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Robot dentist performs first human procedure

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Re: Robot dentist performs first human procedure

#111

Post by progbits »

ZeroGravitas wrote: post #84
smokel wrote: post #74

Earlier quoted context omitted.

Why do you think that? MRI scanners are still terribly expensive machines, for example. And in most countries, the hourly wage for a dentist need not be high. It is more likely that some robot company is going to make a fortune. Whether other people profit from that is an open question.

There is apparently about to be a revolution in MRI, making them portable and cheap to run. I've only read pop science articles on it but I think the gist is to use software (AI!) to make up for a much weaker magnet.

There are fundamental signal processing limitations. AI will just hallucinate plausibly looking garbage and kill people.

Re: Robot dentist performs first human procedure

#112

Post by Scoundreller »

vkou wrote: post #107
Scoundreller wrote: post #92

Earlier quoted context omitted.

The comparisons between countries is hard because roles, processes and existence of other practitioners will vary a ton. High doctor-per-capita could be a sign of inefficient use of resources rather than being a good thing. Examples: Do you need a prescription for stuff that's otherwise over-the-counter elsewhere? Is over-the-counter stuff paid by (state) insurance if you get a prescription for people that don't valu…

If we're going to talk about inefficient use of resources, maybe we could start with the education requirements. In the US and Canada, doctors spend years getting useless degrees before they are allowed into medical school. In Europe, they somehow get through medical school without them. (Not that any of this would matter because the incentives of the residency system are perfectly set up to make it impossible to tra…

100%. The US/Can approach also limits/compresses the potential career length. Make it ~6 years and out, straight from high school (if you so please). It kinda works like this already in Quebec: you can enter medical school straight out of CEGEP.

It's also a meritocratic matter: you have to take a lot of risk to make a go for medical school, and the best candidates may not be able to afford the risk of failing to achieve their med school goal and ending up with a degree with ??? value, so the best may not take that path.

Or worse, taking an easier degree program (to beef up their grades and have time for other application-enhancing activities) and not getting themselves educated to their full potential.

Re: Robot dentist performs first human procedure

#113

Post by whimsicalism »

vkou wrote: post #107
Scoundreller wrote: post #92

Earlier quoted context omitted.

The comparisons between countries is hard because roles, processes and existence of other practitioners will vary a ton. High doctor-per-capita could be a sign of inefficient use of resources rather than being a good thing. Examples: Do you need a prescription for stuff that's otherwise over-the-counter elsewhere? Is over-the-counter stuff paid by (state) insurance if you get a prescription for people that don't valu…

If we're going to talk about inefficient use of resources, maybe we could start with the education requirements. In the US and Canada, doctors spend years getting useless degrees before they are allowed into medical school. In Europe, they somehow get through medical school without them. (Not that any of this would matter because the incentives of the residency system are perfectly set up to make it impossible to tra…

Hm, guess who lobbies for those education requirements?

Re: Robot dentist performs first human procedure

#114

Post by whimsicalism »

pnut wrote: post #79
ProllyInfamous wrote: post #42

Earlier quoted context omitted.

Myself a med-school-dropout, I've found myself several times telling doctors how I really feel: "You aren't paid enough for the sacrifices you made just to be able to help people that probably aren't going to listen to your advice, anyways ." Thank you for your sacrifices, including to the oncoming ML "clinicians."

Come on, doctors are some of the most highly compensated wage earners. Every working stiff at all income levels sacrifices disproportionately to their income, and if I were a high school teacher, I'd belly laugh at this doctor pity party.

Doctors have such high social standing that you're downvoted for saying the obvious

Re: Robot dentist performs first human procedure

#115

Post by SkyPuncher »

whimsicalism wrote: post #4

It’s going to become increasingly apparent in the US over time the degree to which doctors & the regulatory state are blocking us from getting cheap new care. Already ML algos are more accurate at diagnosing melanomas from an image than dermatologists - but we will never get that tech because doctors are fiercely protective of their salaries and have captured the arm of the state to help them do so.

Physician salaries are less than 10% the cost of healthcare. You could eliminate their salary entirely and it'd have no meaningful difference on the cost of healthcare. There is _absolutely_ an artificial supply limitation, but that's increasingly being worked around by the use of PA and NP providers. Doctors essentially become managers for PA and NPs.

My wife is a physician. Actual, scientific diagnosis is a ridiculously small part of her job.

Most of her time is taken up on "soft problems". Writing notes for continuity/quality of care. Justifying medical decisions for billing purposes. Advocating with insurance and healthcare administrators. Discussing treatment plans and options with patients. More notes. Well, really, most of her time is taken up with notes. It's really the only way for her to capture all of the soft variables.

Writing notes is a bit like coding. LLM/AI can help solve the problem, but ultimately you still need to go through them piece-by-piece to ensure they're correct.

