Ask HN: Is it time for AI to start replacing doctors?
Most people, regardless of their politics, understand that healthcare, notably in the US, is too often unaffordable and sometimes destructive through financial means.
Many doctors, from my observations, function as pen pushers in what seems an administrative bureaucracy, relying as often as not, on remembered-information rather than improvisation or critical thinking. Many of the conditions they treat or medicate are done so in an almost automated manner. In many cases, a nurse would suffice at a much lower cost.
Obviously those who sacrifice a decade of their lives to study medicine desire and deserve to be rewarded. The discretion and experience that comes with such an immersive decade is of undeniably great value. However, I am convinced AI could rival a significant portion of what they do, theoretically at a drastically lower cost.
We (or some of we) trust AI to pilot vehicles, some of them weighing 80,000 lbs. We (some of we) trust AI with many serious matters; it could be argued that it has already begun replacing professionals at the PhD level, eg psychologists (Fusion Centers, law enforcement, pre-crime, etc). There's social credit and Trust Scores and more. Clearly we (some of we) are willing, if not eager to shirk our burdens and responsibilities onto artificial shoulders. Why not include, at least one, application that might have a clear, unambiguous and tangible benefit to the majority?
I think the Hippocratic oath is very amenable in this direction.
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[ 2.1 ms ] story [ 70.6 ms ] threadAnd be honest: you've googled some set of symptoms to see what you've got, probably before deciding to see a human doctor. No, you don't have 5-alpha reductase deficiency.
I answered a series of automated questions that would be reviewed by the physician, all far more extensive than anything in my live interaction with the actual doctor. This indicates discretion as the greater force of determination.
The cost was comparatively reasonable, but a machine could have procured the same results at pennies on the dollar.
Anyway, if AI does not eventually pull the rug from physician's feet, telemedicine will certainly shift it a bit. Hopefully enough to get people thinking.
1. My efforts with the IRS interface were futile. Nothing worked, which is odd considering that the browser was the only critical bit. Mozilla. But on spooky Linux
One area you can try is alternative medicine, such as naturopathic medicine, which is a social group much less powerful.
U.S. jurisdictions that permit access to prescription drugs to naturopathic medicine: Arizona, California, District of Columbia, Hawaii, Kansas, Maine, Montana, New Hampshire, Oregon, Utah, Vermont, and Washington.
This contempt towards doctors never fails to impress me... I don't see it aimed at other professions either.
If it seems so in this circumstance, you've misinterpreted. I am contemptuous of certain aspects, but not blindly of all doctors. Not at all. You can take my word, or ask me questions to clarify.
There's a big problem with healthcare and doctors are only part of it (pharmaceutical corps, nu?).
Our society isn't kind to those who fall behind. We need a way to help people without indenturing them. We need a way to help others by evaluating them more earnestly and less capriciously. We need a lot, and the current system isn't keeping up. Clearing the path to better health and less suffering may require changes that are threatening to some. Or perhaps we could go full euthanasia and market it as compassion.
I am also not a technologist. Far from it. I do use tools though. I also observe things, some through difficult experience. There are places I absolutely do not want AI. So as I wrote; why not use it in at least one way that would have tangible benefits to the majority?
Recently a doctor prescribed me some medicine, and I went to the pharmacy to pick it up. Apparently the insurance balked at paying for it (the pharmacist told me this was common), so the pharmacy sent some additional paperwork to the doctor to fill out.
I know multiple doctors (in the US) that are so fed up with "the system" that they refuse to deal with it, operate their own self-pay practices, and refuse to deal with insurance companies in any capacity.
Even the kindest, most talented, and most dedicated doctors are representatives of a system that seems pretty well rotten to me.
They become the face of a malignant industry aiming to maximize profit by extracting the maximum market price under the threat of sickness, suffering, death.
The US is an outlier. There are countries with a similar and a much higher GDP/per capita that pay almost 50% less.
https://www.finder.com/healthcare-costs-by-country
If we can't even do something that simple (granted I understand the goal with chatbots is to prevent people from reaching a human rather than actually helping them) how could we possibly believe that an "AI" doctor is a good idea? Find a simple to moderate complexity consumer interaction that AI does well, and maybe we can begin to think about how it could help on healthcare. For now, it will only lead to the hellscape we see in other areas of customer service
AI can be somewhat helpful in medical research and clinical decision support. But compared to simpler deterministic algorithms it is a marginal improvement at best. In particular AI sucks at gathering actionable clinical data from patients.
And if after those years, one still does not understand, maybe they don't care to. Do you?
Regarding condescension, I humbly suspect some ignorance on your part too, not for the tone of your reply, but for what I've seen some doctors do and not do, say and not say, and... your unwillingness to consider. Your statement followed by "thus" is very much beneath your intellectual acuity. I assume I hit a sore spot, but my intent here was sincerely, if you'll entertain the possibility, to read through a hoped-for extensive discussion. You're actually among the type I was hoping to receive (slightly less confrontational) insight from.
