Hi Carrie, I’m a second-year medical student and I’ve been reading Jen Pahlka’s book “Recoding America,” so this stuff is definitely top of mind. Your article struck a chord with me because it framed doctors as being in conflict with EHR.
EHR design and utility has been a special interest of mine after working for the VA, and helping during an EHR transition. I want a future where the EHR, the care team, and the patient are all in concert, together. I agree that physicians need to not just have a hand in these AI tools, but ownership over their design and implementation… as a safety issue!
My question is, in a perfect world, what does that look like to you? How should these tools be integrated? I’m hoping to write about subjects like these, and would love your opinion!
Hi Chris! I am so happy to hear about your interest on this important topic. A few things come to mind 1) Physician tech dividend. Similar to the Alaska’s Permanent Fund Dividend to residents based on oil and mining revenues, 2) Physician contracts with robust IP rights for physician inventors. Many health systems have employment contracts that assign IP you create to them 3) Seat at the IT table. I joined a medical technology incubator years back. I was able to connect with my health system’s decision makers there but unable to make headway as a physician within the system networking through various committees. Health systems should make it easier for physician entrepreneurs to present their ideas.
Love these ideas, thank you for taking the time to respond! I’ll try and spread the word on physician tech dividends among students. As for the seat at the IT table, I’m hopeful I can make some connections over the next few years within this space. It’s been tough! Lot of emails, not a lot of responses.
I can imagine certain specialties will be more affected by AI like radiology, pathology and maybe even dermatology but I really like the bedside manner of the doctors I go to and no AI will replace that for me. I never thought there were intellectual rights for physicians. Actors have the SAG-AFTRA union. Not sure if doctors have one but perhaps that's a viable option.
I think Dr. Mendoza is confused what intellectual property is. Legally protectable IP consists of one of 4 things: a patent (not relevant to an MD's expertise unless s/he invents and patents something, then gets the required regulatory approvals, then figures out how to market it), a copyright (not relevant), a trademark (ditto), or a trade secret (ditto - in particular, it requires keeping it secret!). What she is talking about is that AI in medicine is using the results of MDs actions in the workplace, recorded in medical records that are the property of (in different dimensions) the MD's employer and the patient. To the extent those records get read into an AI, it requires the consent of the relevant owner - but the MD (unless self-employed) doesn't have a claim over them. What do MDs get for their hard work in medical school, residencies, etc? A legally protected monopoly on lots of medical care via licensing boards. There's good evidence that this impedes delivery of medical care in lots of ways and is a crude way to control for quality. So I am unsympathetic to someone who has a legal monopoly on services complaining that she can't charge enough for her services (the claim she's not being compensated).
In fact, I am quite grateful that people are generating profits (which the tone of the piece appears to suggest is suspect) off the data in medical records as that's going to lead to better care for me someday soon. Go profit motive! Sadly, far too many US medical records are not in machine readable format - a lot of data is coming from Israeli medical records, which are all digital. We need more US medical records in digital format and we need more of them in AIs to get all of us better care. The marginal contribution of my data is pretty low, but the total benefit from lots of our data being accessible to AIs is huge. I'll forgo my 2 cents compensation to get better radiology, better diagnosis, better treatment, etc.
As far as MD compensation models needing a "reboot" - she should get out there and be an entrepreneur and reboot them. There are doctors doing this - we've got friends who've opened new practices that don't take insurance (getting rid of a lot of overhead) and see patients for hour long appointments based on annual fee and fees for specific services. Won't work for everyone, but there are people doing this already. Come up with a new model and take some risks! That's what is rewarded in the marketplace if you pull it off. (Physicians aren't trained in "contract negotiation"? You know who is trained in that? Lawyers! Hire one!) But if you aren't and are going to work in the "medical-industrial complex", then you really don't get to complain that you don't like it.
