Mal Fletcher considers the implications of the threat to carry forward the junior doctors' strike indefinitely.

Specialised medicine may also be affected by automation, at least to a point. A few countries already use surgical robots on an experimental basis to perform simple operations - with or without human intervention.

Given these near-future developments, doctors cannot afford to become complacent. They cannot assume that their grievances will always be met with forbearance by a largely supportive community.

If technology starts replacing some of their more specialised roles, medicine might start to look less like a vocation and more like a job.

Yes, doctors may need to spend time in picket lines now and again. But more important is their need to recognise and maximise their "unique selling points"; focusing more, not less, time and attention on the level of human care they provide.

In their present strike action, as in any other public grievance, perception is as important as fact.

In a time of rapid technological change, the perceptions we create today may be harder to break tomorrow, when even the most admired jobs are no longer guaranteed.

That change may happen more quickly than we think. In advance of it, even highly paid professionals need to focus on improving their human trust quotient.

If doctors allow their commitment to medicine to be seen as little more than another career move; if they appear to lose their sense of duty to an attitude of entitlement; if they are seen as becoming less committed to human care, people may soon trust them less and begin to wonder if a machine might not do as good a job.