WEBVTT - SYSK Selects: Will Computers Replace Doctors? 0:00:01.200 --> 0:00:03.720 Hey, everybody, it's me Josh and for this week's s 0:00:03.840 --> 0:00:08.039 Y s K Selex, I've chosen will computers replaced doctors. 0:00:08.680 --> 0:00:11.799 It's an episode so dated I still wore a fitbit 0:00:11.960 --> 0:00:15.320 when we recorded it. No, but seriously, it is a 0:00:15.400 --> 0:00:19.160 really interesting episode. And even though we recorded it years ago, 0:00:19.640 --> 0:00:22.439 the stuff that we're talking about still quite hasn't come 0:00:22.480 --> 0:00:26.120 to fruition. So sit back and enjoy this peek into 0:00:26.120 --> 0:00:33.400 the future. Welcome to Stuff you should know, a production 0:00:33.440 --> 0:00:41.640 of My Heart Radios How Stuff Works. Hey, and welcome 0:00:41.680 --> 0:00:44.879 to the podcast. I'm Josh Clark. There's Charles W. Chuck Bryant, 0:00:44.880 --> 0:00:48.720 our guest producer Noel is here. Yeah, Jerry needs a 0:00:48.720 --> 0:00:53.320 buffer day from her Christmas break. I can't say that again. No, 0:00:53.880 --> 0:00:56.360 she's at home on her buffer day. And the freezing 0:00:56.400 --> 0:01:00.360 cold because we record these somewhat in advance, we are 0:01:00.360 --> 0:01:04.640 in the midst of the polar vortex and um, yeah, 0:01:04.680 --> 0:01:06.440 everyone's just talking about how cold it is. We're back. 0:01:06.480 --> 0:01:09.560 It is our first recording after the holidays. It's literally 0:01:09.600 --> 0:01:12.319 freezing cold up. So welcome back, buddy. Thanks, Welcome back 0:01:12.319 --> 0:01:13.840 to you too. Even though this will be what like 0:01:13.920 --> 0:01:17.200 late January, it will be a balmy sixteen. I think 0:01:17.200 --> 0:01:19.320 the end of the end of January. When is when 0:01:19.319 --> 0:01:21.560 this one comes out? All right, Well, happy New Year 0:01:21.560 --> 0:01:24.080 and happy New Year to YouTube, and happy holidays to you. 0:01:24.200 --> 0:01:28.400 Thanks um Chuck, Yes, sir, you're feeling good. You're loose, 0:01:28.400 --> 0:01:31.280 You're ready. I'm loose. So you see this, you've seen 0:01:31.319 --> 0:01:33.679 this before. Yeah, your Fitbit, My fit bit is that 0:01:33.720 --> 0:01:37.920 buzz marketing. Not really, It's just a really good example. Um. 0:01:38.280 --> 0:01:42.160 I feel like fit Bit. I'm not like necessarily loyal 0:01:42.200 --> 0:01:44.280 to it or anything like that. They don't pay me 0:01:44.319 --> 0:01:48.040 money to mention the podcast. Sometimes I'll just be like, 0:01:48.080 --> 0:01:50.760 stop staring at me. Fit Bit. Yeah, um, but no, 0:01:50.880 --> 0:01:53.520 I like it. I'm happy with it. Um I I 0:01:53.640 --> 0:01:57.960 pointed out though, because it's part of this to me, 0:01:58.120 --> 0:02:00.440 and I don't think it's over confirmation bias. It seems 0:02:00.480 --> 0:02:05.440 like there really is a growing desire among just average 0:02:05.520 --> 0:02:10.919 ordinary people to be able to track there their health, 0:02:11.120 --> 0:02:16.040 their well being, their activity. Um, and to do it easily. Yeah, 0:02:16.120 --> 0:02:18.839 we have tools now that make it like that thing 0:02:19.240 --> 0:02:21.600 super convenient. Yeah, it's in fit It's not the only one. 0:02:21.639 --> 0:02:24.400 There's like Nike fuel Band. There's Jawbone is another really 0:02:24.400 --> 0:02:28.399 good one. There's others like um that track uh, your 0:02:28.520 --> 0:02:32.080 galvanic response, so they're able to put that together with 0:02:32.520 --> 0:02:35.520 respiration and heartbeat and come up with a pretty good 0:02:35.520 --> 0:02:38.160 assessment of how many calories you're burning at any given time, 0:02:38.480 --> 0:02:40.120 which is like kind of a holy grail with this 0:02:40.240 --> 0:02:43.160 kind of thing right now. Um, there's others that track 0:02:43.200 --> 0:02:46.920 your sleep. There's apps out there that let you, um 0:02:47.600 --> 0:02:51.880 track your mood. Um. There's sites like quantified self, which 0:02:51.880 --> 0:02:55.760 are basically like people trying to push wearable technology like 0:02:55.840 --> 0:03:00.000 this further into