And as far as physicians "requiring their compensation to reflect the profits earned from their work" - it seems to me that this is just a question of negotiating power. Unfortunately for Dr. Mendoza, she's wrong about all the other people in the "medical-industrial complex" being employed by physicians' intellectual property and hard work. Medical care is the joint product of a lot of people -- how about all those researchers (who often actually do have IP!) inventing drugs and devices, figuring out protocols for treatments, creating the products she uses every day in her practice)? And those software engineers making AI products? They are dramatically improving everything from colonoscopies (real time spotting of suspicious places to look with AI assisting the doctor) to radiography (dramatically improved detection of tumors) to the fabulous machine that adjusted my new lenses in my eye after cataract surgery using UV light (I asked the eye doctor how it worked - he said "software, I just aim this at your pupil and the machine does everything else" - an innovation that is protected by dozens of patents). And even the hospital cafeteria worker and cleaning staff are all contributing (MD Anderson has the famous story about how when a janitor was asked what his job was, he replied "I am helping cure cancer" -- he was right! The division of labor in large medical organizations makes the scarce resource of the MD's attention be able to be focused on patients and all those other folks are also critical pieces of the enterprise. Dr. Mendoza's efforts would be far less productive without their contributions.
This didn't make a strong case (other than Hollywood stars have more influence and ego than most). Physicians borrow the intellectual property of others all the time. Most of them don't do the research, develop the guidelines or make the products they use in medicine. They are the end user of a long chain of knowledge production. The rest of what they do is common human decency, which is not even that common in the profession these days. They are subject to incredible forces from administrators, unions, patients, pharmaceutical industry and licensing authorities who threaten them if they start thinking for themselves. While I think the capacity of current AI is overblown, the biggest barrier to its implementation will be doctors, for reasons which have more to do with protecting the cartel than concerns about patient outcomes. It's not only factory workers who resist new technologies which threaten to put them out of work. I've yet to meet a doctor who embraces it in their field, but a non radiologist is of course enthusiastic about AI getting rid of radiologists. Funny that.
AI is only as good as the info created for it to digest and make pontifications ….removed from most any actual hands on. So much of medicine is experience….the actual exam….and who at the high class AI level is going to exam the patient. How many experts I have seen now with minimal exam!….like the new attitude now for MDs/DOs with their DEI certificate in hand and just guess what is going on. Pay for real exams .
You want to be paid according to the value you provide? Get rid of third-party payment for your services, Medicare and private insurance. Let the market decide. That means returning to private practice. We already have unions. They're called medical associations and societies. Work to return them toward advocating for private medicine. As a start, reform Medicare to stop the restriction of private practice, which is the common situation in most other advanced countries.
Interesting take but let's face facts. Medical care is vital while Hollywood and pro sports are pure entertainment. Our society demands and needs medical care but third party payment systems destroyed its value. 4000 dollars for a Super Bowl ticket is happily spent, but 200 bucks for a medical office visit is met with cries of greed.
Wow. As a former professional musician it never dawned on me that there are intellectual rights for clinicians but it sure makes sense. One thing I know from the music world that I’m willing to bet will apply to medicine…AI sucks at real music. There’s no soul. You can tell immediately when music (and I bet art, too) is AI. A doctor with no soul? I’m sure there are a few out there, but I’ve met only one in 60 years of living both as a patient and as a clinician, and that doctor has been stripped of the medical license. So I believe nothing. NOTHING…can compare to the positive spirit of the human element for medicine.
The inevitable decline of traditional occupations is upon us, a process that has been ongoing throughout history. From the farrier to the blacksmith, and even the Columbus Buggy Company, countless jobs have been lost due to technological advancements. This phenomenon brings to mind the Sta Puff Marshmallow Man, a colossal figure that hurdles down the street wiping out what it needs in order to survive.
While I am fortunate to avoid losing my job, I cannot help but feel a sense of trepidation about the profound impact this change will have on our lives. Change is inherently unsettling, and I am still grappling with the disappearance of landlines, the decline of street gatherings for game planning, and the demise of the milkman. Yet, society is compelled to adapt, often with resistance and reluctance.
Fortunately, I will not witness the majority of these changes firsthand. However, I am acutely aware of their impending arrival and the challenges they pose.
The larger concern IMHO is once again the consolidation of something important to human society; medicine. Just imagine how things would have played out differently if these LLM's (Large Learning Models and not actual true AI) had started just 10 years sooner. Covid treatment, especially teh vaccine, would have been railroaded over all b/c instead of having 1.1 million independent thinking physicians we'd have a handful of easily controlled AI's and that should be FAR more concerning to all then compensation. Don't get me wrong, I do believe a valid point is being made about compensation but in comparison it's a distraction.
Consolidation is a very, VERY sharp and dangerous double-edged sword. On one hand it can more easily cut thru a problem to find the cause but on teh flip side it can be used to effectively eliminate any and all challenges to an official government narrative like teh ones Fauci had created around covid. This is how I see this playing out:
1) LLM/AI's are officially adopted for use by physicians after a few years of testing.
