Isotretinoin is a common acne medication and a bit of a breakthrough that also has potentially serious side effects. My take is more that if the medication is safe enough to be given out by an AI then maybe it should just be over the counter.
OTC is a reasonable argument to explore, at least.
I don't think it's automatically true though. In the case of acne medication, I remember there's a well-known one that carries the very real caveat that it'll kill or severely deform the baby if you're pregnant. When you consider the old classic line "Think of the average person. Half of the people are dumber than that" I don't feel comfortable with that medication sitting on the shelf next to the Clearasil, where a busy person will just grab it because they heard it was super effective, or because the other types were out of stock.
The AI inference involved there no doubt costs pennies; so having it screen the patient to ensure that she understands the risks and has taken a pregnancy test recently if unsure, seems like a "why not" kind of thing.
Now, if some AI-healthcare company is capturing 90% of the money saved by not having doctors do this, then it would be barely worth it.
There's the "in between" of "behind the pharmacy counter", requires you to interact with a tech if not a pharmacist to ask/answer some questions before dispensing, but at point of sale.
If a 20 minute telehealth visit with a PA is a sufficient level of screening for a medication, it's hard to imagine a compelling reason why an AI system would not be.
Amazon's pharmacy prescribes a large swath of medications over text.
No call or video necessary.
To make things more complicated, every message I sent was responded to by a different nurse practitioner. So it seemed everytime i sent a response or question, it would get routed to a random NP and she would respond without reviewing the full conversation.
Works if you know what you need, and I can't imagine AI being a worse process than whatever Amazon is doing.
Isotretinoin (formerly sold under the brand name Accutane) is not one of the drugs which can be prescribed by the system. Also, the reason you know its name is precisely because it is abnormally associated with increased risk of suicide.
While I am too ignorant to have an opinion about whether AI is a good idea, I do think that ungating relatively safe medications from needing an MD's prescription is a good idea.
You don't have to go to medical school to know what bad acne looks like, or how to treat a UTI. We should be working on tiering prescriptions based on ease of diagnosis and risk.
I was recently hospitalized, on two occasions using Claude Fable solved a medical question that nurses could not answer.
I was having pain from antibiotics, nurses/doctors began thinking about switching antibiotics due to the irritation. This was a big deal since the other options were less effective and much harder on the body.
The AI model instructed me to take a somewhat obscure body position to open up my jugular, which helped dilute the antibiotic, removing the pain. It was a measurable improvement of care.
This is great. It removes a big time waste of appointments and procedures for things that you know you need.
I have for example had tonsilitis 5+ times, and a lot of common colds/flus/etc. I know how my body reacts and how it feels when I have one or the other.
Yet, I have to be screened by nurses, sent around, given weak antibiotics, and in general wasting a lot of time when I could just convince a model to give me the prescription.
I have a friend with acne who has the same issues with tretinoin prescriptions. Endless appointments and time waste.
I have for example hypersensitivity to radio waves. I know how my body reacts and how it feels when I'm exposed to such radiation, especially during vaxxine toxicity flareups.
Yet, I have to be screened by nurses, go through appointments with psychologists, and in general wasting a lot of time when I could just convince a model to prescribe the radium water I need.
It would be also be great if people with libedo issues could then get a medical prescription for porn, which if I know my AI, and I dont, could be accomodated instantly during the 'examination'
Because as an adult the operation is genuinely full of risk. Think about the anatomy of your neck and how close your tonsils are to your major blood vessels.
Sometimes doctors make choices that reflect a landscape of risk the patient is no more prepared to understand than the doctor is ready to run a network test. People who say they “know they need something” are often confidently wrong.
There was an assessment for this and deemed not worth the risk because of the size of the connective tissues/blood supply and closeness to major blood vessels.
> when I could just convince a model to give me the prescription
The concern I have is that you (proverbial) would pretty much always be able to convince the model, they’re incredibly suggest-able.
For antibiotics specifically, I’ve seen a significant change in my lifetime; 20 years ago you could walk into any urgent care and leave with a prescription for antibiotics. These days there’s much more effort put into making sure you actually need them. I don’t want to see that trend reversed.
There's other solutions that can also be explored.
