machado: ai has the power to transform health care for the better. but is losing the human touch too high a price?
6 minute read
a university of arizona study asked this exact question and found that more than half of people wouldn't trust medical advice if it came from an ai-powered doctor. getty
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perfect.
just when i thought i had all of the things i need to worry about covered: kids, cancer, the variable mortgage, the water stain on my ceiling that keeps getting bigger, neck wrinkles, climate change, matching my pay with my dreams … now there’s artificial intelligence (ai).
“that there technology is going to put everyone out of business,” guffawed the grumpy man who sits on his porch every morning (6:30 a.m.!!) sipping a tall can of beer. “we’re not gonna need writers, we’re not gonna need doctors … even that there starbucks with the crappy coffee … (he shook his beer in the direction of the coffee store that almost always had a line poking out the door) some robot will be doing that, too.”
he was sporting a shiny black leg brace, the reward, he explained, for not wearing the right shoes for a long hike along toronto’s don river.
he described the month-long wait for an appointment with his doctor to get his swollen leg looked at, and then, when the pain became too much, the steamy three hours spent in a crowded waiting room of a local walk-in clinic.
“not sure what you’re going to about your job, lady,” he said as he tipped his head back, shaking the can to get the last drop of beer into his mouth. “but i bet that robot coffee is going to taste amazing, and we won’t have to wait for those docs anymore.”
his optimism about the effect of ai on health care was surprising
his optimism about the impact he expects artificial intelligence to have on health care — and well, coffee — was a bit surprising. many of the letters we get here at healthing are a little less exuberant, tinged with concern and worry about all that we stand to lose in a world that relies on technology to go round. from cooling the warm fuzzies of the human touch to the risk of disastrous mistakes, there’s some serious worry out there that ai will change our health-care system — and the treatment we get within it — for the worst. much, much worse.
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it’s worth mentioning that artificial intelligence has been humming in the background of health care for awhile now — it’s not new. ai and health care connected long ago, with robots assisting in surgeries, technology helping pathologists make accurate diagnoses and computerized appointment-bookers streamlining the workload for front line staff in clinics.
it’s also worth noting that we have been ok with it for the most part. after all, it means efficiencies and time-saving both at the front-end of our patient experience, during (with tests and screening), and at the end (when a diagnosis is made). easy peasy.
openness to ai gets sticky when it comes to replacing medical experts
but our openness to the use of ai gets sticky when we consider its potential to fill the shoes of medical experts. imagine staring at your computer screen, rhyming off your health history and symptoms, only to wait mere seconds for a virtual “doctor” to spell out your diagnosis and text you a prescription. would you feel confident that dr. ai nailed it when it came to what ailed you?
the university of arizona studied this exact question and found that, in fact, more than half of people wouldn’t trust medical advice if it came from an ai-powered doctor. the paper, diverse patients attitudes towards artificial intelligence (ai) in diagnosis, published in may, also reported that when given the choice between ai and a human doctor for diagnosis and treatment, 52 per cent of patients preferred the human. the severity of the disease didn’t matter — the researchers used the examples of leukemia versus sleep apnea. also, black participants, those who were older, and those who described themselves as politically conservative or rated religion as being important were also less likely to choose ai over a warm body.
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it got more interesting, though, when the same naysayers were told that their primary doctor considered ai helpful or good. this endorsement pushed the level of acceptance of an ai-powered diagnosis or treatment plan up a notch, a good indication that patients continue to value the involvement of a human in managing their health.
could technology replace doctors?
a similar theme was echoed in a recent report by two professors of strategy from the kellogg school of management at northwestern university, david dranove and craig garthwaite. their work looked at how ai would affect the role of doctors — essentially, could technology one day make them obsolete?
according to dranove, people have a critical need for human interaction in health care which, for now, puts ai on the “sidelines as a complement, rather than a substitute, for doctors.” he talks about the importance of compassion, which ai is “unable to contribute,” suggesting that a human doctor may be more skilled than ai at helping a patient talk about their health and determining their quality of life while living with disease. he even goes so far as to predict that as ai becomes smarter, perhaps this necessary personal touch shifts to a “lower-paid” nurse or physician assistant who can check the compassion box, while still making decisions that are guided by ai. regardless of the messenger, technology won’t completely take the place of a human.
tech strategist azra dhalla agrees. in an interview with reader’s digest best health, she rhymes off the massive potential for ai to improve health care, citing personalized medicine, which would allow us to predict illness; drug discovery, which could help determine different uses for the same drug; and increasing efficiency in our health system by eliminating wait times, supporting staffing and helping to allocate resources to areas that need them the most. but when asked what she thought would not happen as ai meets canada’s health-care system, she said replacing the physician is out of the question.
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“[ai] will augment clinical decision-making, but it won’t replace it,” says dhalla. “it’s more like a virtual second opinion, not meant to override human judgment or expertise.”
for sure, there are areas in health-care that could use a little updating, especially as we come out of a pandemic that pretty much brought our system to its knees. health education and increased efficiency in workflows and patient management? bring it on. certainly, no one would balk at doing whatever it takes to smooth the logistical bumps that pop up in the patient journey. but ai-powered health-care providers that diagnose, treat, and prescribe? our well-being — heck, our lives — counting on the intelligence of a wiry back end? despite the excitement of my beer-drinking neighbour, maybe the rest of us aren’t quite ready for that yet.
imagine ai that diagnoses, treats and prescribes
it doesn’t help that, despite dranove and garthwaite’s impressive list of ai capabilities like data mining to predict the most effective treatments or surgeries, accurate diagnoses and detecting invasive cancer missed by radiologists, there are also justifiable concerns about its reliability, including its tendency to make things up, or “hallucinate.” and in health, these blips can literally mean the difference between life and death.
scary, if you spend too much time thinking about it.
but perhaps with strategies and protocols in place to continuously monitor, evaluate, and measure its effectiveness and accuracy, we can ensure patients are always protected and kept safe, while reaping the benefits of all the good that ai can do.
personally, i believe that humanness is essential to care. it’s what gives us hope, connection while suffering, and a sense that we are being taken care of — authentically and with purpose. do what you want with coffee, but when it comes to quality of life and survival, it’s probably best left in the fleshy hands of living and breathing experts, maybe with just a dash of ai.
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