the future. There's entire websites like share 0:03:00.120 --> 0:03:03.800 care dot com that are dedicated to health information and 0:03:03.880 --> 0:03:08.560 health um uh support yeah, self advocacy, yeah. And and 0:03:08.600 --> 0:03:11.440 there's this It seems to me, this desire to kind 0:03:11.480 --> 0:03:14.720 of say, hey, this is my health, this is my body. 0:03:14.919 --> 0:03:17.360 I want to know more about it, you know, totally 0:03:17.440 --> 0:03:20.639 Like I don't want to necessarily cut out doctors, but 0:03:21.160 --> 0:03:24.440 I I want to decide if I should go to 0:03:25.120 --> 0:03:27.320 the doctor, if it's time or not, and I want 0:03:27.360 --> 0:03:30.640 to use data to do that. Yeah. I imagine I 0:03:30.760 --> 0:03:32.880 frustrate a lot of doctors because I'm one of those 0:03:33.639 --> 0:03:36.600 obnoxious people that goes in and it's like, well, here's 0:03:36.600 --> 0:03:39.880 what I think I have based on my research. There's 0:03:39.960 --> 0:03:42.280 nothing wrong with that. Yeah, that is what you're an 0:03:42.320 --> 0:03:44.920 informed patient. That's true, exactly what you're supposed to do. 0:03:44.920 --> 0:03:47.160 And if you're getting on your doctor's nerves, then go 0:03:47.240 --> 0:03:51.400 see another doctor. Uh yeah, I agree. Actually in search 0:03:51.440 --> 0:03:53.800 of a new GP right now for those because and 0:03:53.920 --> 0:03:57.960 others you got on his nerves. Other reasons too, really 0:03:58.000 --> 0:04:01.480 cold cold hands now like poor bedside manner, never seen 0:04:01.520 --> 0:04:06.880 the doctor Like here's my intern from Emory. Yeah, which great. 0:04:06.920 --> 0:04:09.160 You know. I love them getting experienced, but I would 0:04:09.200 --> 0:04:11.080 like them both to be in there, not just like 0:04:11.600 --> 0:04:14.000 smell you later and the doctor leaves. Well that's another 0:04:14.040 --> 0:04:18.040 thing too. It's kind of like, um, doctor, okay, let's 0:04:18.080 --> 0:04:20.000 let's just lay it on on the table here. What 0:04:20.000 --> 0:04:22.839 what you've just mentioned and what I was talking about, 0:04:22.960 --> 0:04:26.800 if you put it all together. The medical field, physicians 0:04:27.160 --> 0:04:31.160 in particular, are currently in a what's the beginning of 0:04:31.160 --> 0:04:36.000 what's possibly a really pickle of a state for them. 0:04:36.040 --> 0:04:38.640 I think a transition period, yes, but they may be 0:04:38.720 --> 0:04:41.680 transitioned right out of existence in large parts. Yes, I 0:04:41.800 --> 0:04:44.280 may for sure, depending on who you talk to. There's 0:04:44.320 --> 0:04:47.200 like this whole question now, like, what is the future 0:04:47.640 --> 0:04:51.359 of medicine, and more specifically, in the case of this 0:04:51.400 --> 0:04:56.039 episode that we're talking about, do human physicians factor largely 0:04:56.200 --> 0:05:02.040 into that future? And the answer is no, yeah, depending 0:05:02.080 --> 0:05:04.520 on who you ask, Like I said, um, we there's 0:05:04.560 --> 0:05:09.000 this one guy, Dr Kent Bottles, who um, he feels 0:05:09.640 --> 0:05:13.360 that GPS might go the way of the Dodo and 0:05:13.480 --> 0:05:19.200 be replaced by diagnostic computers, maybe with avatars. Then there's 0:05:19.279 --> 0:05:22.600 other people like farhad Manjou is a technical writer, his 0:05:22.640 --> 0:05:25.359 wife as a pathologist. He thinks, no, no, no, the 0:05:25.400 --> 0:05:27.239 GPS are the ones that are going to be in business. 0:05:27.680 --> 0:05:30.120 The specialists are gonna be out of business because computers 0:05:30.120 --> 0:05:33.200 are really good at specializing on one single thing, not 0:05:33.360 --> 0:05:38.000 maybe so good at a general practitioner thing. So there's 0:05:38.040 --> 0:05:40.839 lots of opinions out there on how much they'll be 0:05:40.880 --> 0:05:43.160 replaced and who might be replaced. Right then, as a 0:05:43.200 --> 0:05:47.840 reclient wrote a column who basically he basically said like now, like, 0:05:48.040 --> 0:05:50.920 we we will still need humans, but we mainly need 0:05:51.000 --> 0:05:55.400 humans to communicate to the other humans and facilitate the 0:05:55.400 --> 0:05:57.560 the interaction between the robots and the humans, and we 0:05:57.560 --> 0:06:01.000 already have this. They're called nurses or a nurse practitioners. 