2) After a few years of real world use the DB used by these medicine based AI's grows exponentially to where just about anyone with intelligence could be a doctor bc they no longer need to go to Med School, they can just access the AI's.
3) Instead of trying convince/bribe physicians on some topic of debate, like what are the best/most effective treatments for SAR-COVID2, the pharmaceutical industry, which has had a disproportionate impact and control over general medicine for a few generations, targets the union leadership for physicians, convincing all to make use of the AI's mandatory. This means all medical licensing boards now require it. Eventually this goes form requiring the use of these AI's to opt right discouragement of anyone getting actual training b/c this leads to physicians that challenge Big Pharma's decisions, the monetary/profit desires of it's CEO's.
I respect the compensation angle and it is definitely something that needs to be weighed but it is NOT the largest/worst concern rising from the use of these AI's but how they will allow consolidation of effectively all thought on something to do with medicine. You can bet teh farm things like homeopathy will quickly be banned along with ANYTHING that challenges the Pharmaceutical industry. The industry has long been too big for the best interests of humanity it's just that the system has so long been captured, co-opted and controlled that it took something revoluotionary like a Donald Trump + Team to even try to change this.
If you think an industry like the Pharmaceutical industry WON'T try something like this then you're a fool. There is WAY too much $$ at stake for them NOT TO. Technology should always be a tool and not a replacement for humans.
The Pharmaceutical industry might try to get control of the "AI in Medicine" industry, but that doesn't mean it will succeed. Even though the world AI Industry is currently only 14% the size of the world pharmaceutical industry, it is expected to surpass the pharmaceutical industry in size by 2030 {Ok, those figures are from ChatGPT 4.5, but show me your figures if you disagree}.
Also, if LLMs had existed during Covid, I think people would just have had more information. Around June 2021, there were plenty of doctors writing about about the the problems with covid vaccinations, mandates, distancing, and masks, but they were drowned out by the government "consensus" broadcast by the mass media. If you had been able to ask LLMs in summer, 2021, "What are the arguments against covid vaccinations, mandates, distancing, and masks?" . . . they would have listed the arguments of doctors, McCullough, Kory, Bhattacharya, Makary, Redfield, Ladapo, and many others.
You won't see me shed any tears. I'm a programmer and all of our work has been used to train the LLMs. You're not special. They stole from everyone. There is no going back. Personally I can't wait till the AI takes over doctors jobs. I guarantee they will be better in most cases. They certainly will make it cheaper and faster. I lost all respect for doctors during COVID and I will never defend them again. Maybe learn to code.
The response to Covid, by Doctors on the front lines, was our finest hour (from one who was on the front lines, and with 40 years of experience). I can understand the loss of respect towards the arrogant bureaucrats who not only lied to us, while claiming that they "were the science" while censoring open debate to hide their role in the Pandemic.
As far as the role of AI, and those programming it, I have little concern that Doctors will be replaced. I offer the example of AI in the performance of ECG interpretation. This should be one of the simplest tasks for AI - there are limited numbers of variables. Yet, the computer interpretation of a simple 12 lead ECG is, in my opinion, is less than 70% accurate and often misses important conditions while falsely reporting others.
Absolutely correct on the ECG interpretation. The cardiology group I joined in the 1970s contracted with our large community hospital to read ECGs (usually 100 or more daily). These were old style on rolls that we had to unroll and perform measurements. When the single sheet 12 lead with the computer reading came out, our hospital bought it as did most others. But it didn't take long for a few lawsuits based on inaccurate reading to convince the hospital to have us "overread" the computer based diagnosis. The problem is that there are lots of variations on normal and miscellaneous factors such as age, body habitus, and lead placement can affect the ECG. Every few years a new and "improved" system would come out and the hospital would bite on it every time. However, they kept us overreading in order to avoid the expensive lawsuits that resulted from misread tests. Over 40 years time I saw 5 or 6 "new and improved" systems but the amount of correcting we had to do did not change significantly. The fact is that computers cannot replace things that require judgement. Another example I give people who think AI is the answer is computerized bridge. There is so much judgement involved in bidding and playing a hand in bridge that it is impossible for a computer to equal the performance of a competent player.
You embarrassed yourselves and now want to act like heroes. You have no spine. You will never gain my respect again. AI will take doctors jobs. Not all but some for sure. I am excited for that day. At least the AI will listen to me for more than 5 minutes.
