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Robot dentist performs first human procedure

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Re: Robot dentist performs first human procedure

#121

Post by SkyPuncher »

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.

Sure, but it's extremely hard to overcome the hole that medical school and residency puts you into. 4 years of tuition, then 4 years of pitiful wages is a long time. The top, most competitive fields have astronomical wages, but most doctors salary is closer to that of an engineer.

Anecdotally, I'm a software engineer. My wife is a physician. We'll be in our 50's before my wife's career out earns mine. That financial hole of med school and residency is so deep and the salaries on the other side just aren't _that_ much better than other paths. I didn't even pursue FAANG level salaries, either.

That being said, job security and availability is far, far better for my wife. We can basically live anywhere we want and she can find a job.

Re: Robot dentist performs first human procedure

#122

Post by whimsicalism »

rscho wrote: post #120
whimsicalism wrote: post #102

Earlier quoted context omitted.

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 ?

You can find the studies on the recent melanoma classifiers. There are tons showing in various settings that they pretty clearly outperform physicians.

If 'additional mouse clicks' is a major barrier to physicians using a tool that leads to far better diagnosis outcomes of a fast-progressing and deadly disease, I'm not sure why that is an argument for why things should continue to be as physician-gated as they are.

I will happily perform the 30 extra clicks myself if it is my potential melanoma. But if I were to offer it as a self-serve app ($2 for melanoma diagnoses too cheap to meter), I would be thrown in jail.

Re: Robot dentist performs first human procedure

#123

Post by whimsicalism »

15155 wrote: post #44
rscho wrote: post #37

Earlier quoted context omitted.

So, why hasn't it been done yet ?? (I'm a doc, BTW)

Every piece of breakthrough technology you use has followed this process to some degree, it takes time. As with any field, folks are resistant to new ideas and methods. Despite being poorly-organized, the medical field is collectively quite conservative and moves slowly - "first do no harm" is kind of the name of the game.

> Despite being poorly-organized, the medical field is collectively quite conservative and moves slowly - "first do no harm" is kind of the name of the game.

The medical profession seems to hold on too dearly to the action/omission distinction. Preventing life saving tech from becoming prevalent, arguing against challenge trials, advocating against NP responsibility expansion, etc. etc. -- all of these things do tons of measurable harm.

Re: Robot dentist performs first human procedure

#124

Post by SkyPuncher »

loandbehold wrote: post #98
rscho wrote: post #35

Earlier quoted context omitted.

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.

Can you explain why optometrist is necessary to buy glasses? Eye exam is already automated to a large extend, and it shouldn't be hard to make it 100% automated by having machine ask questions instead of optometrist. Optometrist already follows a well defined algorithm to come up with prescription by putting a series of lens pairs in phoroptor and asking patient which one is better.

It's not entirely required. You can go on Zenni (and other online stores) and buy a pair of glasses with whatever correction you want.

Though, I do largely agree that the actual assessment by an optometrist is literally unnecessary. I've personally had to adjust my prescriptions because the optometrist pushes me to something that strains my eyes.

Re: Robot dentist performs first human procedure

#125

Post by onemoresoop »

rurban wrote: post #12

Dental repair is really nothing. Automatic welders are very common e.g. I've worked on automatic brain surgery robots, which really needs to be automatic. because 3d, tricky, and the doctor outside sees much less than the tiny sensors inside. but you can interfere and even invite remote specialists on remote duty to observe or handle the pedals.

> I've worked on automatic brain surgery robots, which really needs to be automatic. because 3d, tricky, and the doctor outside sees much less than the tiny sensors inside. but you can interfere and even invite remote specialists on remote duty to observe or handle the pedals.

Just curious.. Are these fully automatic/autonomous? I assume human supervision is required but are there steps that humans have to choose/decide such that the robot could not possibly work without any human supervision?

Re: Robot dentist performs first human procedure

#126

Post by SkyPuncher »

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?

US supply is artificially limited. There's literally no arguing this. There are essentially a fixed number of residency spots and that's basically the only way to become a physician.

> Do you think most doctors would take less hours for a somewhat lower salary if you it was possible?

It is possible. Lots of doctors work fractionally. It's one of the easiest fields to do it in. Given the artificial shortage, hospitals essentially have to accept it.

The reality is many doctors are simply driven people. They don't really mind the hours, but they do mind the type of work. A lot of it is just terribly unfun.

Re: Robot dentist performs first human procedure

#127

Post by kube-system »

loandbehold wrote: post #98
rscho wrote: post #35

Earlier quoted context omitted.

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.

Can you explain why optometrist is necessary to buy glasses? Eye exam is already automated to a large extend, and it shouldn't be hard to make it 100% automated by having machine ask questions instead of optometrist. Optometrist already follows a well defined algorithm to come up with prescription by putting a series of lens pairs in phoroptor and asking patient which one is better.

An eye exam doesn't simply prescribe lenses. They also, for example, evaluate for disease.

Re: Robot dentist performs first human procedure

#128

Post by SkyPuncher »

analyte123 wrote: post #69
BenFranklin100 wrote: post #26

Earlier quoted context omitted.

The medical establishment also artificially limits the number of doctors in order to keep salaries high. I live in Boston, arguably the top city for medical care in the US, and it is not uncommon to have a six month waiting list to see a specialist. People talk about prescription drugs being the cause of high medical costs in the US, but it’s really the hospitals and doctors that are driving the majority of the costs…

Doctors don't seem to be driving the majority of the costs. After adjusting for inflation, doctors don't make much more than they did in 1984, yet the percentage of GDP spent on healthcare has almost doubled since then (and the real GDP has also doubled in that time). For example, see [1] where a general surgeon made an average of $118,689 in 1984 and a family practitioner $84,256. This would be $358k and $254k in 20…

I can't remember the exact cost, but physician's salary/costs are less than 10% of healthcare spending.

Cutting their salaries in half would have almost no perceivable impact on the cost of care.

Re: Robot dentist performs first human procedure

#129

Post by whimsicalism »

ChumpGPT wrote: post #101
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.

I know very little about the regulatory system but, what is stopping an app to scan your skin via mobile camera to try and determine melanoma. As long as there is a disclaimer to see your physician and this is not medical advice. It would be the same as taking your blood pressure or blood sugar test at home.

The FDA would absolutely not permit that, you cannot just 'disclaimer this is not medical advice' for an actual diagnosis service.

Re: Robot dentist performs first human procedure

#130

Post by rscho »

whimsicalism wrote: post #118
rscho wrote: post #35

Earlier quoted context omitted.

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.

Ah, RCTs! The final truth, the end all of all arguments. I've been working for enough profs to know that the best thing to do with 90%+ medical papers is to transfer them directly to the wastebin, and that includes RCTs.
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