No offense taken and insight well taken, though I could use a bit more.
I'm not feeling well at this point tonight and will probably end my replies here.
Why don't we ever folks like this ever ask, "when will AI replace SWE?"
Afterall SWEs deal with deterministic systems that follow well-understood laws of physics, while doctors deal with humans with all their capricious complexities. By any logical thought, software engineering is orders of magnitude more replaceable by AI than doctors, yet the people writingb these posts don't ever consider themselves threatened to be replaced by AI. Arrogant ignorance.
People ask this all the time.
Now please offer an intelligent, insightful, un-enraged response. Maybe with examples. And if you're truly brilliant, include something that considers the patient, in some way, preferably constructive, figuratively.
That seems like a very odd and backwards conclusion which reeks of treating a symptom instead of the root cause. I think you may have missed the forest for the trees.
I'm going to directly declare it now -- this is my last comment/reply here.
Thanks everyone, or someeveryone
You can even replace the administrators in all the health care middlemen companies too! More opportunity for cutting the fat if you go for administration
They need to deal with patients expectations and understanding of their own diseases
It might be interesting to examine some of this literature in the context of this thread.
...came across two professors who studied the science of complexity, which highlighted three types of problems in the world: the simple, the complicated and the complex. They are defined as:
Simple Problems – “are ones like baking a cake from a mix. There is a recipe. Sometimes there are a few basic techniques to learn. But once these are mastered, following the recipe brings a high likelihood of success.”
Complicated Problems – “are the ones like sending a rocket to the moon. They can sometimes be broken down into a series of simple problems. But there is no straightforward recipe. Success frequently requires multiple people, often multiple teams and specialized expertise. Unanticipated difficulties are frequent. Timing and coordination become serious concerns.”
Complex Problems – “are ones like raising a child. Once you learn how to send a rocket to the moon, you can repeat the process with other rockets and perfect it. One rocket is like another rocket. But not so with raising a child. Every child is unique. Although raising one child may provide experience, it does not guarantee success with the next child. Expertise is valuable but most certainly not sufficient. Indeed, the next child may require an entirely different approach from the previous one. And this brings up another feature of complex problems: their outcomes remain highly uncertain. Yet we all know that it is possible to raise a child well.”
For the longest time medicine has been part of the complex problem set. Doctors (very rightly) are highly trained with a minimum of 4 years of training followed by years of residency. The profession is seen as highly complex where they need to combine their book learning, with hands-on training and decades of experience to diagnose and treat a wide variety of health conditions. However in Low and Middle Income Countries, where doctors are in short supply, can some level of healthcare be provide by applying Artificial Intelligence to the SOAP (Subjective, Objective, Assessment, Plan) Note along with a touch of the Bayesian Priors?
The SOAP Note originated from the early work done by Dr. Lawrence Weed (an American physician, researcher, educator, entrepreneur and author, who is best known for creating the problem-oriented medical record as well as one of the first electronic health records).
SOAP notes are commonly found in Electronic Medical Records as a means to succinctly communicate patient information in a standard format and are particularly useful between hand-offs between medical professionals.
Modern Electronic Health Record (EHR) Systems offer a great deal more in terms of adding additional diagnostic information as well as a longitudinal patient record but the basics SOAP note could prove immensely valuable as we think about how to design a system that can empower Community Health Workers (CHWs).
SOAP Note in Practice (highly simplified for an illustrative example)
Situation: A medical professional encounters an individual who seeks or is identified for medical care
Subjective data collection
Shaking chills
Muscle ache
Fatigue
Objective data collection
Fever of 102 F (suing a Bluetooth connected thermometer or a cell phone camera based temperature detector)
Malaria Rapid Diagnostic Test (RDT) administered - shows positive
Assessment
The Subjective and Objective information is collated in the medical professionals mind and and she assesses that the patient shows indications of Malaria
Plan
Based on the Subjective and Objective and informed by the Assessment, the medical professional develops a Plan that is specific to the situational context - in this case it may involve sending the patient for a confirmatory Malaria confirmatory test or in some cases starting them directly on anti-malarial treatment.
The SOAP note allows a complicated problem to be broken down into components to then become a simple problem. However, in Global Health today, this complicated problem is treated as a complex problem because it is felt that only a doctor with decades of experience and a medical degree would be able to accurately diagnose and treat Malaria.
Doctors salaries are not a major driver of healthcare expenditures - they’re just an easy target because doctors tend to be the most public facing part of healthcare. How many health care administrators do you meet when you go to the hospital?
For-profit medical services are inhumane, immoral, cruel, barbaric at their core.
Every time I describe the US medical industry and medical insurance industry in Europe, people react with disbelief, disgust and horror.
The amount of mass propaganda needed to keep this monstrosity in place explains a lot.
After about 5 years he did this graduation speech and in it he referenced that: “yes, AI is getting great, your phone is a supercomputer, but the truth is that a computer will never be able to hold the hand of a dying patient and tell them it will be all be okay.”
I had written a reply, but abandoned it due to personal matters.