Are you sure you can find that many more doctors? That they'll be any good?
Speaking from Romania: here medicine is prestigious. So many parents push their kids towards medicine. There's a glut of newly minted doctors every year, but rumour has it that the quality drops every year. Sure, they pass the exams and residency and what not, but... They're just not into medicine as much.
Do you want to get treated by such a person?
This year I had to go to a neurologist. I went to one locally, they dismissed me in 5 minutes, told me to take some vitamins basically. Went to another one in a much bigger city, they talked to me for an hour, ordered a ton of tests.
Would it help if we get a lot more of the first kind of doctors?
We do have qualified people to do the work of doctors, and they're called nurses. But arbitrary lines are drawn between what they can do and what doctors can do, just to maintain the existing salary structure.
If nurses are to do more of the work of physicians, nursing education needs to drastically change. Nurses are mostly taught the how of nursing and not the why of medicine. If you look at the curricula of DNP programs, which are often touted as a way to get nurses practicing with lots of autonomy in places where they are short on physicians, they're heavy on nonsense nursing theory and light on things that actually matter like pathophysiology and pharmacology.
We actually do have a better model in the form of physician assistants. They're taught the same kinds of things physicians are taught, just in less depth.
That is the kind of thing makes me wonder how much of "things that actually matter like pathophysiology and pharmacology" can be factored out into the automation land now.
AI isn't perfect, but even loosely scaffolded generalist systems show promise in the field of medicine now. And the alternative isn't some hypothetical "perfect healthcare" - the status quo is often closer to "nurses running near the limits of their competence" or "physicians stretched thin almost to the breaking point".
The fundamental problem of healthcare is that it struggles to scale. The need for well educated, well paid professionals is inescapable. Or, was inescapable? We might be at the point where this can start changing.
> That is the kind of thing makes me wonder how much of "things that actually matter like pathophysiology and pharmacology" can be factored out into the automation land now.
I would say not much. AI is still often wrong and a clinician needs to know when the LLM is saying something crazy. I think AI has the most promise for increasing the productivity of well trained professionals, not replacing them (or their training) entirely.
Human clinicians are also "often wrong", for a given definition of "often". "Get a second opinion" didn't originate with AI.
Are AIs wrong more often or less often?
Would the healthcare get better or worse if the "first opinion" was AI more often than not?
"Increasing the productivity" and "replacing them" is two sides of the same coin. If a human can do five times the work, because AI does most of the work and the human performs "exception handling"? You need less humans. And healthcare, historically, is almost always human-constrained. That's why you get insane wait times and overworked clinicians. Most other inputs scale more readily than human expertise.
Thus the impetus to figure out where "human expertise" can be substituted for that of a scalable machine system - and what would be the best ways to implement that.
I was replying to "how much of 'things that actually matter like pathophysiology and pharmacology' can be factored out into the automation land"
I'd argue they aren't being factored into automation land if they're still the responsibility of a human expert, even if there are fewer more productive human experts.
(Though I do think AI will have a role in pathophysiology and pharmacology, initially catching errors, and probably some day taking responsibility, but not soon.)
Yep. I haven’t seen an actual MD in quite some time. Instead my general care provider is a Nurse Practitioner and he’s been handling all my routine healthcare needs.
estearum · · focus · HN ↗
There's no solution other than training a lot, lot, lot, lot more doctors.
Their salaries need to be lower, training needs to be cheaper and faster, and we need a lot more of them.
rolisz · · focus · HN ↗
Speaking from Romania: here medicine is prestigious. So many parents push their kids towards medicine. There's a glut of newly minted doctors every year, but rumour has it that the quality drops every year. Sure, they pass the exams and residency and what not, but... They're just not into medicine as much.
Do you want to get treated by such a person?
This year I had to go to a neurologist. I went to one locally, they dismissed me in 5 minutes, told me to take some vitamins basically. Went to another one in a much bigger city, they talked to me for an hour, ordered a ton of tests.
Would it help if we get a lot more of the first kind of doctors?
postalcoder · · focus · HN ↗
prh8 · · focus · HN ↗
uurrnn · · focus · HN ↗
b38484848 · · focus · HN ↗
[dead]
wl · · focus · HN ↗
We actually do have a better model in the form of physician assistants. They're taught the same kinds of things physicians are taught, just in less depth.
ACCount39 · · focus · HN ↗
AI isn't perfect, but even loosely scaffolded generalist systems show promise in the field of medicine now. And the alternative isn't some hypothetical "perfect healthcare" - the status quo is often closer to "nurses running near the limits of their competence" or "physicians stretched thin almost to the breaking point".
The fundamental problem of healthcare is that it struggles to scale. The need for well educated, well paid professionals is inescapable. Or, was inescapable? We might be at the point where this can start changing.
leereeves · · focus · HN ↗
I would say not much. AI is still often wrong and a clinician needs to know when the LLM is saying something crazy. I think AI has the most promise for increasing the productivity of well trained professionals, not replacing them (or their training) entirely.
ACCount39 · · focus · HN ↗
Are AIs wrong more often or less often?
Would the healthcare get better or worse if the "first opinion" was AI more often than not?
"Increasing the productivity" and "replacing them" is two sides of the same coin. If a human can do five times the work, because AI does most of the work and the human performs "exception handling"? You need less humans. And healthcare, historically, is almost always human-constrained. That's why you get insane wait times and overworked clinicians. Most other inputs scale more readily than human expertise.
Thus the impetus to figure out where "human expertise" can be substituted for that of a scalable machine system - and what would be the best ways to implement that.
leereeves · · focus · HN ↗
I'd argue they aren't being factored into automation land if they're still the responsibility of a human expert, even if there are fewer more productive human experts.
(Though I do think AI will have a role in pathophysiology and pharmacology, initially catching errors, and probably some day taking responsibility, but not soon.)
nkrisc · · focus · HN ↗