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But the difference is still in the tails. The top 1% is where the money is made in any competitive industry. That is why top tech companies are so obsessed with talent and recruiting. That is harder to automate than the rest.
It can automate the diagnosis process based on some input of symptoms, but other parts harder, like treating. Same for invasive tests and biopsies. Ai will disrupt it in some ways, but I don't think it will lower costs much.
I think you're adopting too much from a programming background when it comes to productivity. 10x programmers are far more common than 10x doctors or lawyers, because it isn't nearly as feasibly to simply automate the gruntwork without hiring more junior docs/lawyers.
I would say that productivity in the vast majority of professions is more along the lines of the Pareto Principle, such that a 80% competent agent can capture a substantial chunk of profits.
And what exactly is so hard about treatment? An AI doctor can write drug charts and have a human nurse dispense them. Invasive tests and biopsies are still further away, but I full believe that the workload of a modal doctor in say, Internal Medicine, can be fully automated today without any drawbacks. The primary bulwark against the tide is simply regulatory inertia and reflexive fear of such unproven advances.
Is there a good AI substitute for clinical examinations at present, or are we going to rely on patients self-examining?
I can honestly buy that in the short-medium term AI would take a better history and get differentials and suggest treatment plans better than the modal doctor. I could even buy that within that timeframe you could train AI to do the inspection parts/things like asterixis, but I don’t know how you’d get an AI to…palpate. Movement and sensation etc. are quite difficult for computers, I am to understand.
Alternatively maybe they’d just get so fucking good at the rest of it that professional examinations aren’t needed anymore, or that some examination findings can be deduced through other visual/etc means…
You'd be rather surprised at how little doctors palpate, auscult etc in practise. They're most used for screening, if there's any notable abnormality they get sent off straight to imagining instead of simply relying on clinical signs as was once common. It certainly plays a role, but with robots with touch sensors, it's hardly impossible to have AI palpate, it's just a skill that's rapidly becoming outmoded.
Oh I know well how doctors don’t do the things they teach us to do in medical school! But it did seem like one thing that they can’t (that easily) but we can (relatively easily), due to it being more of a physical and tactile thing.
That said, I find that I do examine people at least a few times a day.
I agree it’s hardly impossible but I’d be surprised if it wasn’t markedly harder to train?
I didn't realize you were a doctor too, or I'd have elaborated further! For example, humans have fine touch, pressure and proprioception right? That's how we feel a lump below all the subcutaneous tissue.
My Google-fu has failed me, and I can't find the video in question, but over a year or two ago, I saw a demonstration of a robot that's learned to do the same, identify and outline objects through pressure alone without visual imaging.
They took a hard object and embedded it within gel that had the same consistency as human tissue, and then the robot used pressure sensors to accurately identify the foreign object without directly touching or visualizing it.
The only reason we don't see that being done in clinical practise or in robotic surgery is because humans can do it themselves, or because by the time someone ends up on the operating table you don't need to palpate at all anymore. It's not an insurmountable problem!
That’s quite impressive!
That still leaves a few problems with things like kidney ballotment (where there’s kind of a manual dexterity and a proprioception issue, both of which are apparently difficult for computers iirc) or correctly registering tenderness etc, but if robot tactile sensation is already close to there, those seem small potatoes in comparison (esp. if you can get a model to read both the tactile data plus monitor facial expressions etc). Not to mention that such silly techniques like kidney ballotment would probably get phased out with superior robot-powered assessment that can look at a million other things without doing something like that. I’m a convert!
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It's harder to train in the sense that there's less data for grounding. On the other hand, we can cheaply make robot fingertips with superhuman tactile resolution, and if anyone bothered, it'd be easy to train a model (riding on top of some multimodal LM, probably?) on general tactile recognition in reality and simulation, and then finetune it in the clinical setting. This isn't very different from how humans are trained. How many hours of palpation did you do in your life? It's a minor addition to your general manual skill. And even if sample efficiency turns out to be abysmal in comparison, two hundred hands at $1000 a pop, over a year, do not amount to even one American GP's compensation. Granted, proper hands are for now much more expensive, mostly due to small-scale production (which in turn is explained by worthless software), but I expect this to be solved rapidly once Tesla Optimus, 1X and other robots enter the market.
Actually sounds like a cool project for the developing world (@self_made_human, what do you think?). Might even increase the diagnostic value of tactile assessment. Too bad we can't have nice things.
I expect to be (un?)pleasantly surprised, but how well do you think robots (now, or will in the near future) integrate proprioceptive input and movement with tactile data?
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I think your attempt to ping me failed somehow, I had to dig down to find this.
In terms of utility in the 3rd world, I would wager that the reason more investment hasn't been made into tactile medical robotics is because of how redundant palpation etc have become in the modern age of imaging. Back in the day, they simply didn't have anything better, and now, due to both technical advances and fear of litigation, it's only used as a screening tool before actual investigations like xrays or USGs.
I would think in the contexts where you managed to setup a clinic with robots that could do touch assessments, it wouldn't be particularly hard to just have a token human do the same. If such functionality came downstream of other useful things such a bot could do, that might work, but the need for a robot that purely does palpation seems rather limited to me.
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If GPT hallucinates a wrong and deadly treatment, who do you sue for malpractice?
Right now? Nobody, because it's not licensed for medical use and uses massive disclaimers.
In the future when regulators catch up and it's commercially deployed and advertised to that end? Whoever ends up with the liability, most likely the institution operating it.
I see this as a comparatively minor roadblock in the first place.
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