to jargon and claimed the technology might make call center nurses and employees more efficient and effective.
But some businesses are signaling that their AI models could replace human workers. Their websites hint at reducing reliance on staff. And they are developing pricing strategies based on reducing the need for labor, said Michael Yang, a venture capitalist at OMERS.
Yang described the prospect for businesses as a 'we-share-in-the-upside kind of thing,' with startups pitching clients on paying them for the cost of 1½ hires and their AI doing the work of twice that number.
But providers are building narrow services at the moment. For example, the University of Arkansas for Medical Sciences started with a limited idea. The organization's call center closes at 5 p.m. — meaning patients who try to cancel appointments after hours left a phone message, creating a backlog for workers to address the next morning that took time from other scheduling tasks and left canceled appointments unfilled.
So they started by using an AI system provided by Luma Health to allow after-hours cancellations and have since expanded it to allow patients to cancel appointments all day.
Michelle Winfeld-Hanrahan, the health system's chief clinical access officer, who oversees its deployment, said UAMS has plenty of ideas for more automation, including allowing patients to check on prior authorizations and leading them through post-discharge follow-up.
Many executives claim AI tools can complement, rather than replace, humans. One company says its product can measure "vocal biomarkers" — subtle changes in tone or inflection — that correlate with disease and supply that information to human employees interacting with the patient.
Some firms are using large language models to summarize complex documents: pulling out obscure insurance policies, or needed information, for employees. Others are interested in AI guiding a human through a conversation.
Even if the technology isn't replacing people, it is reshaping them. AI can be used to change humans' behavior and presentation. Call center employees said in interviews that they knew of, or had heard omnipresent rumors of, or feared, a variety of AI tools.
At some Kaiser Permanente call centers, unionized employees protested — and successfully delayed — the implementation of an AI tool meant to measure 'active listening,' a union flyer claimed.
And employees and executives associated with the call center workforce in the Philippines said they'd heard of other software tools, such as technology that changed Filipino accents to American ones. There's 'not a super huge need for that, given our relatively neutral accents, but we've seen that,' said Madrid, the trade group leader.
'Just because something can be automated doesn't mean it should be,' he said.
Tahir writes for KFF Health News, a national newsroom that produces in-depth journalism about health issues and is one of the core operating programs at KFF — the independent source for health policy research, polling, and journalism.
Sign up for our Wide Shot newsletter to get the latest entertainment business news, analysis and insights.
This story originally appeared in Los Angeles Times.
Try Our AI Features
Explore what Daily8 AI can do for you:
Comments
No comments yet...
Related Articles
New York Post
5 hours ago
- New York Post
Why Ozempic users should be extra careful during heatwaves
Talk about melting the weight off. Summer may be filled with beach days and barbecues, but it can also bring blistering temperatures. This week, millions of Americans — including New Yorkers — are bracing for what forecasters are calling a 'very sweaty' heatwave. People who are on GLP-1s need to be on particularly high alert amidst the high degrees. New Africa – And people who are on weight loss drugs like Ozempic, Wegovy and Mounjaro need to be on particularly high alert amidst the high degrees. That's because these drugs work by suppressing appetite, which means they can wind up curbing thirst as well. This, in turn, can unwittingly lead to dehydration — a dangerous condition that can cause dizziness, headaches, low blood pressure, blurred vision, kidney problems and, in extreme cases, fatal heatstroke. Since eating normally stimulates saliva flow, eating less while on Ozempic can mean less stimulation to the salivary glands, which can in turn lead to dry mouth — another symptom of dehydration left unchecked. And if you've heard about Ozempic teeth, you know some of the most common side effects of GLP-1s pose their own dangers during a heatwave. 'You'll need to be extra careful about hydration during hot weather as these medications often cause nausea, vomiting or diarrhea — all of which can lead to fluid loss,' nutritional therapist Deborah Grayson told The Daily Mail. 'This is particularly important for new users of the weight loss medication, whose bodies are still adjusting.' 'You'll need to be extra careful about hydration during hot weather as these medications often cause nausea, vomiting or diarrhea — all of which can lead to fluid loss,' Grayson said. millaf – To remain vigilant, Grayson recommends the following: Drink plenty of water, even if you don't feel thirsty Put a timer on to remind you to hydrate Avoid alcohol and caffeine Avoid being outdoors during peak heat hours Eat easy-to-digest foods such as those on the BRAT diet In addition to suppressing thirst and potentially inducing vomiting/diarrhea, GLP-1s could mess with your body's ability to regulate body temperature, making it harder to tolerate heat. This is all the more reason to drink lots of water — sprinkle some electrolytes into the mix to stay hydrated longer. Use urine as your barometer — light yellow means you're in the clear, whereas darker colors are a bad sign. And avoid physical exertion, especially outside. It might be excruciatingly hot, but perhaps the heatwave is a good excuse to stay on your Ozempic butt for a bit.
