In the age of spiritual machines Ray Kurzweil in 2001 predicted:
By 2020, a $1,000 computer will match processing speed of the human brain — 20 billion calculations per second.
By 2030, it will simulate the brain power of a small village about 1,000 human minds.
By 2048, it will have the brain power of the entire population of the U.S.
I predict that within 20 to 30 years the computer will replace the venerable physician. Computers can already be programmed to detect sarcasm and read emotions. They can study your face and body language. Computerized psychotherapists or cybertherapy is soon to come. Programs can detect deviation from the standard pattern of human physiology, thinking and behavior. We can already program standards of care and integrate it into an electronic health record. The U.S. government program of meaningful use is forcing the adoption electronic health record use in 3 stages by 2017. As always, encouragement is by reward initially, followed by penalty in the later stages.
Now as you sit in a doctor’s office, you are likely yourself talking to yourself rather to your doctor who’s not spending any face to face time with you. He or she is likely staring at a computer screen and typing notes as you speak. Because of physician shortages or need to meet RVU targets (unit measure of patient care), your doctor has 10 to 15 minutes to spend with you. During that time, your doctor has to document all key elements of the visit and check off various measures meaningful use but if you are lucky, a minute will actually be spent on a limited physical exam.
Compare that with the experience you had when you were younger. Decades ago my old family doctor sat in front of me, talked to me and talked with me. He would jot a few notes on paper. I got an examination and a treatment plan. He made me feel as if I had spent a long time with him. I would call that “meaningful.”
As the government, health insurers and hospitals demand greater efficiency, more documentation and of course, error-free care, it is in their best interest to replace us with machines. There will no longer be any medical errors, malpractice will become history, and your doctor won’t be exhausted or troubled with anything so trivial as feelings. Who needs that sort of interaction because you are only here for a service. In the near future, we will be talking to a computer with voice recognition. We won’t miss the warmth of a patient-physician relationship since that will have been bled from our experience and our memory. It would be like the depiction in the movie, Elysium, when Matt Damon talks to a computer rather than a human parole officer with hilarious results.
The human physician will become history. Laying of the hands will be replaced by computerized probing and touch sensitive feelers, not by doctors, but by providers.
I can hardly wait.
Robert Khoo is a surgeon who blogs at Social Media and Surgery.
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