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Demand for human radiologists is at an all-time high

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Re: Demand for human radiologists is at an all-time high

#41

Post by bilbo0s »

addcommitpush wrote: post #26
djoldman wrote: post #10

> Three things explain this. First,... Second, attempts to give models more tasks have run into legal hurdles: regulators and medical insurers so far are reluctant to approve or cover fully autonomous radiology models. Third, even when they do diagnose accurately, models replace only a small share of a radiologist’s job. Human radiologists spend a minority of their time on diagnostics and the majority on other activi…

If they had absolute perfect performance at zero cost, you would not need a radiologist. The current "workflow" is primary care physician (or specialist) -> radiology tech that actually does the measurement thing -> radiologist for interpretation/diagnosis -> primary care physician (or specialist) for treatment. If you have perfect diagnosis, it could be primary care physician (or specialist) -> radiology tech -> ML…

Nope.

To understand why, you would really need to take a good read of the average PCP's malpractice policy.

The policy for a specialist would be even more strict.

You would need to change insurance policies before your workflow was even possible from a liability perspective.

Basically, the insurer wants, "a throat to choke", so to speak. Handing up a model to them isn't going to cut it anymore than handing up Hitachi's awesome new whiz-bang proton therapy machine would. They want their pound of flesh.

Re: Demand for human radiologists is at an all-time high

#42

Post by theOGognf »

vel0city wrote: post #39
djoldman wrote: post #10

> Three things explain this. First,... Second, attempts to give models more tasks have run into legal hurdles: regulators and medical insurers so far are reluctant to approve or cover fully autonomous radiology models. Third, even when they do diagnose accurately, models replace only a small share of a radiologist’s job. Human radiologists spend a minority of their time on diagnostics and the majority on other activi…

As a patient I don't think I've ever even talked to any radiologist that actually analyzed my imaging. Most of the times my family or I have had imaging done the imaging is handled by a tech who just knows how to operate the machines while the actual diagnostic work gets farmed out to remote radiologists who type up an analysis. I don't even think the other doctors I actually see ever directly talk to those radiologi…

No, that is the norm. Radiologists speak with their colleagues the most, and patients rarely

Re: Demand for human radiologists is at an all-time high

#44

Post by catoc »

jonas21 wrote: post #29
lomase wrote: post #5

In 2016, Geoffrey Hinton – computer scientist and Turing Award winner – declared that ‘people should stop training radiologists now’. If we had followed every AI evengelist sugestion the world would have collapsed.

People love to bring this up, and it was a silly thing to say -- particularly since he didn't seem to understand that radiologists only spend a small part of their time reading scans. But he said it in the context of a Q&A session that happened to be recorded. Unless you're a skilled politician who can give answers without actually saying anything, you're going to say silly things once in a while in unscripted settin…

No, this was not an off-hand remark. He made a whole story comparing the profession to the coyote from road runner “they’ve already run of the cliff but don’t even realize it”. It was callous, and showed a total ignorance of the fact that medicine might be more than pixel classification.

Re: Demand for human radiologists is at an all-time high

#45

Post by stonemetal12 »

djoldman wrote: post #10

> Three things explain this. First,... Second, attempts to give models more tasks have run into legal hurdles: regulators and medical insurers so far are reluctant to approve or cover fully autonomous radiology models. Third, even when they do diagnose accurately, models replace only a small share of a radiologist’s job. Human radiologists spend a minority of their time on diagnostics and the majority on other activi…

>Human radiologists spend a minority of their time on diagnostics and the majority on other activities, like talking to patients and fellow clinicians.

How often do they talk to patients? Every time I have ever had an x-ray, I have never talked to a radiologist. Fellow clinicians? Train the xray tech up a bit more.

If the mote is 'talking to people' that is a mote that doesn't need an MD, or at least not a full specialization MD. ML could kill radiologist MD, radiologist could become the job title of a nurse or x-ray tech specialized in talking to people about the output.

Re: Demand for human radiologists is at an all-time high

#47

Post by ralusek »

kstrauser wrote: post #18
maz1b wrote: post #8

As a doctor and full stack engineer, I would never go into radiology or seek further training in it. (obviously) AI is going to augment radiologists first, and eventually, it will start to replace them. And existing radiologists will transition into stuff like interventional radiology or whatever new areas will come into the picture in the future.

