Can a Computer Replace Your Doctor?

I was looking forward with amusement to reading such an article. Mainly because I realized that all the arguments the doctor would make would come down to decision making. He could pose vague rhetorical questions ("do you treat the MRI or the patient?") but at the end of the day it's about collecting data, analyzing it, making a decision (about diagnosis etc), and informing the patient. All the things that he discusses, therefore, are about justifying a human doing it instead of a computer. A human currently has the advantage in certain "soft" undefinable aspects of decision making, which we can call intuition. But if this is eventually formalized into a algorithm whose performance can be measured and quantified vis a vis human doctor performance, it will be like computer image recognition. In some cases it will be obvious that the computer has erred, but for the majority of cases it will be able to notice things humans don't, because of the sheer amount of collective experience around the world as well as correlations that humans may not have been able to detect.

(I should pause here and note the danger of confirming nontestable theories though, as Karl Popper once wrote, "Once, in 1919, I reported to him a case which to me did not seem particularly Adlerian, but which he found no difficulty in analyzing in terms of his theory of inferiority feelings, Although he had not even seen the child. Slightly shocked, I asked him how he could be so sure. "Because of my thousandfold experience," he replied; whereupon I could not help saying: "And with this new case, I suppose, your experience has become thousand-and-one-fold."" http://www.stephenjaygould.org/ctrl/popper_falsification.htm...)

Go back and look at all the arguments the doctor makes. Once you remove the vague handwaving, you're still left with the basic question: what are you measuring, analyzing and deciding? Can computer aided methods do it better and more accurately, and in the areas they can't, why not, exactly? - and can this be improved? If so, it's a matter of time.

I am not saying a computer can replace a nurse's bedside manner or a doctor's ability to make the final call but computer aided medicine would seem to be as superior to regular medicine as computer aided chessplaying has long been shown to be superior to both grandmasters and computers alone.

Even the maxim he quoted, that doctors should only measure things that may affect the diagnosis or treatment, is a heiristic not unlike the chess heuristics that guide grandmasters' thinking. But how often does a tactical line or particular "hidden" property of a position override that heuristic? And similarly, a computer can help uncover hidden correlations that a simple human rule may miss. After all, medicine thought for millennia that washing hands was just a ritual with no medical benefit until bacteria were discovered.

No.

Betteridge's Law of Headlines states: Any headline that asks a question can be answered with No.

How would improved diagnosis bring down the price of medicine? Medicine doesn't only consist of diagnosis, there's also treatment and infrastructure. It's obvious that any improvement in diagnosis of illness cuts down on misdirected treatment and improves public health, saving money would be a secondary effect.

Besides, the fact that healthcare in the US is so expensive compared to the rest of the Western world is due to political reasons; we know how to bring down the cost of healthcare here without affecting outcomes by doing what the rest of the civilized world does.

Seriously, what is the cause for this in American medicine? Every time I go in for something simple, I have to go through about 3 layers of administrative people before even a nurse practitioner sees me. I'd be really glad if I could interact with a computer-based system in the mean time.

I despise this attitude that people go to the doctor to figure out what is making them sick. Most of time, when people visit general practice doctors, they already know what's wrong with them. But we have to wait hours or days for an appointment, drive through traffic, sit in a waiting room for hours, and pay a bunch of money so that some jerk can spend five minutes typing our symptoms into his laptop.

I get it: they're gatekeepers to prevent people from abusing or misusing medicines. But wouldn't it be better to allow people access to medicine based on objective measurements taken over a long period of time rather than making people interview for it?

When I'm sitting in a waiting room, I'm thinking about what I need to say and do to convince the doctor that I'm sick. If I'm polite and smile is he going to believe me when I tell him I'm in pain? If I don't have a fever is he going to believe I had one two hours ago? I know that he gets paid whether he treats me or not and that he knows every treatment is a potential lawsuit if he makes a mistake. He has every incentive to play it safe and find some reason to avoid treating me.

The other day, I read an article about a woman in Houston. Emergency room doctors avoided treating her for a stroke because her boyfriend mentioned that she has occasionally smoked marijuana. Classifying her as a drug user allowed them to just give her some Zoloft, push her out the door, and collect the check. She'll never be the same again. And this happened in one of the best hospitals in one of the best medical centers in the world. The problem is systemic.