0:06:01.400 --> 0:06:03.880 He kind of as reclined, is the one that thought 0:06:03.960 --> 0:06:07.360 that a computer avatar might have a better bedside manner 0:06:07.360 --> 0:06:10.039 than a doctor. Well, let's give that one example. There's this, 0:06:10.279 --> 0:06:12.800 there was there's an example I kept finding while we 0:06:12.800 --> 0:06:14.719 were doing research for this, and it's actually in the 0:06:14.800 --> 0:06:18.839 article on how stuff works. Um, it's uh. There was 0:06:18.880 --> 0:06:22.440 a kiosk, a medical kiosk, during a panel called man 0:06:22.520 --> 0:06:26.279 Made Minds colon Living with Thinking Machines. When there's a 0:06:26.279 --> 0:06:29.479 colon in there, you know it's serious stuff. Um. And 0:06:29.520 --> 0:06:31.360 it was at the World Science Festival in two thousand 0:06:31.360 --> 0:06:36.599 and eleven. And basically, this, this computerized avatar um interacted 0:06:36.640 --> 0:06:41.720 with a woman whose baby had diarrhea, and the woman said, hey, Avatar, 0:06:42.360 --> 0:06:44.479 my baby has diarrhea. What are you going to do 0:06:44.560 --> 0:06:47.680 about it? And the avatar said, well, tell me all 0:06:47.720 --> 0:06:50.520 the symptoms and all this stuff, and avatar decided that 0:06:50.800 --> 0:06:54.799 the baby's diarrhea, while present, wasn't severe enough to warrant 0:06:55.120 --> 0:06:58.120 immediate medical attention, so it went ahead and made an 0:06:58.120 --> 0:07:02.000 appointment with a hue and doctor for later on that week, 0:07:02.560 --> 0:07:06.800 and the mother said that she preferred the treatment by 0:07:06.800 --> 0:07:10.200 the avatar to the real life nurses at the hospitals 0:07:10.400 --> 0:07:13.720 where she lived in New York. Yeah. Uh so it 0:07:13.840 --> 0:07:18.080 is possible to create computers with better bedside manner than say, 0:07:18.120 --> 0:07:21.160 your g P. Well, it's at the very least it 0:07:21.160 --> 0:07:23.240 will be consistent. And that's one of the things that 0:07:24.120 --> 0:07:27.160 I'm not poopooing. Doctors or nurses are many, many, many, 0:07:27.200 --> 0:07:29.560 many great ones, but I've also had some pretty bad 0:07:29.560 --> 0:07:33.080 experiences in emergency rooms and with doctors and nurses. With 0:07:33.120 --> 0:07:36.200 a computer, at least it's a consistent you know, their 0:07:36.280 --> 0:07:40.920 program to display empathy no matter what. You know, they're 0:07:40.960 --> 0:07:43.000 not too busy and they're not, you know, having a 0:07:43.040 --> 0:07:46.560 bad day, so they don't you know, they don't have 0:07:46.600 --> 0:07:50.520 any prejudices against you personally or anything like that. Their computer. 0:07:50.680 --> 0:07:55.920 They don't hate diarrhea. But humans, humans respond to even 0:07:55.960 --> 0:08:01.000 programmed empathy, even synthetic empathy from a a computer. I 0:08:01.040 --> 0:08:05.440 could see that a little bit. Like I've dove into 0:08:05.480 --> 0:08:10.000 the gaming world enough to know that, you know, the 0:08:10.040 --> 0:08:14.240 realism of a of a avatar can be convincing, and 0:08:14.280 --> 0:08:15.840 it's not like you think, oh, it's a real person, 0:08:15.880 --> 0:08:17.720 but it helps to put a human face on it, 0:08:17.760 --> 0:08:22.040 you know, exactly. Literally, Um, they I saw a reference 0:08:22.080 --> 0:08:25.400 to a study that found um, people who are being 0:08:25.440 --> 0:08:30.720 treated for anxiety disorders tended to share more about their 0:08:30.760 --> 0:08:35.880 experiences and themselves with an avatar them with a human psychiatrists. 0:08:36.000 --> 0:08:39.760 Oh that's interesting because they're like not embarrassed to tell 0:08:39.800 --> 0:08:41.920 a real person. Yeah, that makes sense, I might open 0:08:42.000 --> 0:08:44.240 up more to to a computer. Right, So so we've 0:08:44.240 --> 0:08:47.120 got that part, like the bedside manner. It is possible 0:08:47.360 --> 0:08:50.400 that we can create machines now and are creating machines 0:08:50.440 --> 0:08:54.400 now that have at least equal, if not better bedside 0:08:54.440 --> 0:08:58.400 manner than some physicians. Yeah, okay, so bedside manner one 0:08:58.440 --> 0:09:00.360 of the big things that doctors bring to the table. 