41–50 of 55 posts
AI has been used to deny healthcare coverage for generations, we just called it actuarial science
All regulations involving AI just make me wonder how the hell anyone can draw a line between statistics and whatever ""AI"" means in 2024. Getting angry at the moment every time i see "AI" because the terminology is just nonsense to me. Is it just neural networks now?
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All regulations involving AI just make me wonder how the hell anyone can draw a line between statistics and whatever ""AI"" means in 2024. Getting angry at the moment every time i see "AI" because the terminology is just nonsense to me. Is it just neural networks now?
"Statistics" = models with interpretable decision outcomes "AI" = models without It's just a little bit easier to hold someone accountable for a logistic regression with predictive bias than for a neural network with similar issues.
I don’t see how we can use ai and not have it generate new biases. I also feel like biases have been baked into insurance data in a discriminatory way for a long time — think about how much car insurance is for a 16 year old boy.
Yes but consider the alternative - how will we eliminate bias without it? Having worked in medical billing, it is very scary how medicine as an applied science is carrying around a huge ball and chain of “insurance hasn’t figured out that their medical model is decades out of date.” Big, complex, data intensify problems are not going to be solved by an army of humans on legacy ERPs.
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If the US could get costs down to levels of other developed countries, we could approve everything and still afford it. As of now, medical care in the US is about 2x-3x the cost it is in other developed countries.
cost of living though
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Exactly this. Decisions based on statistical models can be fully audited and understood, and the results are reproducible because the algorithm is well documented. The same can't be said of AI models.
I believe it’s possible with decision trees and forests, even though they’re very complex inside, to calculate the contribution that each independent variable made to the final result. Of course, I suppose those haven’t been deemed “AI” for a few years.
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as a med student, those guys are an embarrassment to us all. I had to deal with those guys to get my insurance to cover recombinant antibodies for the treatment of several autoimmune diseases. They haven’t practiced clinically for a decade, haven’t kept up with research ever since they left residency, but still don’t see any problem with denying anything but the cheapest immunosuppressant, no matter how bad the side…
As a med student DROP OUT, I want to encourage you to keep this soul as you slowly enter practice. Oftentimes, the "embarrassment to us all" is just trying to pay his own bills/obligations [not saying this is "correct" — it's not].
There’s a difference between doing an unsavory job to the best of one’s abilities and calling women’s mental health issues "hysterics" and invoking psychosomatics to avoid paying out after someone was badly injured horseback riding and are bedridden due to debilitating neurological disorders following her injuries.
There’s a decidedly difference between being strict, maybe even excessively so, whilst doing a controversial job and systematically being misleading, manipulative and untruthful when confronted with established standards of care.
I fully get having to yield to the way the world works, and i sincerely feel for your view. My parents have basically disowned me and trying to sustain myself through medical school is taking a fat toll on me.
But I’m sorry, but "savying" away any sort of criticism of the conduct of our profession on the basis of "that’s not of the real world works" has it’s limits. Maybe you haven’t been at the receiving end of this sort of ordeal, but i can attest you first hand that this group of physicians, at least here, has issues way beyond having to sustain themselves. Maybe our generation will be different, but the ease of your dismissal is kind of troubling to me.
A few months ago i came across an interview with a physician who worked for one of the online pill mills that sprung up after the US loosened the rules for RXing scheduled substance via telemedicine. He pretty much approved Benzos and Adderall all day. He invoked pretty much the very same argument you have, and I’m sure his situation was everything but easy. The pressures of becoming a US physician are very alien to me, so maybe i just don’t get it. But "well, that’s how the world keeps spinning, grow up kiddo" isn’t a carte blanche for being oblivious to the damage you’re doing. You have sworn or will swear an oath. Being a mercenary liar, misrepresenting medicine for monetary gain is not quite what was implied there. If you don’t see a glaring issue with behaving this way, maybe you should look into an alternative career path.
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As a med student DROP OUT, I want to encourage you to keep this soul as you slowly enter practice. Oftentimes, the "embarrassment to us all" is just trying to pay his own bills/obligations [not saying this is "correct" — it's not].
maybe there are some differences from medical system to medical system, but that’s decidedly not what those characters are over here in Germany. This isn’t a case of student loans going overboard, we have it pretty good in this regard, the physicians working as insurance consultants/experts are almost exclusively retired physicians with decades of clinical practice long behind them. At least over here, if you don’t s…
I'm sorry you perceived my comment this way. It's not a dismissal, rather a charge to maintain your purity.
>The pressures of becoming a US physician are very alien to me, so maybe i just don’t get it.
The US training schedules for physicians are ridiculous, absolutely. I never really "got it," either, which is why I do not practice medicine.
>"well, that’s how the world keeps spinning, grow up kiddo" isn’t a carte blanche for being oblivious to the damage you’re doing
Please consider how this misdirected ANGER resonated with myself, others.
>If you don’t see a glaring issue with behaving this way, maybe you should look into an alternative career path.
I did, having left medical school over a decade ago [I wouldn't have been able to maintain the purity I saw in your above-comment, so I changed professions].
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Best of luck in your studies. I truly hope one day you'll "make it" and be able to help people in the real world.
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Insurers now refuse to release the name of the contracted doctor who made the denial.
That's one way to prevent a malpractice suit I guess. Why doesn't the AMA expel these doctors from its ranks?
As the first of many examples, limiting accredited residency program seats nationwide places an artificial restriction on produced-physicians.
I'm very happy to see increase in ancillary licensure/practice, although I know this just increases "the race to the bottom" which echoes so familiarly in regulatory capture / oligarchy.
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The physician who gives legitimacy to denying coverage at an insurance company is at the very heart of what you're complaining about. As the other poster has pointed out, and many physicians online, they are so out of practice and out of touch they basically say whatever the insurance company wants them to for money.