Where I am in BC, Canada, pharmacists can prescribe specific medications for certain pre-approved conditions, and there is also the concept of an "emergency" refill for if you lose your medication or are unable to get an appointment in time, a few days of a previously prescribed medication can be provided.
At the end of the day, a better solution is to have tiers of prescription meds. Not everything needs to be gate-kept by MDs. If an AI can prescribe it, there is no reason a nurse, pharmacist or other medical professional shouldn't be able to as well.
Might be super specific to my country, but antibiotics are for example given on a staircase hierarchy here to avoid resistance. This means that if one does not work, you need to go to the doctor again to ensure you get the right next step.
Same for percentages of strength in medicine. If a certain percentage strength of tretinoin does not work, you need to get a new prescription for the stronger one.
Another thing are different providers. If you get care at one provider they won't have the data of the other providers necessarily.
---
None of these things are insurmountable and would just require some good software to fix(connect databases, make hierarchies of medicine, etc) However it's in no-ones incentive to do so.
The doctors, nurses and other medical staff have 0 interest in:
1) making themselves obsolete
2) learn new software systems
3) change their workflow
And will not only express this, but also actively misuse the new tools that they are given (happened in my country) to make a point of how things can't be trusted and why they are necessary.
In order to solve this you need something like the solution proposed coming in from the outside. This way the current medical staff have 0 control and have to change/adapt.
It's in the interest of the company. If there are multiple pharmaceutical companies, you will have more customers and win over competition if you sell stuff easier. Shouldn't be too hard by the incentives.
Acne is a real problem for some people, but comparatively low stakes, mostly visual evaluation, and with pretty well-known solutions. (Of course everything has corner cases, but in general this is a well understood area.)
I have no idea how well this will go, but starting here rather than, say, robotic cancer treatments, can help AI medicine develop into more.
If it does go badly, then after a year we can re-evaluate and either give up or refine the system.
What is the actual benefit here? If we believe the doctor's oversight is required, the AI introduces a dangerous potential for error. If we don't think a doctor's oversight is required, the medication shouldn't require a prescription in the first place. What positive value does the AI actually add that isn't circumventing a legal requirement that we decided to put in place?
Well in this age of performative bullshit, it gives the appearance of "medical practice" and allows the government to keep people drugged and complacent. What other reason do you need?
> allows the government to keep people drugged and complacent
Drugged with a topical ointment and complacent by having less acne? This is a one-year trial for patients with mild-to-moderate acne. Let's not blow this situation out of proportion. This trial seems rather narrowly scoped and overall a positive idea for well understood treatments that hardly need an MD to begin with.
If you want to get into conspiracy theories of a government wanting a drugged and compliant citizenry just look no further than the sudden push legalizing THC across the country.
This is such a low quality comment that I wonder whether people even know how AI is used!
I see this same fallacy repeated all the time when we speak about AI.
"I want AI to be 100% accurate and not 99.999%"
"If AI makes even one mistake, why would I even use it?"
"What's the point of using AI if I have to verify it anyway?"
Here's how it could work.
You could always have a CI sort of thing for doctors prescriptions where you run the prescription through AI and it can flag any potential error to the doctor.
The LLM can be accurate enough that it only flags things when necessary
You could always have a CI sort of thing for doctors prescriptions where you run the prescription through AI and it can flag any potential error to the doctor.
Yes, and we call this CI system a "pharmacy". It might even employ some human experts to review DDI warnings and suggest alternatives to the prescribing physician.
What fallacy are you on about? They asked a question.
> What positive value does the AI actually add that isn't circumventing a legal requirement that we decided to put in place?
You only reply with stuff nobody said. Which explains why you "see those fallacies repeated" every time, if you bring them up. A simple solution is to stick things actually are saying.
In certain states, scheduling an appointment to see a doctor is >6 months out. If AI is able to take in your complaints, perhaps order some tests, triage and pass you to a doctor, that's a plus. Depending on the severity, not everybody needs to see a doctor. I appreciate what doctors do but most people can self-diagnose pretty well now but they are not able to get themselves tested which sucks. I'm happy to take my health into my own hands.
They serve as a good second opinion and helps catch stuff humans may miss. What I do want however is for AI to scale the medical training pipeline, it's about time the residency system experience some disruption. They have been shielded for too long through lobbying. A good old fashioned job loss would be the kick up the butt they need. It's not like the FTC would enforce anti trust against medical professionals, so tech disruption is pretty much the only way.
