[DigDugDude]

Actually, there is widespread use of what are called clinical decision support systems (CDSS). But, one of the primary problems with these systems is they generate a large number of false positives and negatives depending on the context.

You still need a physician/nurse/pharmacist to "hand fly the plane". In my own practice, they have been useful to an extent, but they are light years away from automating away clinicians.

[meltyness]

Medical education is largely qualitative, overwhelming physicians with basically word associations that approximate a top-5 causes and effects for each body system.

Thankfully, I assume most can look things up effectively.

This becomes the route, and I'd argue from my experience as a patient that treatment pathways in those CDSSes bias towards the simplest condition-treatment decision calculus, so you can largely strike

- in depth history

- change over time

- transient conditions not needing treatment

- drug and non-drug treatment combinations

- side effects, long term effects

- therapy duration

- a clear risk benefit analysis

- novel monitoring and feedback mechanisms

Doctors burdened with tremendously ineffective EMR systems will miss these things even presented on a silver platter, and you report that the CDSSes do the same thing.

Even better - how are they constructed? Voting. In the EU care standards go to a congress of sorts, largely if x then y conditional universal facts are slapped onto a document and supposed to be adhered to. Or in the US (God knows how poisoned these are by "interests") guilds of doctors construct detailed decision trees by committee.

That's before we even jam it into some software. It's tough, I understand, but I'm personally a bit inflamed about the matter.

And what of CV/ML-based radiological interpretation? ... similarly, how is it that psychiatry doesn't identify cures?

[DigDugDude]

I appreciate your frustration as a patient. Myself, I am both a patient and a clinician.

I do think you're missing some things about the way things work "behind the curtain", and I was hoping to offer some insight.

I'm not an expert in medical education, but insofar as it is similar to nursing education, a good one is actually taught from "first principles" of anatomy, physiology, chemistry,physics, etc etc, and you diagnose from there with the assistance of heuristics.

To the extent that medical education is qualitative, that is because human beings experience things in very qualitative ways. You're treating patients and not fixing servers.

Hope this helps. Doing medicine is extremely hard, and automating it is an equally difficult task.

You won't have an argument from me about difficult to use EMR systems.