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'AI' Is Supercharging Our Broken Healthcare System's Worst Tendencies

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Re: 'AI' Is Supercharging Our Broken Healthcare System's Worst Tendencies

#141

Post by forgetfreeman »

skohan wrote: post #107
forgetfreeman wrote: post #104

Earlier quoted context omitted.

We've already got NPs and PAs "picking up the slack" in the US. Prices are still outrageous for folks without health insurance and healthcare outcomes continue to decline. Adding another half-assed tool to the chain isn't how this gets fixed.

The US is not the only country with healthcare needs. There are plenty of developed nations with public health care systems which primarily suffer from scarcity rather than cost to patient, and AI could help with that.

What part of healthcare provided rote by untrained individuals at the behest of a LLM sounds like a solution to anything?

Re: 'AI' Is Supercharging Our Broken Healthcare System's Worst Tendencies

#142

Post by skohan »

forgetfreeman wrote: post #139
skohan wrote: post #111

Earlier quoted context omitted.

Yes and no. No doubt the medical profession requires talent and rigor, but I think to some extent the hurdles which are placed in front of students who want to become doctors are artificially high to help justify the small number of graduates medical schools put out, which protects the artificially high salaries. For instance, if you read up on the frankly cruel residency process which doctors are forced to clear in…

Yeah I'm not convinced. I've worked adjacent to the healthcare and pharma industries most of my adult life and I can tell you the complexity of the human body beggars belief. You aren't going to run the equivalent of a coding bootcamp for healthcare and get good results.

Not all of medicine is dealing with the full complexity of the human body. A lot of it is applying wrote knowledge to essentially follow a flow-chart to map a set of symptoms and details about the patient to a diagnostic / treatment plan. Doctors are trained to not deviate from medical orthodoxy, and for instance it's been studied that if doctors are told another doctor has already come to a given conclusion about a diagnosis, there is a strong effect that they will confirm the diagnosis even in the face of contravening evidence.

I.e. I don't need "Dr House" to tell me to take 2 and call him in the morning. There is a whole large swath of routine medicine which AI could probably do.

And I am happy if you and your family have been lucky to be blessed with good health and good care, but many people have experienced having a mysterious medical condition, and going to several doctors or waiting months before it can be properly diagnosed. Human medicine is far from perfect.

Re: 'AI' Is Supercharging Our Broken Healthcare System's Worst Tendencies

#143

Post by skohan »

forgetfreeman wrote: post #140
RecycledEle wrote: post #118

Earlier quoted context omitted.

> There aren't but so many households with children that fit inside the venn diagram of can afford med school, has the intellectual capacity and bloody-mindedness to actually finish med school, and is interested in going to med school. That is the artificial scarcity he was referring to. There is no reason to lump all medicine together in a MD degree /certification. Why not have one certification for each common prob…

Why not? Symptom overlap springs to mind. Both anxiety and reflux can present 90% of the common symptoms of a heart attack. Get a reflux specialist when what you needed was a cardiologist and you're fucked. Labor costs also spring to mind. I can only imagine the look on some hospital administrator's face when the proposal to triple headcount comes across their desk.

Presumably you would structure such a medical system such that lower level practitioners would know enough to know when to escalate to an MD.

90% of medicine is stuff like people going to the doctor with the flu to get a sick note to stay home from work and instructions to rest and drink fluids. I don't think you need an MD for that.

Re: 'AI' Is Supercharging Our Broken Healthcare System's Worst Tendencies

#144

Post by tcbawo »

to11mtm wrote: post #84
cmiles74 wrote: post #68

Earlier quoted context omitted.

Right now, the only products I've seen leveraging LLMs are the tools from Nuance[1] that fill in physician notes. Arguably this is not an improvement; physician notes are already an incomprehensible garble of cut-and-paste content (often from other systems).[2] But at least it is unlikely to negatively impact patient care. So far, AFAICT, the drive is to cut costs by saving the time the physician spends with the EHR.…

> The UnitedHealthcare example in this article is interesting in that is was being used in production. OTOH, it sounds much more like something evaluating business rules or some heuristics rather than an LLM or even an ML based solution. I'm fairly certain that at least one insurance company VP out there is using the LLM/ML hype to trumpet what is actually a statistical model evaluation. OTOH if it provides cost savi…

It helps keep doctors treating patients instead of bogged down in documentation and bureaucracy. More time for patients and less stressed-out doctors means better outcomes.

Re: 'AI' Is Supercharging Our Broken Healthcare System's Worst Tendencies

#145

Post by a_gnostic »

What worries me with AI is *garbage-in, garbage-out*. As seen with current year chatbot responses skewered by programmer's politics.

