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Doctors and nurses need to be replaced by computers and robots

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Re: Doctors and nurses need to be replaced by computers and robots

#41

Post by PavlovsCat »

bigchewy wrote: post #37
EGreg wrote: post #7

I hear people saying that medicine can't have doctors be replaced by computers and it's more of an art than a science. I'd like to get more information and see why they think that and if their reasons really hold up. It intuitively seems to me computers can do a better job. Here are a few reasons: 1) When you think about what a doctor does, they use a combination of their memory, experience, knowledge and judgment. 2…

You've hit a minor portion of what a doctor actually does, the differential diagnosis. At my last business (in sleep medicine), we learned that our patients who met their long term respiratory therapist (RT) before their differential diagnosis had a 20% higher adherence rate than patients who met their RT afterwards. Concentrating on the Dx is a common desire of the bay area crowd but the reality is we value human re…

> the reality is we value human relationships

that reminds me of this:

We don’t utilize EMR at the Surgery Center of Oklahoma. Partly due to patient confidentiality concerns. Partly because every operating room I’ve ever been in that has computer capability results in a nurse with her back to the surgeon and patient, typing constantly. Not good patient care, in my humble opinion.

http://032a410.netsolhost.com/WordPress/?p=275

Re: Doctors and nurses need to be replaced by computers and robots

#42

Post by vacri »

EGreg wrote: post #7

I hear people saying that medicine can't have doctors be replaced by computers and it's more of an art than a science. I'd like to get more information and see why they think that and if their reasons really hold up. It intuitively seems to me computers can do a better job. Here are a few reasons: 1) When you think about what a doctor does, they use a combination of their memory, experience, knowledge and judgment. 2…

There's factors you're completely missing. One of the things doctors do is ferret out information that the patient doesn't volunteer - they socially manage the patient to divulge information. Until we have diagnostic computers that can pick up on non-verbal cues and other such nuances, we'll have doctors.

Re: Doctors and nurses need to be replaced by computers and robots

#43

Post by discreteevent »

na85 wrote: post #2

No, they really don't. I'm married to a physician and I can tell you that Medicine is an incredibly nuanced profession, and though doctors and nurses can benefit greatly from computer assistance, they cannot be reliably and safely replaced by computer algorithms. The single data point of Watson diagnosing lung cancer is not enough to generalize over the entire profession and range of ailments. Medicine is a great dea…

I agree. I think this is the same kind of narrow minded mistake that AI made by focusing on getting computers to play chess instead of realising that the hard problem was really building something that could even recognise a single chess piece in different lighting conditions.

A lot of medicine is about perception. Obviously there is a huge amount of physical perception and pattern recognition but also, for example, a brilliant doctor who is not from the same culture as the patient will often miss something vital when taking a history from that patient that a local doctor will pick up straight away. These things are complex and subtle. We need to recognise just how limited technology is if we ever want to really improve it instead of getting too exited about the things it can do.

Re: Doctors and nurses need to be replaced by computers and robots

#44

Post by zarify »

gfodor wrote: post #13

Of course, they won't be replaced anytime soon, but will be augmented via technology, just like the rest of us. Hopefully sooner rather than later. Every field is disrupted by software in the same fashion: massive resistance where practitioners claim the human element is crucial, then of gradual swapping out of manual for automated where it helps, to in the long run largely automated. I see a big parallel here with e…

I'd agree about the parallel with education (I'm a teacher and a number of my family are doctors). Both are fields where the metrics for success (lives/gets better/graduates/etc) come along a road paved with soft skills.

I'm not too interested in getting into (yet) another argument over automating education (or medicine), and I agree with you about the long view on it, but I really do think that it's going to be a lot harder than many people with a "let's solve it with technology!" point of view would like to think (and I came into education with this exact mindset.

Re: Doctors and nurses need to be replaced by computers and robots

#45

Post by ghshephard »

baddox wrote: post #8
na85 wrote: post #2

No, they really don't. I'm married to a physician and I can tell you that Medicine is an incredibly nuanced profession, and though doctors and nurses can benefit greatly from computer assistance, they cannot be reliably and safely replaced by computer algorithms. The single data point of Watson diagnosing lung cancer is not enough to generalize over the entire profession and range of ailments. Medicine is a great dea…

The fact that the discipline is incredibly nuanced is precisely why I want computers doing the heavy lifting, at least when it comes to diagnosis. I find it extremely hard to believe that even the best doctors could come close to touching the accuracy of an expert system. Now, obviously there is still the necessity of a trained and skilled doctor. A doctor should always have the last decision (before the patient, tha…

Interesting you bring up the chest pain scenario. In 2003, when I was 32, I had crippling chest pains, and, simultaneously, (this is what scared the crap out of me) my entire left arm went absolutely numb - I was certain I was going to die of a heart attack, and so I immediately called Kaiser (in hindsight, 911 would have probably made more sense, but I was overly sensitive to calling 911 for anything other than murder in progress, somebody not breathing, or house on fire).

