Comments on: The art of medicine and whether computers can replace doctors

By: EHR Scope

EHR Scope — Wed, 28 Jul 2010 12:29:25 +0000

I don’t think any doctor has anything to worry about until robots start passing the turing test. Until then (if it ever happens), human intuition, reasoning, and experience will continue to be invaluable. At the very least, humans will be needed to monitor robots.

Anyways, don’t worry about anything until you start hearing that robots are passing the turing test. At that point everyone’s jobs are in trouble though, so you won’t be lonely!

By: Margalit Gur-Arie

Margalit Gur-Arie — Wed, 28 Jul 2010 04:42:36 +0000

“Please state the nature of the medical emergency;”
Emergency Medical Hologram, U.S.S. Voyager (a century later)

By: jsmith

jsmith — Wed, 28 Jul 2010 00:00:13 +0000

NPs are great for the simple stuff or stuff that they see over and over, but even computerized diagnostic tools required skilled operators, and, crucially, judgment, which is linked to experience and intelligence. Most docs simply have a lot more experience with serious disease than NPs do. And , yes, they usually come from a higher cognitive class. These issues are critical if somewhat nebulous.
Uncomplicated ear infection, give me an NP if there’s no doc available. Heart failure or lymphoma, I want a doctor, at least I can get diagnosed and stabilized. Then, fine, turn me over to the NP for routine follow-up.

By: jsmith

jsmith — Tue, 27 Jul 2010 23:50:30 +0000

Medicine is a personal service profession. Everyone in medicine knows this. All normal people know this. Even a lot of computer-heads know this. Why the long post?

By: HJ

HJ — Tue, 27 Jul 2010 22:48:11 +0000

If a well programmed computer can make a diagnosis, information gathering and compassion can then be supplied by other medical personal. Nurses, lab techs, radiology techs can collect most of the objective information. I find very few doctors have time for counseling and bedside manner stuff.

I often see comments that nurse practitioners are better at the human side of medicine, but lack a depth of education of a doctor. A computerized diagnostic tool would close that knowledge gap, making a NP an attractive, cost effective choice.

By: Dr. Van De Graaff

Dr. Van De Graaff — Tue, 27 Jul 2010 21:17:06 +0000

Jackie,

You’re welcome to use any of this for your grand rounds presentation and I’m flattered by your request. The topic of doctor-patient communication is so voluminous that I’m sure you’ll have plenty to discuss.

Eric VDG

By: Doc99

Doc99 — Tue, 27 Jul 2010 21:12:53 +0000

“I’m a doctor, not an algorithm..”
Leonard “Bones” McCoy, MD

By: Jackie Fox

Jackie Fox — Tue, 27 Jul 2010 19:50:40 +0000

A lot of what you’re describing is compassion, which is not programmable except by whoever you believe may have programmed it into human beings. The art of medicine in large part comes from that compassion and that human spark. On behalf of patients everywhere, I’d like to answer the question of whether computers can replace doctors. The answer is an unequivocal “NO.”

Dr. Van De Graaff, I would be honored if you would consider submitting this for Grand Rounds when I host on August 10th. My theme is doctor-patient communication.

By: anon

anon — Tue, 27 Jul 2010 18:09:50 +0000

reminds me of a short story i read. it was set in the future and in space. the people aboard the ship had a computer for a doctor. one of the people develops appendicitis, only the computer keeping diagnosing food poisoning. if the computer had been told to ignore food poisoning as a possible diagnosis, it would have come up with appendicitis and the computer could have take out the appendix. but alas, no one on the ship had any medical knowledge and the person dies. the flaw in the computer program was that there wasn’t an risk factor analysis. and as flawed as human doctors are, we are looking another person in the eye and can see that it might not be the #1 diagnosis all the time.

By: IVF-MD

IVF-MD — Tue, 27 Jul 2010 17:36:54 +0000

Nice post. You did a good job of asking and answering your own question. It will be a long time before doctors can be fully replaced by machines.

The computer program you described seeks to tackle only one component of doctoring – making the diagnosis. As you pointed out, doctors are not diagnosis machines. In order for machines to replace us, there would have to be a module for gathering data from the history, physical exam and lab tests and spitting out a ranked differential diagnosis list. Granted, this is the subsection of medical practice that is most amenable to computerization at present. Then, there would also have to be a module that does counseling and bedside manner stuff. And another robotics module that can perform surgery. We are nowhere near the capability to do either of the latter two, although it’s my understanding that vision correction surgery is pretty much automated now.