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How to Fix Health

Entry 2286, on 2023-08-17 at 19:00:09 (Rating 3, Comments)

Maybe the most concerning thing about our dysfunctional country (and others) right now is the state of the health system. OK, sure, you could probably argue that the state of education is as bad, and maybe the current status of democracy in general is also a concern, but when it comes to having a direct and immediate effect on people's lives, health might be the biggest problem.

It's difficult to tell from the stats whether this claim is valid, although waiting times, shortages of health professionals, and unaffordable costs are all well documented. But I'm more making this claim based on various individual's experiences. Yes, I know, I often dismiss anecdotes, but in a discussion like this I think they are relevant, and the data seems to back them up as well.

A friend of mine, who is a retired medical professional, has spent a bit of time recently as a patient in this system, and agrees that it is inefficient and frustrating to deal with. During a stay in hospital he couldn't find a doctor to discuss his medical issues with, for example. No doctor? In a hospital?

So the biggest problem seems to be lack of staff. This applies to both the hospital system and general practitioners. We don't seem to be training enough medical professionals, and many that we do train head overseas, especially to Australia, for better pay and conditions.

Additionally the health system is very politicised and the current bunch of muppets we have in government have decided to centralise a lot of the operations in Wellington, at great cost, and apparently while making things even worse.

That's not surprising to me, because I believe the bigger the organisation, the worse it is run, and the less efficient it is (obviously there are exceptions, but I believe there is a clear trend in this direction). Obviously, governments and international organisations, like the UN, are the ultimate manifestation of this bungling incompetence.

So, what's the answer?

Like most jobs, I suspect the majority of a doctor's time is spent on relatively mundane tasks, but there are occasional more complex issues to tackle. Maybe we should try minimising the amount of simple, routine work so they can concentrate on the more complex stuff, but how would we do this?

Well as a technology geek, I unsurprisingly would offer a technological solution: artificial intelligence!

As I have said in previous posts, I have really seen a rapid expansion in the utility of this technology in recent years, and that has meant it is now being used in many places where it wasn't a few years back. It's being used to perform complex tasks in image processing, creating original written text, creating completely artificial new video, helping with search, answering questions in a natural way, and aiding in a variety of other tasks humans have had to tackle on their own in the past.

And this includes tasks in medicine. I've heard the argument that those other functions I listed above are trivial, and that medicine is far more complex, but in my opinion, the complete opposite is true. Sure, you have to remember a lot of facts to be a medical professional, but the level of creativity and complex processing of facts is actually quite low. In fact, to a computer, processing an image or creating an original piece of fiction is far more complex than generating a diagnosis for a disease.

Already AI is performing as well as, or better than humans in various medical tasks, such as analysing test results, x-rays, MRI scans, etc. And I think that diagnosing a medical condition should be far simpler than that. So we could not only allow AI to perform more mundane tasks to free up doctors to do more complex things, but we could possibly replace the doctors completely!

I rarely visit a doctor, because I am strangely healthy, but when I do there are two major things I notice: first, I know what the problem is but can't prescribe what I need to fix it; or second, the doctor gets it wrong. OK, I've got to be honest here: that is probably not an entirely fair appraisal, but my experience with my and other people's interactions with medical professionals is they get it wrong as much as they get it right. I'm always advising people to get a second opinion for diagnoses they see as doubtful.

So I suspect that not only could AI replace doctors, but it would do a far better job at the same time. And remember, an AI can diagnose hundreds of people simultaneously, and is far cheaper to train!

Currently, it is impractical to have an AI controlled machine, like a robot of some sort, take blood samples or perform other tests, so the more mundane tasks could still be done by humans, but they wouldn't need anywhere near the level of training doctors are given now, and it is only a matter of time before machines can take over those tasks as well.

At this point, many people will be feeling a bit uncomfortable about this proposed future, and I fully understand that, but it is a solution to many of our current problems, and looking at the state of health care in the world today, it's hard to see how the outcome could be much worse.

Here are a few details on how this idea might happen...

All doctors would need to train their replacements. That's a standard way to humiliate a workforce which is about to be replaced with something cheaper and/or better, so why not. So they would continue working as the are now, except the systems they type their notes into would be connected to AI systems. Note that this would require no extra work on their part.

The doctor's and the AI's diagnoses would be compared and used to improve the performance of both. When it got to the point that the AI was consistently outperforming the human, then the patient could just feed the AI the information it needs directly, probably through the internet from their homes.

Anything beyond the AI's abilities, tests, etc, could go to the remaining human doctors, but eventually they could go as well. Of course, the test results (blood tests, MRI, etc) would all be examined by AI systems trained in a similar way.

Note that one reasons I avoid doctors is that there tend to be a lot of sick people there. If you aren't too bad before you go to a doctor, there's a good chance you'll catch something from all the sick people waiting to be seen. Also note that it seems standard practice to have to wait 15 to 30 minutes in this environment before seeing the doctor, even when you have organised a specific time. It's almost as if they want you to get sick, but that's just a crazy conspiracy!

This future seems inevitable to me, and the main thing stopping it will probably be medical people trying to protect their jobs and status in society, but that sort of thing never lasts forever.

Note that many other professions could be given similar treatment: lawyers and accountants for example. Ironically, it is the highest paid professions, and those often held in the highest esteem, which might be the easiest to replace. I kind of like that!

Comment 1 (7480) by Jim Cable on 2023-08-17 at 20:02:56:

A friend in Wellington had his prostate removed via robotic surgery. It was successfully completed. I'm told with such procedures it's quite possible for the operating surgeon to be elsewhere - ie. at Auckland for example.

Not quite entirely AI, but it's getting there.

Comment 2 (7481) by OJB on 2023-08-17 at 20:14:12:

Yes, that is a first step, at least. And that sort of technology can produce efficiencies too.

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