The program is limited to a few prescriptions. I searched their website and found this about their AI prescription platform:
> Only topical acne medications from a restricted list: tretinoin, adapalene, clindamycin with benzoyl peroxide, benzoyl peroxide, and azelaic acid, some combined with niacinamide or topical spironolactone. Each plan includes a morning and an evening treatment. The pilot does not include oral or systemic medications, hormonal therapies, or isotretinoin.
So it's a short list of topical creams. Several of them are already available over the counter. Benzoyl peroxide creams are on the shelf of your nearest grocery store. Some of them are available in higher strengths via prescription only and should be reserved for only severe or refractory cases after escalation. A lot of people go straight for the highest strength they can find on the shelf, so having a prescription gate for the stronger stuff can be justified.
Others on the list like tretinoin are currently prescription only. That one is a strong chemical that will burn your skin if you don't read the instructions about to apply and also makes you prone to sunburn. A lot of people don't read the instructions, they just apply the cream and see what happens. Having a provider, even if it's AI, do something to force them to understand the risks can be arguably justified. Tretinoin is also a risk to fetal development, so having a provider ask if female patients are on birth control is important. That said it is OTC in some other countries, so there's an argument that it should be OTC here as well.
The AI doctor is not allowed to prescribe anything really serious. It's a combination of prescription versions of OTC creams and a few topicals that benefit from some light provider instructions. Having a $5 option to get them with the serious cases shunted to actual doctors is not a bad tradeoff.
> Being a doctor is one of the jobs expected to be least at risk from AI replacement
I wouldn't say that, but it's certainly one where the consequences are high and doctor-in-the-loop seems highly desirable for the foreseeable future, especially since most patients are not going to be knowledgeable enough to realize the shortcomings of an LLM and make an informed decision about whether they're OK taking an LLM-prescribed medication.
This is the type of reform that has been difficult to achieve in the US (And I presume other high-regulation, Western countries).
We usually regulate a one-size-fits-all approach to everything in medicine. An M.D. (or whatever NPs have?) is required to prescribe medicines, even medicines which are just the same or slightly stronger formulations of OTC medications like a 400mg Ibuprofen or a 1% hydrocortisone cream. Compare this to Mexico, where you can buy many of our "prescription-only" meds OTC.
A lot of healthcare issues are just not high-stakes. Requiring a doctor in these cases doesn't help the average patient, because the average patient would rather ignore the problem, or now, ask ChatGPT how to treat it with OTC options, than deal with the mess of scheduling doctor appointments, dealing with insurance (or in Canada, long wait times to see the doctor for free), only to get just 5 minutes with the actual doctor who may not even listen to you.
I know it's a tough pill to swallow for doctors, and I recognize that it's not doctors who chose the terrible healthcare system we have or decided that they should have 5-10 minutes with a patient. But I do think we need to change the rules for things that have little risk of causing harm but a great chance of improving the aggregate outcomes by increasing access to healthcare.
The phrase "regulations written in blood" comes to mind.
> A lot of healthcare issues are just not high-stakes. Requiring a doctor in these cases doesn't help the average patient
Normally, I am not inclined to get involved whenever I see bad takes on the internet but this is one of those "so harmful you really need to nip it in the bud" type of things.
Do not listen to this person's armchair speculation.
If you want to remind yourself why the united states invented an FDA (and why every major medical establishment enjoys the benefits of institutions like ICD and CPT standardization), go reread your Progressive Era history (~1900-1925). Go read about how we already learned all of these lessons the hard way, and save yourself the trouble of reinventing the wheel. Go read about the social impact of Upton Sinclair's The Jungle, "snake oil salesmen", disasters like the Triangle Shirtwaist Fire and the creation of organizations like OSHA.
This commenter may not know any better, but humanity does.
Wow. I can't believe your condescending response cited the FDA as a proud success. It is widely regarded as a deeply flawed agency. It is the most conservative compared even to European regulators. Why are you lionizing them as though they are the wisest? Do not mistake conservatism for excellence.