0:09:00.640 --> 0:09:04.480 Check computers have that. Yeah, it's it's different now than 0:09:04.520 --> 0:09:06.920 it was in the old days. I feel like just 0:09:07.000 --> 0:09:10.559 the whole quality of personal care is gone down. It's 0:09:10.600 --> 0:09:13.080 not necessarily the doctor's falter. There's a lot of reasons 0:09:13.120 --> 0:09:15.160 to place the blame. But it's not like when you 0:09:15.200 --> 0:09:16.600 were a kid and you feel like you had your 0:09:16.880 --> 0:09:20.320 family doctor who knew you, maybe even gave birth birth 0:09:21.400 --> 0:09:27.000 you're my son exactly. Um, it just invested like you 0:09:27.000 --> 0:09:28.679 gotta stick with the same doctor if you want that 0:09:28.760 --> 0:09:31.040 kind of care, I think, right. And there's another benefit 0:09:31.080 --> 0:09:35.240 besides bedside banner UM that comes with that that kind 0:09:35.280 --> 0:09:38.160 of care, that kind of personal care is an awareness 0:09:38.320 --> 0:09:42.079 of your medical history. Yeah, not just that, but oh well, 0:09:42.160 --> 0:09:46.400 your dad died of congenital heart disorders like that, so 0:09:46.760 --> 0:09:48.840 you may be at higher risk of it. To just 0:09:48.920 --> 0:09:53.040 that kind of awareness has been typically lost to even 0:09:53.080 --> 0:09:54.960 though we have medical histories and they're in our charts 0:09:54.960 --> 0:09:58.080 that they're in our files UM, and intimate knowledge of 0:09:58.840 --> 0:10:04.200 a patients UM medical history is pretty much lost in 0:10:04.280 --> 0:10:08.640 today's modern practice of medicine. Yeah. UM. That's another thing 0:10:08.720 --> 0:10:14.840 that that computers could conceivably top doctors on UM, which 0:10:14.880 --> 0:10:19.400 basically falls under the umbrella of diagnosis or diagnostics. Yeah. 0:10:19.400 --> 0:10:21.920 I mean there's two two sides to this. There's diagnoses 0:10:21.960 --> 0:10:26.360 and treatment and some UH programs. A little bit of 0:10:26.400 --> 0:10:30.360 the history this UM goes back to the nineteen seventies. 0:10:30.559 --> 0:10:36.080 At the University of Pittsburgh, they develop software to diagnose problems. UM. 0:10:36.240 --> 0:10:39.080 MASS General since the eighties has been working on their 0:10:39.160 --> 0:10:45.160 d X plan, which provides ranked list of diagnoses. Whereas 0:10:45.240 --> 0:10:49.320 the what's the computer the M Watson Watson who who 0:10:49.360 --> 0:10:52.400 won at jeopardy. Yeah, that's more based. Um, it looks 0:10:52.440 --> 0:10:56.720 like on treatment options than diagnosis at this point. So 0:10:56.760 --> 0:10:59.160 they're using these well yeah, but they said it's not 0:10:59.280 --> 0:11:01.079 they haven't. I don't think they want to leave it 0:11:01.120 --> 0:11:03.960 alone with diagnosis yet. No, and to do its thing. 0:11:04.160 --> 0:11:08.640 There's already something out there for diagnosis that's meant to 0:11:08.920 --> 0:11:14.400 support physicians. From what I understand with Watson, if there 0:11:14.440 --> 0:11:19.000 is a doctor of the future, it's Watson. Um. He 0:11:19.080 --> 0:11:22.520 has a lot of advantages over not just um human doctors, 0:11:22.600 --> 0:11:28.920 but other artificial intelligence healthcare machines. I guess you could 0:11:29.280 --> 0:11:33.280 clumsily call it. He has a knack for natural language. 