You leaned the wrong lessons from the COVID debacle. The physicians and other healthcare workers you meet in the clinic/hospital/office were not the problem. It was the 'doctors' in government (think Fauci) who deserve your distain.
Yeah they deserve it too. Don't pretend you were a good guy though. You lied and pushed masks and vaccines on people. You were happy to go along with it.
Surprising? You know nothing about me or the work I did during the pandemic. Perhaps you should stick to coding, as here you are offering nothing of value.
I'm speaking generally to doctors. Of course I know nothing of you. I don't expect you (or doctors) to learn from this. The younger generations will not defend you. Socialized medicine, regulations, corporate hospitals or any other issues plaguing doctors are for them to fight. I don't care. Will that impact me, probably? I still don't care.
So be it. All the front line doctors were dancing in your Tiktok videos. They happily enforced masks and vaccines. I know this, my wife had a baby during this. They were happy to enforce masks and turn you away if you aren't vaccinated. My child's doctor wouldn't treat us because we refused the vaccine. We weren't welcome there anymore. No doctors were standing up to the bureaucrats. You want the credit now that's over. Sorry you're not getting it.
A few thoughts on AI: like physicians will it’s use be required to be licensed? Second, the biggest issue in our healthcare system is failing on implementation. There is lots of redundancy in research that points out areas of weakness but if we fail to address what quality data shows the system never improves. AI can not fix this, because the issue is a corporate model obstacle. If the solution to what the data shows does not provide a ROI it’s not going to be implemented.
To the extent you’re calling for an increase or re-distribution in compensation to physicians, where does that come from? From the profits of the organization? From the other employees of the organization? From increased fees to the patients?
Even though US medical care cost twice as much as other developed countries, but produces a worse result, I guess she thinks US doctors deserve higher pay.
Physicians need to be re-educated on how to dispense healing, health and healthy living longer. Up to now, they have failed miserably. A/i retards will not make a person any more well or healthy than a doctor because they will both be using the same putrid methods.
Hi Carrie, I’m a second-year medical student and I’ve been reading Jen Pahlka’s book “Recoding America,” so this stuff is definitely top of mind. Your article struck a chord with me because it framed doctors as being in conflict with EHR.
EHR design and utility has been a special interest of mine after working for the VA, and helping during an EHR transition. I want a future where the EHR, the care team, and the patient are all in concert, together. I agree that physicians need to not just have a hand in these AI tools, but ownership over their design and implementation… as a safety issue!
My question is, in a perfect world, what does that look like to you? How should these tools be integrated? I’m hoping to write about subjects like these, and would love your opinion!
Hi Chris! I am so happy to hear about your interest on this important topic. A few things come to mind 1) Physician tech dividend. Similar to the Alaska’s Permanent Fund Dividend to residents based on oil and mining revenues, 2) Physician contracts with robust IP rights for physician inventors. Many health systems have employment contracts that assign IP you create to them 3) Seat at the IT table. I joined a medical technology incubator years back. I was able to connect with my health system’s decision makers there but unable to make headway as a physician within the system networking through various committees. Health systems should make it easier for physician entrepreneurs to present their ideas.
Love these ideas, thank you for taking the time to respond! I’ll try and spread the word on physician tech dividends among students. As for the seat at the IT table, I’m hopeful I can make some connections over the next few years within this space. It’s been tough! Lot of emails, not a lot of responses.
I look forward to your writing!
I can imagine certain specialties will be more affected by AI like radiology, pathology and maybe even dermatology but I really like the bedside manner of the doctors I go to and no AI will replace that for me. I never thought there were intellectual rights for physicians. Actors have the SAG-AFTRA union. Not sure if doctors have one but perhaps that's a viable option.
I think Dr. Mendoza is confused what intellectual property is. Legally protectable IP consists of one of 4 things: a patent (not relevant to an MD's expertise unless s/he invents and patents something, then gets the required regulatory approvals, then figures out how to market it), a copyright (not relevant), a trademark (ditto), or a trade secret (ditto - in particular, it requires keeping it secret!). What she is talking about is that AI in medicine is using the results of MDs actions in the workplace, recorded in medical records that are the property of (in different dimensions) the MD's employer and the patient. To the extent those records get read into an AI, it requires the consent of the relevant owner - but the MD (unless self-employed) doesn't have a claim over them. What do MDs get for their hard work in medical school, residencies, etc? A legally protected monopoly on lots of medical care via licensing boards. There's good evidence that this impedes delivery of medical care in lots of ways and is a crude way to control for quality. So I am unsympathetic to someone who has a legal monopoly on services complaining that she can't charge enough for her services (the claim she's not being compensated).
