[danso]

What I would like to see more in these discussions is the possibility of using computers for triage in medicine...too often, these kinds of "will computers replace us" discussions focus on the computers doing everything...but how about a computer being trained to do as much of the "mechanical" work of a doctor's judgment as possible? Leaving the humans to focus on the 5%

An example I have in mind is Apgar's score, an almost stupidly simple index of a newborn's baby health, but a system devised by an anesthesiologist who realized that doctors' traditional method of judgment (check to see if the baby is crying "weakly") left many babies at risk of dying needlessly. http://en.wikipedia.org/wiki/Apgar_score

I think if the profession stopped worrying about "replacing" doctors and rather, augmenting them, I think the discussions would be more beneficial.

[jph00]

Well said. That's pretty much what I'm trying to do with my new startup, Enlitic: http://www.technologyreview.com/news/530261/a-startup-hopes-...

Furthermore, the things the author of the NYT piece complains about are exactly the things that even the simplest machine learning algorithms handle easily. I'm worried articles like this will hold back the adoption of effective analytics in medicine, since doctors have no understanding of modern machine learning technology and as a result make wildly incorrect assumptions about the limitations of our ability to use data to support clinical decisions.

[egwor]

I think that people often miss why people go to doctors in the first place and why they trust them. In society a doctor was historically always a very well respected individual. I think it's worth reflecting on that. Why were they respected? Did it help the patient that they were respected?

Considering the impact of placebo medicines, I can't help but wonder if there's an element of psychology that needs to be noticed and addressed here (and whether it is actually key that a doctor is respected (for the right reasons, obviously. Specifically: that they will be able to address the problem addressed to them)). My hypothesis is that a good doctor is someone who asks the right questions but also looks for questions that need to be asked for that individual's needs. Example: the patient has the symptom of a broken arm, but why is that. Is there something more here? Is there some form of domestic violence involved? Or... do they have a weakness in the opposite arm, and when cycling they are more likely to fall off.

One of my doctor friends said to me that they'd recently shown that the better the Doctor communicates with a patient, the lower the chance of lawsuits. I like to call it 'managing expectations', from the whole project managementy world although someone will shoot me for saying that!

It may well be the case that on paper checklists work best, but I assert that there's a lot more personality and social interaction to a doctor than anyone initially realises. The challenge in this space is marrying the two concepts.

[yummyfajitas]

Doctors are expensive. Computers are cheap. The more we can replace doctors, teachers, taxi drivers and other baumol workers with machines, the more consumer surplus is generated.

[HarryHirsch]

How would improved diagnosis bring down the price of medicine? Medicine doesn't only consist of diagnosis, there's also treatment and infrastructure. It's obvious that any improvement in diagnosis of illness cuts down on misdirected treatment and improves public health, saving money would be a secondary effect.

Besides, the fact that healthcare in the US is so expensive compared to the rest of the Western world is due to political reasons; we know how to bring down the cost of healthcare here without affecting outcomes by doing what the rest of the civilized world does.

[yummyfajitas]

How would improved diagnosis bring down the price of medicine?

I didn't say improved diagnosis would. I said replacing humans with machines would. If the process were 1 hour with a diagnostic bot and 1 hour of treatment with a doctor, that will allow 2 patients to be treated in 2 hours of a doctor's time (increasing supply and reducing price).

Your political baiting is completely orthogonal to the point. If you play politics and tweak the payment system (e.g. adopting India's excellent capitalism-based system), a doctor still spends 1 hour diagnosing and 1 hour treating. 1 patient is treated rather than 2.

[Ygg2]

I don't think that is true, by not paying doctors, teachers, taxi drivers, etc. the less consumers there are.

[yummyfajitas]

http://en.wikipedia.org/wiki/Parable_of_the_broken_window

[jiggy2011]

The surplus provides money for the consumers to spend on other things.

[Ygg2]

Consumers can't consume if they don't have the money. Every time you fire someone and he can't get job for time X, you are reducing overall consumption during that time X.

Instead the money if concentrated in fewer hands and there is an upper limit to what a human can consume (e.g. a single rich person can't eat more than hundred middle class people).

[jiggy2011]

If someone is spending less on healthcare, they will instead direct that money into buying perhaps restaurant meals. More demand for restaurant meals means that prices and profit margins in that industry will go up which will cause more restaurants to open, who will in turn employ more chefs and waiters causing their wages to go up and causing them to buy more things (like healthcare).

[Ygg2]

I don't think healthcare expenditure would have reduced cost, because health is not a negotiable goods.

If anyone becomes permanently unemployable, he will become poor. If there is demand for restaurant meals, prices and profit margins will increase and poorer people will be unable to afford it.

Each person that becomes poor, is another consumer less and the rest of people will become richer. Once you have waiters/chefs that have super high wages, they'll be automated and removed permanently from their job. Repeat until there are only few producers/consumers and the rest are living on a fringe.

[lacus]

Totally agree. Of course there is going to be more backlash if this is described as a "replacement." What's wrong with just offering doctors better tools to do their jobs? We offer them surgical tools, why not software tools? That's a less threatening description...but also a less compelling headline.