0:11:33.840 --> 0:11:39.560 So let's say there's like a structured formula or formulaic 0:11:39.960 --> 0:11:47.280 type of language that the medical field is supposed to use, right, yes, okay, Um, 0:11:47.320 --> 0:11:51.520 health records don't always necessarily contain that language. They might 0:11:51.520 --> 0:11:55.800 contain natural language, which is really confusing for computers to 0:11:55.880 --> 0:11:59.960 take in an absorb. Yeah, you know, the humans can 0:12:00.120 --> 0:12:03.320 pick up on meanings of things that robots and and 0:12:03.640 --> 0:12:08.520 software cannot, like inferences, and we might be using sarcasm, 0:12:08.600 --> 0:12:10.960 although there's probably not going to be any sarcasm in 0:12:11.000 --> 0:12:13.880 your medical records. Yeah, but like figurative language and stuff 0:12:13.880 --> 0:12:16.360 like that, but computers a language is a big part 0:12:16.400 --> 0:12:20.040 of the problem. Or more to the point, with the diagnosis, 0:12:20.120 --> 0:12:22.640 patient says he feels like he has a hive of 0:12:22.720 --> 0:12:27.120 bees in his stomach, Like that might mean something that 0:12:27.120 --> 0:12:30.000 you or me, but to a computer it's like followed 0:12:30.000 --> 0:12:32.400 a bunch of bees or something. Right, Watson has the 0:12:32.400 --> 0:12:36.280 advantage of saying, Okay, well, there's a sensation of bees 0:12:36.559 --> 0:12:38.600 in the stomach, there's not actually bees in the stomach, 0:12:38.640 --> 0:12:42.760 So let's figure this out then, Watson, or anything that 0:12:42.760 --> 0:12:47.840 that he eventually becomes UM, well, we'll be able to 0:12:47.880 --> 0:12:52.200 go through medical records, current medical research, UM, the patient's 0:12:52.200 --> 0:12:57.480 medical history, UH, diagnostic tests that were done, blood work, UM, 0:12:57.679 --> 0:13:01.160 instrument tests, and put it all together there and then 0:13:01.240 --> 0:13:06.319 spit out a list of diagnoses with different confidence levels. 0:13:06.320 --> 0:13:07.720 So the one at the top is the one that 0:13:07.800 --> 0:13:12.800 Watson says is he is ninety eight point seven percent 0:13:12.840 --> 0:13:17.240 sure is what's wrong with this patient? And UM as 0:13:17.280 --> 0:13:21.120 a diagnostician, that's pretty impressive, and that's using all the 0:13:21.200 --> 0:13:26.720 available data that's that's available also to human physicians, but 0:13:26.800 --> 0:13:30.600 they simply don't have the time to take it all 0:13:30.679 --> 0:13:33.880 in Yeah. I think some research said that eighty per 0:13:34.200 --> 0:13:37.560 of doctors spend less than five hours a week reading 0:13:37.640 --> 0:13:42.640 medical journals a month a month. Yeah, so that's these 0:13:42.679 --> 0:13:46.280 things can read thousands in seconds. So it's it's sort 0:13:46.320 --> 0:13:50.120 of a matter of of efficiency really, and like if 0:13:50.160 --> 0:13:53.080 doctors don't have time to read all this stuff, I know, 0:13:53.160 --> 0:13:56.640 we we looked into this one sort of a savant 0:13:56.800 --> 0:14:02.240 diagnoser is that a word? I don't gnostician? Diagnostician? Uh 0:14:02.360 --> 0:14:06.599 doctor uh Dolly Wall in San Francisco. He's sort of 0:14:06.679 --> 0:14:10.320 legendary for diagnosing things, to the point where he does 0:14:10.320 --> 0:14:12.520 it on stage as almost like a parlor trick. I 0:14:12.520 --> 0:14:14.160 would love to see it. I would too. They give 0:14:14.240 --> 0:14:18.559 him forty five minutes and and a bunch of symptoms 0:14:18.559 --> 0:14:22.200 basically like really confusing because they're trying to stump him, 0:14:22.240 --> 0:14:25.880 and generally he comes out on top. But he even 0:14:26.000 --> 0:14:29.400 uses a program, a diagnostic program called isabel Right, that's 0:14:29.400 --> 0:14:32.360 the one I said earlier, that's already here. Yeah, so 0:14:32.600 --> 0:14:35.200 doctors are using these to help themselves out. But he 0:14:35.240 --> 0:14:39.400 says that he's never had Isabelle offered diagnosis that he 0:14:39.520 --> 0:14:43.120 has missed, but he's like the dude, Yeah, and He 0:14:43.160 --> 0:14:46.360 also admits that he's like, like, I'm a freak of nature, right, 0:14:46.400 --> 0:14:49.120 go ahead, quiz me exactly. Yeah. He also reads like 0:14:49.400 --> 0:14:52.600 case histories, like for fun, that kind of stuff. He's not, 0:14:53.200 --> 0:14:57.520 he's not a normal physician. He's a complete and total outlier. Um, 0:14:58.320 --> 0:15:01.480 if he were, if every physician we're like this guy, 0:15:01.960 --> 0:15:05.440 then they're there. Probably wouldn't be this conversation going on 0:15:05.600 --> 0:15:09.320 right now. But most physicians aren't. And it's not just 0:15:09.440 --> 0:15:12.160 with current medical research that they're just not aware of 0:15:12.160 --> 0:15:13.960 because they haven't had time to pick up the lance 0:15:13.960 --> 0:15:16.800 at the last few months, but it's also their training 0:15:16.840 --> 0:15:19.080 to Like if a doctors in practice for twenty years, 0:15:19.360 --> 0:15:23.640 the brain and the human brain tends to create habits 0:15:23.680 --> 0:15:26.440 because it likes to expend as little energy as possible. 