Examples of its incompetence:
- It's been 3 years since the government itself concluded that Phenylephrine is not effective at all. Look at the shelf. Want to spend $20 on Sudafed PE? Go for it! FDA isn't going to stop it from being sold even specifically advertised to treat an illness. They don't mind everyone wasting their money on a fraudulently-advertised medicine and subjecting themselves to any side-effects, for nothing.
- It took over 25 years for them to approve new sunscreen active ingredients. They've had many more options than we do in Europe and Asia. Why does this matter? Because our shitty sunscreen sucks, people are less likely to use it. Therefore more skin cancer. The damage is lasting, too. Most people who decided years ago they hate the oily crap that stings their eyes aren't checking the shelves every day, so when the new stuff finally comes to market, many won't even know, and will just carry on in their habit of skipping it.
- The tens-of-billions of dollars a year industry hawking ineffective and sometimes unsafe supplements, advertised in slightly oblique promises, with a fine print "These statements have not been evaluated by the Food and Drug Administration. This product is not intended to diagnose, treat, cure or prevent any disease." The whole FDA, constructed supposedly to protect us from quackery, simply disappears when you print that incantation on your advertising in 4-point font.
- And of course, countless cases where people who are terminally ill anyway find experimental treatments painfully hard to get here compared to other Western countries.
Your hyperbolic comments about The Jungle and the Triangle Shirtwaist fire have zero to do with whether I should be able to buy acne cream without speaking to a human doctor. Nobody said "Don't regulate anything." I said our regulation is done poorly because of how rigid and one-size-fits-all it is. If "humanity" knows better, then maybe take a look at how no other first-world country is as bad at this as we are.
I’m all for this, but I think this is wild. I hope they have some hard programmed limits and guidelines baked in because otherwise people are going to turn these into the new pill mills.
> Being a doctor is one of the jobs expected to be least at risk from AI replacement
Is it? At least as a customer I'd love to replace a doctor with AI. Humans suck, you have to wait so long for an appointment, they spend like 10 minutes on your case, and often have very outdated knowledge. The main issue is that vision still sucks and lack of embodiment is a problem. It could invoke "human subagents" for that.
> While the program will eventually become fully automated, the first 100 prescriptions will have to be reviewed by actual doctors before they are submitted to the pharmacy.
> In the second phase, the next 400 patients will have their prescriptions submitted to pharmacies by the AI and reviewed retrospectively by a physician weekly.
> The final phase will involve a doctor reviewing at least 10% of the total prescriptions issued once a month.
This is a really good way to go. That's how you get to a proper system. It's the route that should've been taken from the very beginning with all human-facing AI-brokered services, and would've meant far fewer nightmare stories.
"The process works when a
person signs up for Nolla Health's $4.99-per-month app and uses it to scan their face. After completing a medical history and personal information form, the AI analyzes their skin..."
Utah is not allowing any general form of no-human-in-the-loop healthcare, but has temporarily allowed this company to operate.
Media companies sell ads. Advertisers pay by impressions. Slopulist clickbait drives impressions.
At this point the term "AI" has been so diluted that it doesn't refer to generative image models or LLMs or traditional machine learning so much as it acts as a memetic sonic screwdriver, i.e. whatever journalists, pundits, founders, etc. need it to be. You can see how each party is wielding it in this specific instance quite clearly.
Subscription based services also sell/push ads. Some sell you data too. It makes no difference at all how much you pay them, it will always make them more money to take your subscription fee and sell you out too. Companies aren't known for leaving huge piles of money on the table. Shareholders won't stand for it.
I’m not comparing privacy angles. Just journalistic quality. If you mainly make your money from subs, you have to keep you readers happy. If you mainly make it from ads, you just need them to click a lot.
I've found it to be extremely helpful for me to research options for what medicsm tools/treatments to use. Then, later, I had to convince a prescribor to agree with my assessment as to which thing I needed, which resulted in some friction, but once they did, I'm happy with the result. So, at a minimum, your preference will block some seemingly unambiguously helpful cases.
87 comments
[ 4.5 ms ] story [ 38.7 ms ] threadI don't think it's automatically true though. In the case of acne medication, I remember there's a well-known one that carries the very real caveat that it'll kill or severely deform the baby if you're pregnant. When you consider the old classic line "Think of the average person. Half of the people are dumber than that" I don't feel comfortable with that medication sitting on the shelf next to the Clearasil, where a busy person will just grab it because they heard it was super effective, or because the other types were out of stock.