I was patched through to an intake nurse, described my symptoms, and she asked a grand total of three questions:

"Are you having any shortness of breath" "Do you feel any nausea or light headedness" "Can you press your fingernail on your left hand, and tell me how quickly it goes from white to red"

After I answered those three questions (No, No, right away) - she then said, "It probably isn't anything, but we'll want you to come in some time this week" - and set me up for an appointment a couple days later.

Total interaction time - less than 5 minutes, and that was with an intake nurse, not even a doctor.

Clearly, an expert system had done the assessment, and had decided, based on some baysean weighing (32 year old is almost certain not to be having a heart attack) plus a few expert-tree questions, that it wasn't really an emergency.

(As it turned out, I was starting to suffer from some RSI in left arm - Doc made the assessment in 90 seconds of prodding my arm, suggested an ergonomic keyboard and less typing - His analysis of the chest pains were, "Likely stress related, nothing to be worried about.")

BTW - my doctor didn't even suggest x-rays. Just a standard stethoscope/Deep Inhale test. When I asked a physician friend of mine later, why they hand't run any tests, his answer was, "You weren't in pain when you visited, had no trouble breathing, - there were no obvious indications of distress, you are 32 years old - there was very low return on running tests, and doctors (particularly at HMOs) are taught not to engage in "fishing" (testing for the sake of testing)

Re: Doctors and nurses need to be replaced by computers and robots

#47

Post by vacri »

Ha! Nurses need to be replaced by computers and robots? The only mention of 'nurse' in the rant is 'the uniforms carry bacteria'... because a robot wouldn't? Every surface in a hospital carries this stuff. I'd like to see the pricetag on a robot (or range of robots) that can do all the physical skills of a nurse, let alone the social management.

I remember having to hold onto a patient's leg for a nurse to put in a needle in a tiny vein in the foot, as all the others had collapsed. The patient was in an altered conscious state and was moving around - I was keeping the leg relatively still. I'd like to see a robot succeed that task without being explicitly designed for that exact use case. It would be genuinely impressive.

Re: Doctors and nurses need to be replaced by computers and robots

#48

Post by vacri »

Suncho wrote: post #29
jastevenson wrote: post #17

Other posts by this author: "Programmers need to be replaced by computers...no more buggy code!" "Lawyers need to be replaced by computers--no more sleazy ambulance chaser ads!" "Money needs to grow on trees! No more financial problems!"

I know this is sarcasm, but law seems like a great candidate for automation. The law is literally a set of rules. And in the process of automating legal stuff, we might be forced to clean up some existing instances of ambiguity and vagueness. Wouldn't that be nice? Regarding programmers, much of their job already is to replace themselves with computers. Once a task becomes routine, you should automate it. Regarding m…

The law is literally a set of rules.

And when you implement them as a simple set of rules, you end up with ridiculous outcomes. The politicians who make the rules don't (and can't) cater for corner cases. "The law is a hammer, not a scalpel"

Re: Doctors and nurses need to be replaced by computers and robots

#49

Post by [deleted] »

derefr wrote: post #34
na85 wrote: post #20

Earlier quoted context omitted.

>Whether evidence is easy or hard to gather is a red herring. No it's not, it's incredibly relevant. How can you take an evidence-based approach to newborn and infant care when no studies have been done? How do you run studies ethically on infants who can't give consent? Are you willing to subject a baby to an untested delivery procedure, that could potentially go very very wrong, or would you rather stick with the d…

> How can you take an evidence-based approach to newborn and infant care when no studies have been done? What do you call the alternative? And why can't computers be trained to do it, too?

[deleted]

Re: Doctors and nurses need to be replaced by computers and robots

#50

Post by dagw »

eru wrote: post #25
Brakenshire wrote: post #10

Earlier quoted context omitted.

I know there are issues which are specific to the States, but I would say this applies almost everywhere. Almost everywhere doctors are paid 5-10 times the median wage, because they are chosen from the top few percent of students, and that difference in wages introduces an inherent asymmetry in how many hours of work are necessary to buy an hour of a doctor's time. The majority of the population, certainly as people…

Oh, sure, there's an infinite amount of (generalized) health care people might want to consume if the prices are low enough. You can get there either by lowering the pay of health care people, or by making them more productive per humman-hour, eg via automation or just better business practices.

There are two prices of health care I have to pay. One is the up front cash (or monthly insurance) cost I have to pay, the other is the massive time sink and general pain and inconvenience it is to get it.

I live in country where the cash cost is basically zero, yet I consume as little health care as possible due to the high second cost. In fact the times I do need health care I often opt to pay more up front to avoid as much of the second cost as possible.

As long as you keep the second high enough the demand for health care won't go to infinity even as the first cost goes to zero.

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