The Hill
11 hours ago
- The Hill
Thanks to imported drugs, America has lost control of its medicine cabinet
America is facing a growing crisis in its medical system — not from a lack of talent or innovation, but from a breakdown in the control, safety and supply of essential medicines. Our growing reliance on imports is now driving serious drug shortages, destabilizing supply chains and increasingly making medications unsafe. At the root of it is a hard truth: We no longer have control of the medicines we depend on every day. In 2002, America manufactured 83.7 percent of the pharmaceuticals it consumed. By 2024, that number had dropped to just 37.1 percent. Meanwhile, the U.S. pharmaceutical trade deficit has soared, reaching a record $118.3 billion in 2024. We didn't just outsource manufacturing — we outsourced the sovereignty and safety of our health care system. This means that nearly two-thirds of America's pharmaceutical supplies are now imported. Most critical medications, such as generic drugs, now come from China and India. China controls 80 to 90 percent of the global supply of active pharmaceutical ingredients — the chemical building blocks of modern medicine. Even drugs labeled 'Made in the USA' often chemically originate in China. And India, which produces about half of America's finished generic drugs, relies on China for up to 80 percent of its active pharmaceutical not a supply chain — it's a ticking time something goes wrong, American patients suffer. In 2023, the Food and Drug Administration shut down a single Indian plant responsible for 50 percent of the U.S. supply of cisplatin, a critical chemotherapy drug, after uncovering a 'cascade of failure' in safety practices and shredded documents soaked in acid. With no domestic backup, patients nationwide had their treatments delayed. That wasn't a fluke. 40 percent of U.S. generic drugs have only one FDA-approved manufacturer. Because of that single chokepoint, when one factory fails, the whole system can crack. We are now seeing widespread drug shortages across the medical system. Hospital pharmacists report an average of 301 critical drug shortages at any given time. And 85 percent say these shortages are moderately or critically affecting care. Doctors often lack crucial medicines such as antibiotics, sedatives and cancer drugs. These aren't obscure drugs. They're foundational medicines. But America no longer makes them. Even when imported drugs do arrive, they're not always safe. A 2025 study found that Indian generics are 54 percent more likely to cause serious side effects than their U.S.-made counterparts. Indian factory violations have also been tied to at least eight U.S. patient deaths. China's record is equally disturbing. In 2008, dozens of Americans died after receiving contaminated heparin from Chinese suppliers. This isn't what the American people want. In a national survey, 85 percent of hospital pharmacists said they would pay more for safer generics. But under today's rules, price overshadows quality. Hospitals have little oversight of drug quality — and foreign producers face few consequences for cutting corners. Even the federal government is flying blind. A 2023 Department of Defense review found that 22 percent of essential military-use drugs had unknown ingredient sourcing. That's a national security April, the Trump administration took a necessary step by launching an investigation into generic pharmaceutical imports that correctly frames the issue as a national security threat. But that recognition alone isn't enough. To address this crisis, Washington should impose targeted tariffs on generic drugs from adversarial nations. It must also rebuild domestic pharmaceutical production through tax credits and long-term contracts. America urgently needs full transparency in drug labeling to disclose where drugs and their ingredients are made. The FDA must step up — with stronger enforcement abroad and a ban on imports from repeat safety violators. And to secure critical ingredients during market disruptions, Washington must pursue a long-term vision that includes a 'strategic pharmaceutical reserve.' This isn't just protectionism. It's a restoration of America's medical security. No nation can call itself sovereign if it can't produce its own medicines, and no patient is safe if their health care depends on quality control in a factory 8,000 miles decades, we were told that offshoring production would make things cheaper, smoother and more efficient. But America can no longer depend on unstable foreign suppliers. It's time to restore our pharmaceutical independence and take back control of our medicine cabinet. Andrew Rechenberg is an economist at the Coalition for a Prosperous America.