The AI inference involved there no doubt costs pennies; so having it screen the patient to ensure that she understands the risks and has taken a pregnancy test recently if unsure, seems like a "why not" kind of thing.
Now, if some AI-healthcare company is capturing 90% of the money saved by not having doctors do this, then it would be barely worth it.
[0] - https://www.mobihealthnews.com/news/nolla-health-launches-ut...
If a 20 minute telehealth visit with a PA is a sufficient level of screening for a medication, it's hard to imagine a compelling reason why an AI system would not be.
To make things more complicated, every message I sent was responded to by a different nurse practitioner. So it seemed everytime i sent a response or question, it would get routed to a random NP and she would respond without reviewing the full conversation.
Works if you know what you need, and I can't imagine AI being a worse process than whatever Amazon is doing.
Hard disagree. The only acne treatment I know by name has serious side effects that IMO should be discussed with a human at length before being used.
Why do you think this is fine?
Just in case anyone else has the gut "oh ffs" reaction to this.
You don't have to go to medical school to know what bad acne looks like, or how to treat a UTI. We should be working on tiering prescriptions based on ease of diagnosis and risk.
I was having pain from antibiotics, nurses/doctors began thinking about switching antibiotics due to the irritation. This was a big deal since the other options were less effective and much harder on the body.
The AI model instructed me to take a somewhat obscure body position to open up my jugular, which helped dilute the antibiotic, removing the pain. It was a measurable improvement of care.
They had never heard of this technique
I have for example had tonsilitis 5+ times, and a lot of common colds/flus/etc. I know how my body reacts and how it feels when I have one or the other.
Yet, I have to be screened by nurses, sent around, given weak antibiotics, and in general wasting a lot of time when I could just convince a model to give me the prescription.
I have a friend with acne who has the same issues with tretinoin prescriptions. Endless appointments and time waste.
Step in the right direction
I have for example hypersensitivity to radio waves. I know how my body reacts and how it feels when I'm exposed to such radiation, especially during vaxxine toxicity flareups.
Yet, I have to be screened by nurses, go through appointments with psychologists, and in general wasting a lot of time when I could just convince a model to prescribe the radium water I need.
Step in the right direction.
Sometimes doctors make choices that reflect a landscape of risk the patient is no more prepared to understand than the doctor is ready to run a network test. People who say they “know they need something” are often confidently wrong.
The concern I have is that you (proverbial) would pretty much always be able to convince the model, they’re incredibly suggest-able.
For antibiotics specifically, I’ve seen a significant change in my lifetime; 20 years ago you could walk into any urgent care and leave with a prescription for antibiotics. These days there’s much more effort put into making sure you actually need them. I don’t want to see that trend reversed.
Where I am in BC, Canada, pharmacists can prescribe specific medications for certain pre-approved conditions, and there is also the concept of an "emergency" refill for if you lose your medication or are unable to get an appointment in time, a few days of a previously prescribed medication can be provided.
At the end of the day, a better solution is to have tiers of prescription meds. Not everything needs to be gate-kept by MDs. If an AI can prescribe it, there is no reason a nurse, pharmacist or other medical professional shouldn't be able to as well.
But there are. Costs and wait times go down. Can be handled like a drive-through. No mis-diagnoses due to fatigue, etc.
Great. Perhaps this will motivate the exploration of them. Because the prevailing racket is in desperate need of disruption.
Same for percentages of strength in medicine. If a certain percentage strength of tretinoin does not work, you need to get a new prescription for the stronger one.
Another thing are different providers. If you get care at one provider they won't have the data of the other providers necessarily.
---
None of these things are insurmountable and would just require some good software to fix(connect databases, make hierarchies of medicine, etc) However it's in no-ones incentive to do so.
The doctors, nurses and other medical staff have 0 interest in:
1) making themselves obsolete
2) learn new software systems
3) change their workflow
And will not only express this, but also actively misuse the new tools that they are given (happened in my country) to make a point of how things can't be trusted and why they are necessary.
