[PartiallyTyped]

See, the more time goes by, the more I prefer robot surgeons and assisted surgeons. The skill of these only improves and will reach a level where the most common robots exceed the 90th, and eventually 95th percentiles.

Do we really want to be in a world where surgeon scarcity is a thing?

[rscho]

What we really want is a world without need for surgery. So, the answer depends on the time frame, I guess ?

[bigmadshoe]

We will always need surgery as long as we exist in the physical world. People fall over and break things.

[rscho]

Bold assumption. I agree regarding the foreseeable future, though.

[bluefirebrand]

It's really not a bold assumption?

Unless we can somehow bio engineer our bodies to heal without needing any external intervention, we're going to need surgery for healthcare purposes

[rscho]

Well, it depends on your definition of 'surgery'. One could well imagine that transplanting your conscience into a new body might well be feasible before we get to live on Mars.

[bluefirebrand]

I am not remotely convinced that "transplanting consciousness" is a thing that is even possible

At best we may eventually be able to copy a consciousness, but that isn't the same thing

[BriggyDwiggs42]

I don’t want to be too confident on something like this, but I feel like consciousness comes somehow from the material body (and surrounding world) in all its complexity, so transplanting consciousness absent transplant of physical material wouldn’t be possible in theory. This assumes it’s a consequence of the structure of things and not something separate, but I think that’s a reasonable guess.

[doubled112]

Where does one find a new body ready for consciousness transplant? Would we grow them in farms like in the Matrix?

[lll-o-lll]

> Do we really want to be in a world where surgeon scarcity is a thing?

Surgeon scarcity is entirely artificial. There are far more capable people than positions.

Do we really want to live in a world where human experts are replaced with automation?

[Calavar]

I used to think this myself in the past, but my opinion has shifted over time.

If a surgeon needs to do X number of cases to become independently competent in a certain type of surgery and we want to graduate Y surgeons per year, then we need at least X * Y patients who require that kind of surgery every year.

At a certain point increasing Y requires you to decrease X and that's going to cut into surgeon quality.

Over time, I've come to appreciate that X * Y is often lower than I thought. There was a thread on reddit earlier this week about how open surgeries for things like gall bladder removal are increasingly rare nowadays, and most general surgeons who trained in the past 15 years don't feel comfortable doing them. So in the rare cases where an open approach is required they rely on their senior partners to step in. What happens when those senior partners retire?

Now some surgeries are important but not urgent, so you can maintain a low double digit number of hyperspecialists serving the entire country and fly patients over to them when needed. But for urgent surgeries where turnaround has to be in a matter of hours to days, you need a certain density of surgeons with the proper expertise across the country and that brings you back to the X * Y problem.

[lll-o-lll]

To summarise your view, more surgeons means not enough experience in a given surgery to maintain base levels of skill.

I think this is wrong; you would need a significant increase, and the issue I was responding to was “shortage”. There’s no prospect of shortages when the pipeline has many more capable people than positions. Here in Australia, a quota system is used, which granted, can forecast wrong (we have a deficit of anaesthetists currently due to the younger generation working fewer hours on average). We don’t need robots from this perspective.

To your second point, “rare surgery”; I can see the point. Even in this case, however, I’d much rather see the robot as a “tool” that a surgeon employs on those occasions, rather than some replacement for an expert.

[Calavar]

"Rare" is an overloaded word, so let me clarify: I asked one of my friends who's a general surgeon, and he estimates he does 1 to 2 open cholecystectomies or appendectomies per year. It falls in an unfortunate gray zone where the cases aren't frequent enough for you to build up skills, but they are frequent enough that you can't just forward all the cases on to one or two experienced surgeons in the area. (They would get incredibly backed up.) And sometimes a case starts laparoscopic and has to be converted to open partway through, so you can't always anticipate in advance that a senior surgeon will need to be available.

I agree that robotic surgery is not a solution for this. We haven't even got L5 long haul trucking yet, so full auto robotic surgery in the real world, as opposed to controlled environments, is probably decades away.

[pixl97]

> I’d much rather see the robot as a “tool” that a surgeon employs on those occasions, rather than some replacement for an expert.

I mean we already have this in the sense of teleoperated robots.

[wizzwizz4]

Have human surgeons cross-train as veterinary surgeons. Instant increase to the maximum X×Y (depending which parts of the practice contribute to competence).

[PartiallyTyped]

We should always have human experts, things can and will go wrong, as they do with humans.

When thinking about everything one goes through to become a surgeon it certainly looks artificial, and the barrier of entry is enormous due to cost of even getting accepted, let alone the studies themselves.

I don’t expect the above to change. So I find that cost to be acceptable and minuscule compared to the cost of losing human lives.

Technology should be an amplifier and extension of our capabilities as humans.

[hkt]

> Excellent question! Would you like to eliminate surgeon scarcity through declining birth rates, or leaving surgical maladies untreated? Those falling within the rubric will be treated much more rapidly in the latter case, while if we maintain a constant supply of surgeons and a diminishing population, eventually surgeon scarcity will cease without recourse to technological solutions!

https://www.youtube.com/watch?v=ATFxVB4JFpQ

[andrepd]

>The skill of these only improve

Citation effing needed. It's taken as an axiom that these systems will keep on improving, even though there's no indication that this is the case.

[tomhow]

> Citation effing needed

Please avoid internet tropes and fulmination on HN.

https://news.ycombinator.com/newsguidelines.html

[kaonwarb]

Most technological capabilities improve relatively monotonically, albeit at highly varying paces. I believe it's a reasonable position to take as the default condition, and burden of proof to the contrary lies on the challenger.

[lll-o-lll]

You are implying linear improvement, which is patently false. The curve bends over.

[kaonwarb]

Linear? Not at all; generally increasing over time, but hardly consistently.

[PartiallyTyped]

Humans can keep improving, we take that as granted, so there is at least one solution to the problem of general intelligence.

Now, robots can be far more precise than humans, in fact, assisted surgeries are becoming far more common, where robots accept large movements and scale them down to far smaller ones, improving the surgeon’s precision.

My axiom is that there is nothing inherently special about humans that can’t be replicated.

It follows then that something that can bypass our own mechanical limitations and can keep improving will exceed us.

[ACCount36]

[flagged]

[tomhow]

Please don't comment like this on HN. We need you to observe the guidelines, particularly these ones:

Be kind. Don't be snarky. Converse curiously; don't cross-examine. Edit out swipes.

When disagreeing, please reply to the argument instead of calling names. "That is idiotic; 1 + 1 is 2, not 3" can be shortened to "1 + 1 is 2, not 3."

Please don't fulminate. Please don't sneer...

Please respond to the strongest plausible interpretation of what someone says, not a weaker one that's easier to criticize. Assume good faith.

https://news.ycombinator.com/newsguidelines.html

[macintux]

I'd recommend reviewing the site guidelines. HN strives for more courteous discussions than you seem to embrace.

[andrepd]

> Are you completely fucking unaware? Do you not realize what kind of world are you living in?

Sure showed me.

Here, some starting material: https://en.wikipedia.org/wiki/Logistic_function. Let me know if you'd like me to elaborate, I will when I have some time.

[ACCount36]

[flagged]

[tomhow]

You can't comment like this on HN and we have to ban accounts that do it repeatedly. This style of commenting is not what HN is for and it destroys what it is for. HN is only a place where people want to participate because other people make an effort to keep the standards up. If you wouldn't mind reviewing https://news.ycombinator.com/newsguidelines.html and taking the intended spirit of the site more to heart, we'd be grateful.