0:15:26.720 --> 0:15:29.320 It's it's trying to be as ficient as possible. And 0:15:29.360 --> 0:15:32.680 I think the same thing happens with medical practice. You're trained, 0:15:32.760 --> 0:15:35.120 you understand, you come out of medical school with a 0:15:35.160 --> 0:15:37.560 lot of book learning, and then you put it to 0:15:37.600 --> 0:15:40.000 practice and you kind of find your niche and along 0:15:40.000 --> 0:15:41.640 the way you forget a lot of the stuff that 0:15:41.720 --> 0:15:43.840 you haven't done in twenty years or haven't learned about 0:15:43.880 --> 0:15:46.280 in twenty years, so it's not just current stuff, it's 0:15:46.320 --> 0:15:49.200 old stuff too. And if you feed the physician's desk 0:15:49.240 --> 0:15:53.440 reference into Watson or one of his his compatriots, like, 0:15:53.840 --> 0:15:56.640 all of that knowledge can be quickly index in research 0:15:56.720 --> 0:16:00.800 to try to spit out a more accurate diagnosed. Yeah. 0:16:00.880 --> 0:16:03.480 I think that's a great idea. It's like a partnering 0:16:03.560 --> 0:16:08.200 up with computers. It is sarily replacing, but what they're 0:16:08.240 --> 0:16:11.080 doing with Watson is is very much moving towards replacing 0:16:11.120 --> 0:16:14.080 doctors in that sense. Well, here's a scary stat um. 0:16:14.120 --> 0:16:16.840 One in five diagnoses in the United States are incorrect 0:16:16.920 --> 0:16:21.120 or incomplete one in five and a lot of times 0:16:21.120 --> 0:16:23.400 it's not that the doctor is a jerk or not 0:16:23.480 --> 0:16:26.440 any good, but like you said, they just maybe haven't 0:16:26.720 --> 0:16:30.080 seen these cases that were written about in some obscure 0:16:30.120 --> 0:16:33.600 medical journal that the computer has scanned an index, you know. 0:16:33.920 --> 0:16:39.000 And Dolly Wall Dr Dolly Wall himself at Freak Diagnostician Dollywood, Yeah, 0:16:39.080 --> 0:16:41.440 pretty close, which is a wonderful place, by the way, 0:16:41.480 --> 0:16:45.440 I know you love Dollywood. Um. Dr Dolly wall Uh 0:16:45.960 --> 0:16:49.120 himself says a lot even with me, A lot of 0:16:49.160 --> 0:16:53.640 it is intuition, and intuition can be wrong. That's a 0:16:53.720 --> 0:16:58.400 criticism though, of computers as doctors. They lack intuition. Like, 0:16:59.000 --> 0:17:03.120 there's kind of even larger, even larger than this computer's 0:17:03.160 --> 0:17:08.280 replacing doctor's conversation going on. It's kind of a conversation 0:17:08.400 --> 0:17:12.800 or a debate over whether intuition or data. Yeah, trump's 0:17:12.920 --> 0:17:15.920 one or the other. Which one is the right way 0:17:15.960 --> 0:17:19.440 to go? Yeah? This one stat too, it says according 0:17:19.440 --> 0:17:21.040 to an expert, I'm not sure what that means. It 0:17:21.040 --> 0:17:24.320 sounds sinky, but they said, only of the knowledge of 0:17:24.359 --> 0:17:30.040 physicians use to diagnose is evidence based, So that means 0:17:30.119 --> 0:17:33.919 is intuition, which which also jibs and dovetails with that 0:17:33.960 --> 0:17:37.320 one in five being wrong, I mean, or one in 0:17:37.400 --> 0:17:40.040 five being right. I'd like the idea of intuition to 0:17:40.080 --> 0:17:42.720 a certain degree for sure, but there's also got to 0:17:42.760 --> 0:17:47.040 be like data backing it up. Sure, you know, so 0:17:47.600 --> 0:17:49.560 in your perfect world. And it sounds like we still 0:17:49.600 --> 0:17:52.320 have physicians, but they go back and double check themselves 0:17:52.960 --> 0:17:56.639 using a