In order to solve this you need something like the solution proposed coming in from the outside. This way the current medical staff have 0 control and have to change/adapt.
you're assuming you can "convince" the model
Acne is a real problem for some people, but comparatively low stakes, mostly visual evaluation, and with pretty well-known solutions. (Of course everything has corner cases, but in general this is a well understood area.)
I have no idea how well this will go, but starting here rather than, say, robotic cancer treatments, can help AI medicine develop into more.
If it does go badly, then after a year we can re-evaluate and either give up or refine the system.
Drugged with a topical ointment and complacent by having less acne? This is a one-year trial for patients with mild-to-moderate acne. Let's not blow this situation out of proportion. This trial seems rather narrowly scoped and overall a positive idea for well understood treatments that hardly need an MD to begin with.
If you want to get into conspiracy theories of a government wanting a drugged and compliant citizenry just look no further than the sudden push legalizing THC across the country.
I see this same fallacy repeated all the time when we speak about AI.
"I want AI to be 100% accurate and not 99.999%"
"If AI makes even one mistake, why would I even use it?"
"What's the point of using AI if I have to verify it anyway?"
Here's how it could work.
You could always have a CI sort of thing for doctors prescriptions where you run the prescription through AI and it can flag any potential error to the doctor.
The LLM can be accurate enough that it only flags things when necessary
> What positive value does the AI actually add that isn't circumventing a legal requirement that we decided to put in place?
You only reply with stuff nobody said. Which explains why you "see those fallacies repeated" every time, if you bring them up. A simple solution is to stick things actually are saying.
> If we believe the doctor's oversight is required, the AI introduces a dangerous potential for error
This assumes that the doctor won't verify what the AI said. This is a fallacy.
> The final phase will involve a doctor reviewing at least 10% of the total prescriptions issued once a month.
> Only topical acne medications from a restricted list: tretinoin, adapalene, clindamycin with benzoyl peroxide, benzoyl peroxide, and azelaic acid, some combined with niacinamide or topical spironolactone. Each plan includes a morning and an evening treatment. The pilot does not include oral or systemic medications, hormonal therapies, or isotretinoin.
So it's a short list of topical creams. Several of them are already available over the counter. Benzoyl peroxide creams are on the shelf of your nearest grocery store. Some of them are available in higher strengths via prescription only and should be reserved for only severe or refractory cases after escalation. A lot of people go straight for the highest strength they can find on the shelf, so having a prescription gate for the stronger stuff can be justified.
Others on the list like tretinoin are currently prescription only. That one is a strong chemical that will burn your skin if you don't read the instructions about to apply and also makes you prone to sunburn. A lot of people don't read the instructions, they just apply the cream and see what happens. Having a provider, even if it's AI, do something to force them to understand the risks can be arguably justified. Tretinoin is also a risk to fetal development, so having a provider ask if female patients are on birth control is important. That said it is OTC in some other countries, so there's an argument that it should be OTC here as well.
The AI doctor is not allowed to prescribe anything really serious. It's a combination of prescription versions of OTC creams and a few topicals that benefit from some light provider instructions. Having a $5 option to get them with the serious cases shunted to actual doctors is not a bad tradeoff.
I wouldn't say that, but it's certainly one where the consequences are high and doctor-in-the-loop seems highly desirable for the foreseeable future, especially since most patients are not going to be knowledgeable enough to realize the shortcomings of an LLM and make an informed decision about whether they're OK taking an LLM-prescribed medication.
We usually regulate a one-size-fits-all approach to everything in medicine. An M.D. (or whatever NPs have?) is required to prescribe medicines, even medicines which are just the same or slightly stronger formulations of OTC medications like a 400mg Ibuprofen or a 1% hydrocortisone cream. Compare this to Mexico, where you can buy many of our "prescription-only" meds OTC.
A lot of healthcare issues are just not high-stakes. Requiring a doctor in these cases doesn't help the average patient, because the average patient would rather ignore the problem, or now, ask ChatGPT how to treat it with OTC options, than deal with the mess of scheduling doctor appointments, dealing with insurance (or in Canada, long wait times to see the doctor for free), only to get just 5 minutes with the actual doctor who may not even listen to you.
I know it's a tough pill to swallow for doctors, and I recognize that it's not doctors who chose the terrible healthcare system we have or decided that they should have 5-10 minutes with a patient. But I do think we need to change the rules for things that have little risk of causing harm but a great chance of improving the aggregate outcomes by increasing access to healthcare.