What’s your take on pharmacists? To my naive eyes, that seems like a certainty for replacement. What extra value does human judgement bring to their work?

I work on a kiosk (MedifriendRx) which, to some degree "replaces" pharmacists and pharmacy staff.

The kiosk is placed inside of a clinic/hospital setting, and rather than driving to the pharmacy, you pick up your medications at the kiosk.

Pharmacists are currently still very involved in the process, but it's not necessarily for any technical reason. For example, new prescriptions are (by most states' boards of pharmacies) required to have a consultation between a pharmacist and a patient. So the kiosk has to facilitate a video call with a pharmacist using our portal. Mind you, this means the pharmacist could work from home, or could queue up tons of consultations back to back in a way that would allow one pharmacist to do the work of 5-10 working at a pharmacy, but they're still required in the mix.

Another thing we need to do for regulatory purposes is when we're indexing the medication in the kiosk, the kiosk has to capture images of the bottles as they're stocked. After the kiosk applies a patient label, we then have to take another round of images. Once this happens, this will populate in the pharmacist portal, and a pharmacist is required to take a look at both sets of images and approve or reject the container. Again, they're able to do this all very quickly and remotely, but they're still required by law to do this.

TL;DR I make an automated dispensing kiosk that could "replace" pharmacists, but for the time being, they're legally required to be involved at multiple steps in the process. To what degree this is a transitory period while technology establishes a reputation for itself as reliable, and to what degree this is simply a persistent fixture of "cover your ass" that will continue indefinitely, I cannot say.

Re: Demand for human radiologists is at an all-time high

#48

Post by roncesvalles »

djoldman wrote: post #10

> Three things explain this. First,... Second, attempts to give models more tasks have run into legal hurdles: regulators and medical insurers so far are reluctant to approve or cover fully autonomous radiology models. Third, even when they do diagnose accurately, models replace only a small share of a radiologist’s job. Human radiologists spend a minority of their time on diagnostics and the majority on other activi…

I only came to this thread to say that this is completely untrue:

>Human radiologists spend a minority of their time on diagnostics and the majority on other activities, like talking to patients and fellow clinicians.

The vast majority of radiologists do nothing other than: come in (or increasingly, stay at home), sit down at a computer, consume a series of medical images while dictating their findings, and then go home.

If there existed some oracle AI that can always accurately diagnose findings from medical images, this job literally doesn't need to exist. It's the equivalent of a person staring at CCTV footage to keep count of how many people are in a room.

Re: Demand for human radiologists is at an all-time high

#49

Post by matthewdgreen »

tanaros wrote: post #11
simonw wrote: post #3

I wouldn't trust a non-radiologist to safely interpret the results of an AI model for radiology, no matter how well that model performs in benchmarks. Similar to how a model that can do "PhD-level research" is of little use to me if I don't have my own PhD in the topic area it's researching for me, because how am I supposed to analyze a 20 page research report and figure out if it's credible or not?

The notion of “PhD-level research” is too vague to be useful anyways. Is it equivalent to a preprint, a poster, a workshop paper, a conference paper, a journal submission, or a book? Is it expected to pass peer review in a prestigious venue, a mid-tier venue, or simply any venue at all? There’s wildly varying levels of quality among these options, even though they could all reasonably be called “PhD-level research.”

I'm a professor who trains PhDs in cryptography, and I can say that it genuinely does have knowledge equivalent to a PhD student. Unfortunately I've never gotten it to produce a novel result. And occasionally it does frightening stuff, like swapping the + and * in a polynomial evaluation when I ask it to format a LaTeX algorithm.

Re: Demand for human radiologists is at an all-time high

#50

Post by jmhmd »

maz1b wrote: post #8

As a doctor and full stack engineer, I would never go into radiology or seek further training in it. (obviously) AI is going to augment radiologists first, and eventually, it will start to replace them. And existing radiologists will transition into stuff like interventional radiology or whatever new areas will come into the picture in the future.

As a radiologist and full stack engineer, I’m not particularly worried about the profession going away. Changing, yes, but not more so than other medical or non-medical careers.
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