program. Yeah, but I could also be down 0:17:56.720 --> 0:17:59.800 with um simple what is it? What do they call 0:17:59.840 --> 0:18:08.200 it here? Um? Something based diseases, rules based chronic diseases. Yeah, 0:18:08.240 --> 0:18:11.320 like minor things that are pretty easy to diagnose. They're 0:18:11.359 --> 0:18:14.720 not even necessarily minor. We just understand them so fully 0:18:14.760 --> 0:18:17.480 that we say type two diabetes is going to behave 0:18:17.520 --> 0:18:19.840 and present itself like this. Yeah, but I wouldn't mind 0:18:19.840 --> 0:18:22.520 going like it seems like once a year I get 0:18:22.560 --> 0:18:24.560 like an upper respiratory infection. It's been three or four 0:18:24.640 --> 0:18:27.199 years in a row, and I know what the treatment is, 0:18:27.240 --> 0:18:29.399 I know how it feels. It would be great to 0:18:29.400 --> 0:18:33.159 go into a machine and have them take some stats 0:18:33.200 --> 0:18:36.280 and blow into it and hear my wheezing and give 0:18:36.320 --> 0:18:41.040 me a a steroid shot and a Z pack and 0:18:41.160 --> 0:18:43.600 a breathing treatment and send me on my way. So 0:18:43.600 --> 0:18:45.280 it's always what clears it up. Would you care if 0:18:45.320 --> 0:18:48.000 it was a robot that gave you that shot? Not 0:18:48.080 --> 0:18:52.959 at all, um, but I definitely would want more personal 0:18:53.000 --> 0:18:54.879 care if it was something what if it was a 0:18:54.960 --> 0:18:59.080 robot with a nice avatar, sexy avatar maybe or just 0:18:59.160 --> 0:19:01.680 a friendly one. Yeah, that was a little, a little, 0:19:01.680 --> 0:19:04.000 a little it would touch your forearm here there. Yeah, 0:19:04.040 --> 0:19:07.280 well that might be a little creepy. Yeah, if like 0:19:07.520 --> 0:19:09.240 it was an old timey doctor who like gave you 0:19:09.280 --> 0:19:12.199 some epocac if you had diarrhea, just send you on 0:19:12.200 --> 0:19:14.560 your way drink a coke, but it wouldn't send you 0:19:14.560 --> 0:19:16.159 on your way to give you ipocac and then it 0:19:16.200 --> 0:19:19.920 wouldn't let go of your forearm. Yeah, so strong well 0:19:20.440 --> 0:19:22.720 surgical robots. That's a that's a thing. I mean, we're 0:19:22.760 --> 0:19:27.439 kidding around, but they've been performing. They've been performing robotic 0:19:27.480 --> 0:19:32.600 surgery since the early eighties, um doctor assisted until two 0:19:32.600 --> 0:19:35.000 thousand ten, where they were in Montreal. They performed the 0:19:35.040 --> 0:19:40.640 first fully robotic surgeries when they removed a prostate with 0:19:40.760 --> 0:19:47.400 a fully robotic UH surgeon and fully robotic anesthesiologist Dr 0:19:47.520 --> 0:19:50.400 mc sleepy. Dr mc sleepy. Yeah, and the the that's 0:19:50.440 --> 0:19:52.880 the real name the robot surgeon was da Vinci, which 0:19:52.880 --> 0:19:57.240 is like the basically gold standard for robotic surgical or 0:19:57.240 --> 0:20:02.919 surgical robots. Yeah, they had to that thirty thousand robotic 0:20:03.000 --> 0:20:05.919 surgeries performed in the US, So it's it's big, it 0:20:06.119 --> 0:20:09.440 is and um but the da Vinci is a doctor 0:20:10.000 --> 0:20:12.960 basically sitting in a little uh it looks like an 0:20:13.119 --> 0:20:18.879 arcade game and using UM robotic arms to mimic his 0:20:19.040 --> 0:20:23.080 or her movements on more microscopic levels. Right, So the 0:20:23.240 --> 0:20:26.480 robot has more precise movements and can make smaller movements, 0:20:27.200 --> 0:20:30.600 um than the doctor. It's tell it's and what's the 0:20:30.640 --> 0:20:35.800 opposite of telescoping, like going downward in scale? Whatever that is. 0:20:35.880 --> 0:20:38.600 It's taking the movements of the doctor and reducing them 0:20:38.600 --> 0:20:43.720 in scale. Let's call it reverse telescoping, reverse telescoping those movements, um, 0:20:43.720 --> 0:20:46.560 which is a pretty awesome achievement in and of itself. 