In fact, I am quite grateful that people are generating profits (which the tone of the piece appears to suggest is suspect) off the data in medical records as that's going to lead to better care for me someday soon. Go profit motive! Sadly, far too many US medical records are not in machine readable format - a lot of data is coming from Israeli medical records, which are all digital. We need more US medical records in digital format and we need more of them in AIs to get all of us better care. The marginal contribution of my data is pretty low, but the total benefit from lots of our data being accessible to AIs is huge. I'll forgo my 2 cents compensation to get better radiology, better diagnosis, better treatment, etc.
As far as MD compensation models needing a "reboot" - she should get out there and be an entrepreneur and reboot them. There are doctors doing this - we've got friends who've opened new practices that don't take insurance (getting rid of a lot of overhead) and see patients for hour long appointments based on annual fee and fees for specific services. Won't work for everyone, but there are people doing this already. Come up with a new model and take some risks! That's what is rewarded in the marketplace if you pull it off. (Physicians aren't trained in "contract negotiation"? You know who is trained in that? Lawyers! Hire one!) But if you aren't and are going to work in the "medical-industrial complex", then you really don't get to complain that you don't like it.
And as far as physicians "requiring their compensation to reflect the profits earned from their work" - it seems to me that this is just a question of negotiating power. Unfortunately for Dr. Mendoza, she's wrong about all the other people in the "medical-industrial complex" being employed by physicians' intellectual property and hard work. Medical care is the joint product of a lot of people -- how about all those researchers (who often actually do have IP!) inventing drugs and devices, figuring out protocols for treatments, creating the products she uses every day in her practice)? And those software engineers making AI products? They are dramatically improving everything from colonoscopies (real time spotting of suspicious places to look with AI assisting the doctor) to radiography (dramatically improved detection of tumors) to the fabulous machine that adjusted my new lenses in my eye after cataract surgery using UV light (I asked the eye doctor how it worked - he said "software, I just aim this at your pupil and the machine does everything else" - an innovation that is protected by dozens of patents). And even the hospital cafeteria worker and cleaning staff are all contributing (MD Anderson has the famous story about how when a janitor was asked what his job was, he replied "I am helping cure cancer" -- he was right! The division of labor in large medical organizations makes the scarce resource of the MD's attention be able to be focused on patients and all those other folks are also critical pieces of the enterprise. Dr. Mendoza's efforts would be far less productive without their contributions.
This didn't make a strong case (other than Hollywood stars have more influence and ego than most). Physicians borrow the intellectual property of others all the time. Most of them don't do the research, develop the guidelines or make the products they use in medicine. They are the end user of a long chain of knowledge production. The rest of what they do is common human decency, which is not even that common in the profession these days. They are subject to incredible forces from administrators, unions, patients, pharmaceutical industry and licensing authorities who threaten them if they start thinking for themselves. While I think the capacity of current AI is overblown, the biggest barrier to its implementation will be doctors, for reasons which have more to do with protecting the cartel than concerns about patient outcomes. It's not only factory workers who resist new technologies which threaten to put them out of work. I've yet to meet a doctor who embraces it in their field, but a non radiologist is of course enthusiastic about AI getting rid of radiologists. Funny that.
AI is only as good as the info created for it to digest and make pontifications ….removed from most any actual hands on. So much of medicine is experience….the actual exam….and who at the high class AI level is going to exam the patient. How many experts I have seen now with minimal exam!….like the new attitude now for MDs/DOs with their DEI certificate in hand and just guess what is going on. Pay for real exams .
Great piece, Dr. Mendoza!
You want to be paid according to the value you provide? Get rid of third-party payment for your services, Medicare and private insurance. Let the market decide. That means returning to private practice. We already have unions. They're called medical associations and societies. Work to return them toward advocating for private medicine. As a start, reform Medicare to stop the restriction of private practice, which is the common situation in most other advanced countries.
A union is the most direct, time tested way forward. Obviously if someone can be more 21st creative, fine. Will AI help us? I'm taking a deep breath.