Yahoo
13 hours ago
- Yahoo
If You're Struggling With Constipation, These 5 Foods And Drinks May Be To Blame
Constipation is the most common gastrointestinal complaint, affecting millions of Americans of all ages. Prevalent as it may be, it's an unpleasant issue that you'd probably prefer to avoid. And what you eat can either help or hinder things in the poop department. According to Johns Hopkins Medicine, you're typically considered constipated when you're passing 'small amounts of hard, dry stool, usually fewer than three times a week.' But when it comes to poop frequency, the normal range is pretty wide: anywhere from three times a day to three times a week. So consider what's a deviation from your usual pattern. Constipation is about more than just frequency of bowel movements, though. Other symptoms include pain or difficulty pooping, feeling like you haven't fully emptied your bowels, bloating, sluggishness and stomach discomfort. Most people deal with short-term constipation at one point or another. Chronic constipation, however, is an ongoing issue that can negatively affect your quality of life and lead to complications, like hemorrhoids or fecal impaction, if left untreated. When you're constipated, you might also experience bloating, sluggishness and stomach discomfort. You may become constipated due to dehydration, lack of exercise, changes to your routine (such as travel), stress, certain medications and health conditions such as irritable bowel syndrome. But below, we'll focus on some of the ways your diet could be contributing to your constipation woes. The main takeaway: Foods that are high in fat but low in fiber tend to be the worst offenders. No one specific food or drink is likely to cause constipation on its own for most individuals — however, your daily eating habits can worsen an existing issue, according to Medical News Today. We asked experts — including gastro doctors and dietitians — to explain which foods and drinks you might want to consider cutting back on when you're backed up and why. Refined grains 'Refined grains like white bread, white pasta and white rice are known to be binding and can contribute to constipation,' registered dietitian Stefani Sassos, nutrition and fitness director for the Good Housekeeping Institute, told HuffPost. 'This is due to the fact that they are lower in fiber than whole grains.' Baked goods such as pastries, cookies and cakes, as well as crackers and flour tortillas fall under this umbrella, as well. With refined grains, the fiber our bodies need to facilitate digestion is stripped away during the milling process. 'Fiber promotes regularity by helping food move through your digestive system,' gastroenterologist Dr. Supriya Rao previously told HuffPost. 'This is because fiber absorbs water and bulks up stools, making them easier to pass.' Cheese and dairy products Related: Invent The Next Big Soda Flavor — Will It Be Delicious Or The Next Big Disaster? Cheese is low in fiber and high in fat, which can worsen constipation. Dairy products like cheese tend to be high in fat, yet low in fiber, which can make constipation worse, gastroenterologist Dr. Rabia A. De Latour told HuffPost. For those with a lactose intolerance, consuming dairy products typically leads to diarrhea and gas. But according to a 2022 literature review, about 30% of lactose-intolerant individuals experience constipation after eating dairy. Red meat Related: Warning: This Ice Cream Generator Is Highly Addictive — What Delicious Or Disastrous Flavor Will You Create? Red meat, such as beef and pork, these kinds It is also rich in protein, the most satiating macronutrient. This means you might feel full after eating that steak or burger, making you less likely to reach for high-fiber foods like fruits and veggies. Fried foods French fries, fried chicken, mozzarella sticks and other fried fare can make you more backed up. 'Fried, greasy foods are very high in fat and can be hard for the body to digest, contributing to constipation,' Sassos explained. 'Plus, they often are void of fiber.' For other folks, these kinds of foods may lead to more urgent and looser stools — it really depends on the individual and the other components of their diet. Alcohol Booze is another one that causes different GI symptoms for different people. For many individuals, a night of drinking leads to soft stool or diarrhea. In other cases, it can have a constipating effect. If you're backed up, Dr. Kenneth Josovitz — a Virginia gastroenterologist with Gastro Health — recommends avoiding alcohol, 'which can cause dehydration and worsen constipation.' So why does alcohol have this effect? Alcohol suppresses the release of vasopressin, a hormone which helps your body hold onto fluids by telling the kidneys to reabsorb water, rather than excrete it. 'That [suppression] is why people will pee more when they drink,' gastroenterologist Dr. Sunana Sohi previously told HuffPost. 'The alcohol is making them pee out all the water in their body, and so they get dehydrated and then constipated because of it.' How To Alleviate Constipation In addition to cutting back on the aforementioned foods and drinks, try to incorporate more high-fiber foods into your diet to help you stay regular. Women should aim to consume at least 25 grams of fiber a day, De LaTour said. For men, that number is about 38 grams per day. Sassos recommends foods like raspberries, apples and pears with the skin on, lentils, beans, broccoli, leafy greens and nuts. Prunes, known for their laxative properties, can also be a good at-home remedy to try, she said. 'If you're not used to eating prunes and fiber-rich foods, start with one to two prunes per day,' Sassos said. 'You can work your way up to five or six as tolerated. Prune juice can be effective too, especially warm prune juice since warm liquids in general can speed up digestive motility.' When increasing your fiber intake, go about it slowly and be sure to drink enough water, she advised. 'We need adequate hydration to help fiber digest properly in the body,' Sassos said. 'If you don't drink enough water, high-fiber foods may actually constipate you even more.' Incorporating more high-fiber foods like leafy greens can help relieve constipation. To ease constipation, you can also try drinking a cup of tea as 'the hot temperature speeds up the motility and the caffeine stimulates the bowels,' Josovitz suggested. Reducing stress and exercising can help get things moving as well, he added. Sassos also emphasized the importance of physical activity in keeping you regular. 'Even a short 10-to 15-minute walk after a meal can help,' she said. The occasional bout of constipation typically resolves on its own with minor lifestyle adjustments. But in other cases, constipation may warrant a visit to your doctor — especially if it's coupled with significant abdominal pain. 'You should seek medical attention if the constipation is new, severe, lasts more than a few weeks, or comes with bleeding, weight loss or weakness,' Josovitz advised. This post originally appeared on HuffPost. Also in Food: "Over Time, It Starves The Brain": Neurologists Shared The Foods They Would Never, Ever Eat And Why Also in Food: People Are Sharing Their Go-To Food Hacks They're Shocked More Home Cooks Don't Already Know Also in Food: People Are Revealing The Homemade Food Items That Cost Less And Taste Better Than Store-Bought, And I'm Taking Copious Notes
