The circular debate on 'machines' replacing doctor expertise

[grow_thumb image=”” thumb_width=”150″ /]The Gimlet Eye laments it is not 5pm in NYC quite yet this Monday. In the breathless and hot discussion of one investor’s remarks at Rock Health’s recent Health Innovation Summit, and to some, the very seismic-ness of its meaning, is a fair amount of ‘quantified self’, as in ‘what is the diameter of my navel’.

Will ‘machines’ (really ‘big data’ aggregated and processed into various interfaces) replace doctors? Not anytime real soon (see IBM Watson news). Are some doctors–themselves working on technology, else they would not be there–outraged? Surely and predictably. Does Vinod Khosla, a co-founder of Sun Microsystems who made big money in the 1990s on now-obsolete networking, like to toss bombs into the middle of an otherwise boring sit-down? It’s a spécialité de la maison–Matt Marshall in MedCityNews documents current and past Khosla-lets such as ‘Eventually, we won’t need the doctor” and doctors clinging to ‘voodoo-like practices’. They delight HIT and tech people, plus journos looking for the meaty quote and, most of all, the…

digital health hypesters. As for investors, Khosla has an eponymous fund with investments in two early stage (and not FDA cleared) iPhone attachments/app platforms, AliveCor for heart monitoring and Cellscope for ear infections, so a cynic might say he serves his own aims on a platter.

Even Dr. Eric Topol, no fan of current medicine, initially pronounced Khosla as having ‘gone overboard’ on predicting that 80% of doctors will be replaced by technology. He then walked the criticism back to a modest disagreement with his old friend, repeating his view that since technology will disrupt healthcare, transform the care model and empower consumers to take charge of their health, the expected doctor shortage will simply not happen. Topol says machines will be vital to healthcare transformation (MedCityNews)

Certainly neither AliveCor or Cellscope will have the ultimate big data power of IBM Watson, which is in the 1.0 stage with WellPoint. But if the effectiveness threshold is the 80th percentile of doctor expertise, you will be doing a lot of circular breathing between now and late 2013, when IBM projects that Watson will master oncology. The next stage is a 2.0 mobile platform once big data can be shrunk to be accessible on handhelds, along with voice and image recognition. So while the points well taken are that healthcare is not using technology well and good use will reduce the projected doctor shortage, where it can be used to lure IT investors into the healthcare ka-ching-ring, it’s to the good. But overheated rhetoric, while amusing, will also alienate many of the users who are going to be the ‘boots on the ground’ of that change. On IBM Watson: IBM Envisions Watson as Supercharged Siri for Businesses (Bloomberg). Arguing for the other side: Will Information Technology Squeeze Physicians Out Of Their Central Role In Health Care? (Mind the Gap) Rock Health Video of Health Innovation Summit Khosla session (0:27:29)

2 thoughts on “The circular debate on 'machines' replacing doctor expertise

  1. I’m not in the medical field whatsoever, but I know where this whole thing leads:

    Technology will not make things “easier” on medical practitioners of the future. It will just raise the bar. It will help you do more, and do it better. But that doesn’t mean you can take it easy.

    There will be more that you will be expected to do. There will be more competition. There will be disruption in your business practices.

    It will make the practice of medicine better, but not easier.

  2. Barrett, I don’t know if you saw Dr. Topol’s comments (this was added after initial publication), but I’d think you’d be on the side of those who believe that tech might well be adding to doctor and clinical workload. And that it won’t replace doctors or nurses at all, or ameliorate the expected shortage. 😡

    In this field electronic health records (EHRs) were supposed to do the trick and get rid of paperwork (charts). Instead we now have medical assistants doing transcribing and filling in of written notes in high volume practices–and in others, doctors taking notes when their EHRs slow or go down and spending extra uncompensated hours filling in when systems go back up.

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