Blog | Wednesday, October 10, 2018

Artificial intelligence and medicine, is your doctor obsolete?

I read about artificial intelligence software that can rival high school juniors armed with #2 pencils. The program attacked SAT math questions and performed at the level of a typical 11th grader. The study was too complex for me to grasp. I guess I should ask an 11th grader for assistance. Artificial intelligence is well beyond conventional computational exercises. It can think.

Increasingly, we see functions executed by machines that were formerly performed by living breathing human beings. Examples range from the mundane to the preternatural.
• Order food and drink from an iPad. No server needed.
• Driverless auto travel. This may lead to a resurgence in prayer.
• Pilotless air travel. Hard times ahead for the Airline Pilots Association.
• Making precision tools from 3D printers.
• Gourmet meals created with a voice activated command.
• Theater and film productions starring faux actors created on keyboards.

Will artificial intelligence invade the medical arena? The question is only how deeply it will invade. The role of the traditional physician is at risk of being marginalized as computer software hits the profession hard. Sure, computers cannot palpate an abdomen or perform a rectal exam yet, but they can listen to heart sounds with much greater accuracy than a physician with a stethoscope can. Additionally, as most practicing physicians know, the physical examination is much less useful than the patient's medical history, although our medical school teachers and mentors always preached how critical the physicians' eyes, ears and hands were. Most doctors know what's going on most of the time after carefully listening to the patient's story, the medical history.

I know that sophisticated computer algorithms can synthesize an individual's personal medical data and generate specific diagnoses, many of which might not have been considered by a human physician. Of course, there's a lot more to being a decent physician than spitting out a list of diagnoses, as we doctors know despite when empowered patients bring us lists of diseases they think they have after spending some time in the Google School of Medicine.

Although artificial intelligence is not a real doctor, it offers an incredible tool for the medical profession to serve the public. For example, if a 50-year-old man who has just returned from rural Kenya comes to see me with diarrhea, a 7-pound weight loss, vision change, fever, and a rash, I may not be able to provide an instantaneous diagnosis. If I could plug the patient's profile with his symptoms into a computer program, along with various laboratory features and photograph of the rash and the retina, it might alert me to diagnostic possibilities that are beyond my reach.

Let's say that a machine outperforms me on my medical board certification exam. If you could only see one of us, which of us would you choose?

This post by Michael Kirsch, MD, FACP, appeared at MD Whistleblower. Dr. Kirsch is a full time practicing physician and writer who addresses the joys and challenges of medical practice, including controversies in the doctor-patient relationship, medical ethics and measuring medical quality. When he's not writing, he's performing colonoscopies.