If only Aaron would have succeeded liberating all medical knowledge already in the public domain; Then we could ensure AI's honesty.

Re: 'AI' Is Supercharging Our Broken Healthcare System's Worst Tendencies

#146

Post by snowpid »

LegibleCrimson wrote: post #82
sofixa wrote: post #73

Earlier quoted context omitted.

That's assuming the extremely broken and frankly incomprehensible American model. Over in the EU, where most of the healthcare is single-payer (sometimes with optional add-ons/extra payers/private care), cost of care has been growing too. There are simply many more treatments which are available now than before, more tests possible to discover issues, etc. as well as of course the higher life expectancy and higher av…

I agree 100%. In America the capitalist dream of competition and technological innovation actually driving costs lower for the consumer has mostly just died in almost every category. Any savings are now passed onto a cabal of private equity firms and legislatively-entrenched insurance corporations. Goodhart's Law is in full force, and the measure of business health, profit, has become the target, rather than consumer…

Even that is very American specific. In Germany there is a certain limited competition between health insurances.

Re: 'AI' Is Supercharging Our Broken Healthcare System's Worst Tendencies

#147

Post by zaptheimpaler »

tempodox wrote: post #97
zaptheimpaler wrote: post #30

Alternate headline: "Our Healthcare System continues to deny claims, now with AI". Makes it clearer who the culprit is.. its not AI. They have been denying claims for decades without any help from AI too.

Yes, but if “AI” denies you, humans are suddenly no longer responsible.

The company using the tool is responsible regardless of how the decision is made, same as it is today, for whatever good that does us.

Re: 'AI' Is Supercharging Our Broken Healthcare System's Worst Tendencies

#148

Post by skohan »

forgetfreeman wrote: post #141
skohan wrote: post #107

Earlier quoted context omitted.

The US is not the only country with healthcare needs. There are plenty of developed nations with public health care systems which primarily suffer from scarcity rather than cost to patient, and AI could help with that.

What part of healthcare provided rote by untrained individuals at the behest of a LLM sounds like a solution to anything?

So for example, a treatment plan might look like this:

1. Go to a GP and explain symptoms 2. GP orders some tests based on symptoms 3. GP refers you to a specialist based on test results 4. Specialist orders more tests 5. Specialist analyzes results and orders more tests, or prescribes treatment plan 6. Check in with specialist in weeks or months to evaluate results and update treatment

It seems to me that for many common issues, 1-4 could plausibly be replaced by AI guided care with minor downsides.

If you are normally spending a lot of time waiting between steps for a practitioner to become available, then it's going to be a net win for many people.

Re: 'AI' Is Supercharging Our Broken Healthcare System's Worst Tendencies

#149

Post by dsaavy »

hotnfresh wrote: post #109
dsaavy wrote: post #59

Earlier quoted context omitted.

Yep, and ever since a certain insurance provider has switched to an AI system, I've had nearly all my Type 1 Diabetic prescriptions rejected (that I've had no problem getting for over a decade). Then it takes hours on the phone for every prescription to finally get one approved. Rinse and repeat every 3 months.

We’ve had a flex spending account (HSA wasn’t an option) that we were only putting as much in as we were sure we’d spend, rejecting a very high rate of payments this year, even from doctor’s offices (WTF do you think that’s for?!) and demanding documentation, seemingly with no rhyme or reason. Seems like they’re actively trying to keep us above the roll-over limit so they can steal our money, which isn’t something we…

I agree, sounds like their systems are optimizing based on the roll-over limit.

Basically I'm just going back to cash pay and negotiation for everything either before the visit, or at the facility. Then using alternatives to health insurance for the original purpose of insurance (lol), to cover unexpected events.

Re: 'AI' Is Supercharging Our Broken Healthcare System's Worst Tendencies

#150

Post by johnnyworker »

altairTF wrote: post #115
johnnyworker wrote: post #65

Earlier quoted context omitted.

The gap between rich and poor is growing at increasing pace, just like the gap between rich and mega-rich is. If you went completely hungry yesterday, nearly starved to death, but today you get enough calories that you feel less pain so you can at least stand up and walk around a bit, while you watch your brother stuff his face with so much cake he has to puke 3 times to make room for more, to then play frisbee with…

Do you think rich people should be responsable for others or they have the freedom to get rich and do nothing?

For some people to be extremely rich, others have to be poor. If everybody had a billion it would be the same as if everyone had a dollar.

I think sociopaths should be called out as the dumb fucking sociopaths they are.

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