| Agree that technology enabling better health care delivery is a great thing and still completely under-delivered. But as for technology replacing doctors... I think in general it is misunderstood what doctors actually do... ie that they perform some kind of analysis to produce some kind of output. What they actually do, is take responsibility for the well being of a complete stranger. There are certainly a number of doctors that don't understand this, and have some other kind of agenda like making money, getting through another day etc... but ultimately, a doctor's 'special' role is to take responsibility. This is not really measured or paid for or even expected, but I would say that the success of a healthcare system relates to how much it helps or interferes with this process. People don't really get this, because there are very few jobs like this, and we are used to not having anyone take responsibility for anything. Government and business are masters of diluting responsibility in an ocean of bureaucracy. Accountability/transparency are not a substitute for responsibility either. I don't know how a computer is going to take responsibility for my health, or my child's health. It seems a frankly ridiculous idea to me, like replacing the world's violinists with robots. There is probably a role for a 'computer' to deal with nuisance (as in, currently a nuisance for the person who has to take time off work, go to a medical centre, wait for the doctor) medical problems like routine blood tests, rewriting a script, routine screening. These jobs are already being taken on by non-doctor health practitioners like physician assistants, nurse practitioners. This is a reimbursement issue really, and it can be done because: 1. There is strong evidence base for the activity (eg doing a pap smear for pre-cancerous cervical lesions, or vaccinating a baby). 2. It is easy to measure the success or failure of the outcome (eg the pap smear is done, or not done). 3. There is a very small risk of legal action. (so that the intervention can be indemnified in such a way that it is still economically viable). Much of medicine is not like this however. There is not a clear evidence base. There are not easy to measure outcomes. The consequences when things go wrong can be significant for the patient and the doctor/treating team. Health systems are already ruined by an irrational focus on optimizing the wrong thing eg surgical waiting times, time to hospital discharge, profits, so lets not make the problem worse with technology that is apparently better at the outcome we've decided to apply to the cornucopia of human disease and dysfunction. Disclaimer: I'm a doctor (in Australia). I'm sorry for the waiting times. The truth is, I don't have the skills to invent an adaptive appointment queuing algorithm. Isn't that an engineering problem? edit: clarity |