> A lot of healthcare issues are just not high-stakes. Requiring a doctor in these cases doesn't help the average patient
Normally, I am not inclined to get involved whenever I see bad takes on the internet but this is one of those "so harmful you really need to nip it in the bud" type of things.
Do not listen to this person's armchair speculation.
If you want to remind yourself why the united states invented an FDA (and why every major medical establishment enjoys the benefits of institutions like ICD and CPT standardization), go reread your Progressive Era history (~1900-1925). Go read about how we already learned all of these lessons the hard way, and save yourself the trouble of reinventing the wheel. Go read about the social impact of Upton Sinclair's The Jungle, "snake oil salesmen", disasters like the Triangle Shirtwaist Fire and the creation of organizations like OSHA.
This commenter may not know any better, but humanity does.
Examples of its incompetence:
- It's been 3 years since the government itself concluded that Phenylephrine is not effective at all. Look at the shelf. Want to spend $20 on Sudafed PE? Go for it! FDA isn't going to stop it from being sold even specifically advertised to treat an illness. They don't mind everyone wasting their money on a fraudulently-advertised medicine and subjecting themselves to any side-effects, for nothing.
- It took over 25 years for them to approve new sunscreen active ingredients. They've had many more options than we do in Europe and Asia. Why does this matter? Because our shitty sunscreen sucks, people are less likely to use it. Therefore more skin cancer. The damage is lasting, too. Most people who decided years ago they hate the oily crap that stings their eyes aren't checking the shelves every day, so when the new stuff finally comes to market, many won't even know, and will just carry on in their habit of skipping it.
- The tens-of-billions of dollars a year industry hawking ineffective and sometimes unsafe supplements, advertised in slightly oblique promises, with a fine print "These statements have not been evaluated by the Food and Drug Administration. This product is not intended to diagnose, treat, cure or prevent any disease." The whole FDA, constructed supposedly to protect us from quackery, simply disappears when you print that incantation on your advertising in 4-point font.
- And of course, countless cases where people who are terminally ill anyway find experimental treatments painfully hard to get here compared to other Western countries.
Your hyperbolic comments about The Jungle and the Triangle Shirtwaist fire have zero to do with whether I should be able to buy acne cream without speaking to a human doctor. Nobody said "Don't regulate anything." I said our regulation is done poorly because of how rigid and one-size-fits-all it is. If "humanity" knows better, then maybe take a look at how no other first-world country is as bad at this as we are.
Don't worry, it's going to be ok... probably.
Is it? At least as a customer I'd love to replace a doctor with AI. Humans suck, you have to wait so long for an appointment, they spend like 10 minutes on your case, and often have very outdated knowledge. The main issue is that vision still sucks and lack of embodiment is a problem. It could invoke "human subagents" for that.
How do you hold an AI accountable for getting it wrong in ways that fuck you up?
> In the second phase, the next 400 patients will have their prescriptions submitted to pharmacies by the AI and reviewed retrospectively by a physician weekly.
> The final phase will involve a doctor reviewing at least 10% of the total prescriptions issued once a month.
This is a really good way to go. That's how you get to a proper system. It's the route that should've been taken from the very beginning with all human-facing AI-brokered services, and would've meant far fewer nightmare stories.
"The process works when a person signs up for Nolla Health's $4.99-per-month app and uses it to scan their face. After completing a medical history and personal information form, the AI analyzes their skin..."
Utah is not allowing any general form of no-human-in-the-loop healthcare, but has temporarily allowed this company to operate.
At this point the term "AI" has been so diluted that it doesn't refer to generative image models or LLMs or traditional machine learning so much as it acts as a memetic sonic screwdriver, i.e. whatever journalists, pundits, founders, etc. need it to be. You can see how each party is wielding it in this specific instance quite clearly.
Ad-powered media sells ads. There is plenty of media that is primarily subscription based. The difference is glaring.
Your summary is misleading. Acne is diagnosed, prescriptions are written and applied, initially with Dr review and then only 10% reviewed by doctors.
Medicines are topical and said to have mild side effects - so I guess no retinoids (or accutane pills).
fwiw, physician assistants generally work under a doctor, who's supposed to review about that many of their cases.