Re: Robot dentist performs first human procedure

#116

Post by syedkarim »

torginus wrote: post #67
rscho wrote: post #54

Earlier quoted context omitted.

Most docs are overworked for many, mostly bad reasons. Clinical overload is one thing, but healthcare is more like drowning in admin work, these days. So mostly yes, but the true answer is more complex than I can write about in a comment.

The US has 26.1 doctors per capita, while Germany has 42.5, which is a middle-of-the-road number for the developed West. Do you accept the criticism that the US simply artificially limits the supply of doctors, which leads to overwork for physicians, and worse health outcomes for patients? Do you think most doctors would take less hours for a somewhat lower salary if you it was possible?

How is a 26.1 per capita calculated? Various unrelated sources state that there are 1.1M physicians (MD and DO) in the US. The US has a population of 360M?

Re: Robot dentist performs first human procedure

#117

Post by pkaye »

d_burfoot wrote: post #71

This is great news. Many people, even in developed countries, suffer a lack of quality dental care because of the cost. Once these devices become widespread, costs should start to drop significantly.

Its not going to be cheaper than training more dentists in those countries.

Re: Robot dentist performs first human procedure

#118

Post by whimsicalism »

rscho wrote: post #35
whimsicalism wrote: post #4

It’s going to become increasingly apparent in the US over time the degree to which doctors & the regulatory state are blocking us from getting cheap new care. Already ML algos are more accurate at diagnosing melanomas from an image than dermatologists - but we will never get that tech because doctors are fiercely protective of their salaries and have captured the arm of the state to help them do so.

Being a doc, I can confidently tell you you are totally incorrect as to why things happen the way they do in healthcare. That won't surprise you, I guess. I long tried to make outsiders, and especially tech people, understand what our job is, but discussions always lead to the same stereotypes.

I would like to see RCTs on whether the current approach of care gatekept by doctors (ie. prescription for glasses, can't use this melanoma diagnosis tool unless you visit and pay for a derma) actually has any measurable impact on downstream health.

It's interesting that we have all these RCTs for drug interventions, but never conduct the RCTs on policy like letting NPs do more procedures, etc.

Re: Robot dentist performs first human procedure

#119

Post by whimsicalism »

SkyPuncher wrote: post #115
whimsicalism wrote: post #4

It’s going to become increasingly apparent in the US over time the degree to which doctors & the regulatory state are blocking us from getting cheap new care. Already ML algos are more accurate at diagnosing melanomas from an image than dermatologists - but we will never get that tech because doctors are fiercely protective of their salaries and have captured the arm of the state to help them do so.

Physician salaries are less than 10% the cost of healthcare. You could eliminate their salary entirely and it'd have no meaningful difference on the cost of healthcare. There is _absolutely_ an artificial supply limitation, but that's increasingly being worked around by the use of PA and NP providers. Doctors essentially become managers for PA and NPs. My wife is a physician. Actual, scientific diagnosis is a ridicul…

Unlike the other comment defending current medical practice, this one I absolutely agree with. I do not think that physician salaries are the major drivers of healthcare cost. I do think that occupational licensing reform would help bring down cost, but agree it is only a relatively small factor.

However I do think that in the process of engaging in wage protectionism (and there is absolutely no question that doctors do this) there is a ton of consumer surplus that is being lost and not captured by either patient or provider. For instance, in the case of the melanoma AI, that is a casualty of the wage protectionism (+ medical conservatism + FDA failure) - the value there isn't being captured by doctors, it is just disappearing into thin air and tons more people will just have undiagnosed melanomas.

Re: Robot dentist performs first human procedure

#120

Post by rscho »

whimsicalism wrote: post #102
rscho wrote: post #58

Earlier quoted context omitted.

In a nutshell, no amount of lobbying will stop equivalent service for 100x cheaper. Tech does not permeate healthcare for 2 reasons: 1. mostly inapplicable. Everyone is focusing on ML model performance, but really information retrieval in healthcare is dismal and prevents the use of such new tech altogether except in very niche cases. 2. no integration in the workplace. Tech people and docs don't understand each othe…

If there are algos out there (and there are) that can accurately provide a strong heuristic on melanoma from a photo and this is being blocked by the state - that seems like an obvious instance of regulatory apparatus stopping an equivalent 100x+ cheaper service. I've discussed with a number of people who work directly on DL for imaging at a major hospital system in Boston. They say that (outside of the doctors they…

Yes, so as usual it's so superior but it's never used. And the people building it say it's stellar, promise! Here's a clue: instead of building a tool, and try teaching people already practicing how and why they should use it, maybe we could actually go see what practitioners are doing and try to integrate into that without requiring 30 additional mouse clicks and the use of a new soft that nobody understands ?
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