Interesting take but let's face facts. Medical care is vital while Hollywood and pro sports are pure entertainment. Our society demands and needs medical care but third party payment systems destroyed its value. 4000 dollars for a Super Bowl ticket is happily spent, but 200 bucks for a medical office visit is met with cries of greed.
Wow. As a former professional musician it never dawned on me that there are intellectual rights for clinicians but it sure makes sense. One thing I know from the music world that I’m willing to bet will apply to medicine…AI sucks at real music. There’s no soul. You can tell immediately when music (and I bet art, too) is AI. A doctor with no soul? I’m sure there are a few out there, but I’ve met only one in 60 years of living both as a patient and as a clinician, and that doctor has been stripped of the medical license. So I believe nothing. NOTHING…can compare to the positive spirit of the human element for medicine.
The inevitable decline of traditional occupations is upon us, a process that has been ongoing throughout history. From the farrier to the blacksmith, and even the Columbus Buggy Company, countless jobs have been lost due to technological advancements. This phenomenon brings to mind the Sta Puff Marshmallow Man, a colossal figure that hurdles down the street wiping out what it needs in order to survive.
While I am fortunate to avoid losing my job, I cannot help but feel a sense of trepidation about the profound impact this change will have on our lives. Change is inherently unsettling, and I am still grappling with the disappearance of landlines, the decline of street gatherings for game planning, and the demise of the milkman. Yet, society is compelled to adapt, often with resistance and reluctance.
Fortunately, I will not witness the majority of these changes firsthand. However, I am acutely aware of their impending arrival and the challenges they pose.
The larger concern IMHO is once again the consolidation of something important to human society; medicine. Just imagine how things would have played out differently if these LLM's (Large Learning Models and not actual true AI) had started just 10 years sooner. Covid treatment, especially teh vaccine, would have been railroaded over all b/c instead of having 1.1 million independent thinking physicians we'd have a handful of easily controlled AI's and that should be FAR more concerning to all then compensation. Don't get me wrong, I do believe a valid point is being made about compensation but in comparison it's a distraction.
Consolidation is a very, VERY sharp and dangerous double-edged sword. On one hand it can more easily cut thru a problem to find the cause but on teh flip side it can be used to effectively eliminate any and all challenges to an official government narrative like teh ones Fauci had created around covid. This is how I see this playing out:
1) LLM/AI's are officially adopted for use by physicians after a few years of testing.
2) After a few years of real world use the DB used by these medicine based AI's grows exponentially to where just about anyone with intelligence could be a doctor bc they no longer need to go to Med School, they can just access the AI's.
3) Instead of trying convince/bribe physicians on some topic of debate, like what are the best/most effective treatments for SAR-COVID2, the pharmaceutical industry, which has had a disproportionate impact and control over general medicine for a few generations, targets the union leadership for physicians, convincing all to make use of the AI's mandatory. This means all medical licensing boards now require it. Eventually this goes form requiring the use of these AI's to opt right discouragement of anyone getting actual training b/c this leads to physicians that challenge Big Pharma's decisions, the monetary/profit desires of it's CEO's.
I respect the compensation angle and it is definitely something that needs to be weighed but it is NOT the largest/worst concern rising from the use of these AI's but how they will allow consolidation of effectively all thought on something to do with medicine. You can bet teh farm things like homeopathy will quickly be banned along with ANYTHING that challenges the Pharmaceutical industry. The industry has long been too big for the best interests of humanity it's just that the system has so long been captured, co-opted and controlled that it took something revoluotionary like a Donald Trump + Team to even try to change this.
If you think an industry like the Pharmaceutical industry WON'T try something like this then you're a fool. There is WAY too much $$ at stake for them NOT TO. Technology should always be a tool and not a replacement for humans.
The Pharmaceutical industry might try to get control of the "AI in Medicine" industry, but that doesn't mean it will succeed. Even though the world AI Industry is currently only 14% the size of the world pharmaceutical industry, it is expected to surpass the pharmaceutical industry in size by 2030 {Ok, those figures are from ChatGPT 4.5, but show me your figures if you disagree}.
Also, if LLMs had existed during Covid, I think people would just have had more information. Around June 2021, there were plenty of doctors writing about about the the problems with covid vaccinations, mandates, distancing, and masks, but they were drowned out by the government "consensus" broadcast by the mass media. If you had been able to ask LLMs in summer, 2021, "What are the arguments against covid vaccinations, mandates, distancing, and masks?" . . . they would have listed the arguments of doctors, McCullough, Kory, Bhattacharya, Makary, Redfield, Ladapo, and many others.