0:20:46.800 --> 0:20:51.359 That doctors being fed three d um graphics of what 0:20:51.560 --> 0:20:54.719 the robot is seeing, uh, and just kind of working 0:20:54.720 --> 0:20:59.679 from there. Uh. What we're moving towards apparently is fully 0:21:01.240 --> 0:21:04.720 robotic size surgeries. I was talking to Joe McCormick from 0:21:04.760 --> 0:21:08.280 Forward Thinking and he was saying that, um, there was 0:21:09.000 --> 0:21:13.040 there's something called the Raven four, I believe. Uh. And 0:21:13.080 --> 0:21:15.520 basically you just say, this is going to be a 0:21:15.560 --> 0:21:20.280 gall bladder surgery on a six ft six male age 0:21:20.680 --> 0:21:24.160 you know whatever. And here's his here's the cat scan 0:21:24.320 --> 0:21:28.639 of his abdomen um. So go removes gall bladder and 0:21:28.680 --> 0:21:31.080 you press enter and the thing goes in there and 0:21:31.119 --> 0:21:34.520 like removes the guy's gall bladder and sews him up. Yeah, 0:21:34.760 --> 0:21:40.520 that's fully robotic, like fully autonomous robotic surgery. Button then 0:21:40.520 --> 0:21:42.800 it does it. You're not actually controlling a machine that 0:21:42.880 --> 0:21:46.240 does it exactly the machines doing it at your behest, 0:21:46.320 --> 0:21:49.200 but you're not controlling it. Yeah. Um, and we're right 0:21:49.240 --> 0:21:51.400 on the cusp of that, and apparently it's already happening. 0:21:52.240 --> 0:21:55.760 Uh yeah, but there are some issues. UM. I looked 0:21:55.760 --> 0:21:59.280 into it and found that a lot of injury reporting 0:21:59.280 --> 0:22:04.080 and robotics agery is um not being reported. It's it's substandard. 0:22:04.720 --> 0:22:08.520 And uh, this woman, Sheina Wilson, had robotic surgery for 0:22:08.600 --> 0:22:13.760 hysterectomy in two thousand thirteen and apparently this uh intuitive 0:22:13.760 --> 0:22:17.320 surgical system had there had been a bunch of injuries 0:22:18.000 --> 0:22:20.360 that she didn't know about, and she had her rectum 0:22:20.359 --> 0:22:24.479 burned badly and said, if I would have known that 0:22:24.520 --> 0:22:28.199 this system had these issues, would not have elected to 0:22:28.240 --> 0:22:31.200 take part in it. So there's a lot of under reporting. Um. 0:22:31.240 --> 0:22:34.720 The f d A, UM, they have no authority to 0:22:35.080 --> 0:22:38.760 force a doctor to do this, and apparently there's every 0:22:38.800 --> 0:22:42.359 reason in every link in the chain not to report 0:22:42.440 --> 0:22:46.000 these things, you know, and the f d A not 0:22:46.280 --> 0:22:51.119 enforcing this kind of thing, not enforcing reporting is ridiculous. Yeah. 0:22:51.200 --> 0:22:54.600 You know. The thing is that things like that happen, 0:22:54.800 --> 0:23:00.440 and there's under reporting. UM. With human surgic surgeons as well. Yeah, sure, 0:23:00.440 --> 0:23:04.520 not just robotic. It's like overall, apparently surgical injury and 0:23:04.600 --> 0:23:08.119 accident reporting is not compulsory. Yeah, and here's here's a 0:23:08.160 --> 0:23:11.800 few points though. Counterpoints I guess is one, it's not 0:23:11.880 --> 0:23:15.040 always the robotic component of the surgery that was the 0:23:15.080 --> 0:23:18.800 cause to a lot of times they say they don't 0:23:18.840 --> 0:23:22.199 know about this until like a lawsuit is filed, So 0:23:22.240 --> 0:23:24.440 it could be weeks or months later with the physician 0:23:24.480 --> 0:23:27.679 doesn't know about it, or the FDA might not get 0:23:27.840 --> 0:23:30.120 report on it, and like six months later you follow 0:23:30.119 --> 0:23:32.919 a lawsuit and that's how it comes to light. Um. 0:23:32.960 --> 0:23:35.879 But the FDA is definitely concerned and are supposedly working 0:23:35.880 --> 0:23:41.159 to improve this. That's very concerned. They're very concerned. Uh. 0:23:41.240 --> 0:23:43.920 And another problem too, and that same article, a lot 0:23:43.960 --> 0:23:48.119 of these robotic surgical systems, you still have to have 0:23:48.480 --> 0:23:51.840 the correct amount of training. And Uh. The feeling of 0:23:51.960 --> 0:23:55.240 some experts is that UM or at least this one guy, 0:23:55.440 --> 0:23:58.840 Enrico Benedetti, he's a head of surgery at the University 0:23:58.840 --> 0:24:01.520 of Illinois Chicago, UH, says a lot of it just 0:24:01.520 --> 0:24:03.520