You won't see me shed any tears. I'm a programmer and all of our work has been used to train the LLMs. You're not special. They stole from everyone. There is no going back. Personally I can't wait till the AI takes over doctors jobs. I guarantee they will be better in most cases. They certainly will make it cheaper and faster. I lost all respect for doctors during COVID and I will never defend them again. Maybe learn to code.
The response to Covid, by Doctors on the front lines, was our finest hour (from one who was on the front lines, and with 40 years of experience). I can understand the loss of respect towards the arrogant bureaucrats who not only lied to us, while claiming that they "were the science" while censoring open debate to hide their role in the Pandemic.
As far as the role of AI, and those programming it, I have little concern that Doctors will be replaced. I offer the example of AI in the performance of ECG interpretation. This should be one of the simplest tasks for AI - there are limited numbers of variables. Yet, the computer interpretation of a simple 12 lead ECG is, in my opinion, is less than 70% accurate and often misses important conditions while falsely reporting others.
Absolutely correct on the ECG interpretation. The cardiology group I joined in the 1970s contracted with our large community hospital to read ECGs (usually 100 or more daily). These were old style on rolls that we had to unroll and perform measurements. When the single sheet 12 lead with the computer reading came out, our hospital bought it as did most others. But it didn't take long for a few lawsuits based on inaccurate reading to convince the hospital to have us "overread" the computer based diagnosis. The problem is that there are lots of variations on normal and miscellaneous factors such as age, body habitus, and lead placement can affect the ECG. Every few years a new and "improved" system would come out and the hospital would bite on it every time. However, they kept us overreading in order to avoid the expensive lawsuits that resulted from misread tests. Over 40 years time I saw 5 or 6 "new and improved" systems but the amount of correcting we had to do did not change significantly. The fact is that computers cannot replace things that require judgement. Another example I give people who think AI is the answer is computerized bridge. There is so much judgement involved in bidding and playing a hand in bridge that it is impossible for a computer to equal the performance of a competent player.
You embarrassed yourselves and now want to act like heroes. You have no spine. You will never gain my respect again. AI will take doctors jobs. Not all but some for sure. I am excited for that day. At least the AI will listen to me for more than 5 minutes.
You leaned the wrong lessons from the COVID debacle. The physicians and other healthcare workers you meet in the clinic/hospital/office were not the problem. It was the 'doctors' in government (think Fauci) who deserve your distain.
Yeah they deserve it too. Don't pretend you were a good guy though. You lied and pushed masks and vaccines on people. You were happy to go along with it.
Surprising? You know nothing about me or the work I did during the pandemic. Perhaps you should stick to coding, as here you are offering nothing of value.
I'm speaking generally to doctors. Of course I know nothing of you. I don't expect you (or doctors) to learn from this. The younger generations will not defend you. Socialized medicine, regulations, corporate hospitals or any other issues plaguing doctors are for them to fight. I don't care. Will that impact me, probably? I still don't care.
Such a wide blanket you're throwing. Kinda sounds like you're throwing away the baby with the bath water.
So be it. All the front line doctors were dancing in your Tiktok videos. They happily enforced masks and vaccines. I know this, my wife had a baby during this. They were happy to enforce masks and turn you away if you aren't vaccinated. My child's doctor wouldn't treat us because we refused the vaccine. We weren't welcome there anymore. No doctors were standing up to the bureaucrats. You want the credit now that's over. Sorry you're not getting it.
A few thoughts on AI: like physicians will it’s use be required to be licensed? Second, the biggest issue in our healthcare system is failing on implementation. There is lots of redundancy in research that points out areas of weakness but if we fail to address what quality data shows the system never improves. AI can not fix this, because the issue is a corporate model obstacle. If the solution to what the data shows does not provide a ROI it’s not going to be implemented.
To the extent you’re calling for an increase or re-distribution in compensation to physicians, where does that come from? From the profits of the organization? From the other employees of the organization? From increased fees to the patients?
Even though US medical care cost twice as much as other developed countries, but produces a worse result, I guess she thinks US doctors deserve higher pay.
Physicians need to be re-educated on how to dispense healing, health and healthy living longer. Up to now, they have failed miserably. A/i retards will not make a person any more well or healthy than a doctor because they will both be using the same putrid methods.