WEBVTT - Will computers replace doctors? 0:00:00.960 --> 0:00:04.120 Welcome to you stuff you should know from house Stuff 0:00:04.160 --> 0:00:12.360 Works dot com. Hey, and welcome to the podcast. I'm 0:00:12.440 --> 0:00:15.840 Josh Clark. There's Charles W. Chuck Bryant. Our guest producer 0:00:15.960 --> 0:00:19.480 Noel is here. Yeah, Jerry needs a buffer day from 0:00:19.480 --> 0:00:23.919 her Christmas break. I can't say that again. No, she's 0:00:23.960 --> 0:00:26.520 at home on her buffer day. And the freezing cold 0:00:27.600 --> 0:00:30.240 because we record these somewhat in advance, we are in 0:00:30.280 --> 0:00:34.880 the midst of the polar vortex and um, yeah, everyone's 0:00:34.880 --> 0:00:36.560 just talking about how cold is We're back. It is 0:00:36.600 --> 0:00:40.239 our first recording after the holidays. It's literally freezing cold up. 0:00:40.320 --> 0:00:42.600 So welcome back, buddy, Thanks, Welcome back to you too. 0:00:42.680 --> 0:00:45.199 Even though this will be what like late January, it 0:00:45.240 --> 0:00:47.320 will be a balmy sixteen Atlanta. I think the end 0:00:47.360 --> 0:00:49.880 of the end of January is when this one comes out. 0:00:49.920 --> 0:00:52.080 All right, Well, happy New Year, and happy New Year 0:00:52.120 --> 0:00:56.440 to YouTube, and happy holidays to you. Thanks. Um Chuck, Yes, sir, 0:00:57.240 --> 0:00:59.520 you're feeling good. You're loose, You're ready. I'm loose. So 0:00:59.680 --> 0:01:02.600 you see this. You've seen this before. Yeah, you're fit. 0:01:02.640 --> 0:01:05.720 My fit bit is that buzz marketing? Not really, It's 0:01:05.760 --> 0:01:08.959 just a really good example. Um I've felt like Fitbit, 0:01:09.040 --> 0:01:13.080 I'm not like necessarily loyal to it or anything like that. 0:01:13.480 --> 0:01:17.600 They don't pay me money to mention the podcast. Sometimes 0:01:17.400 --> 0:01:20.320 it's be like, stop staring at me fit Bit. Um. 0:01:20.360 --> 0:01:22.840 But no, I like it. I'm happy with it. Um. 0:01:23.000 --> 0:01:27.039 I I pointed out though, because it's part of this 0:01:27.440 --> 0:01:29.720 to me, and I don't think it's over confirmation bias. 0:01:29.800 --> 0:01:34.400 It seems like there really is a growing desire among 0:01:34.680 --> 0:01:39.320 just average ordinary people to be able to track there 0:01:40.200 --> 0:01:44.679 their health, their well being, their activity, um, and to 0:01:44.720 --> 0:01:47.720 do it easily. Yeah, we have tools now that make it, 0:01:47.880 --> 0:01:51.040 like that thing super convenient. Yeah, it's and Fitbit's not 0:01:51.040 --> 0:01:53.480 the only one. There's like Nike fuel Band. There's Jawbone 0:01:53.560 --> 0:01:56.640 is another really good one. There's others like um that 0:01:56.880 --> 0:02:01.280 track uh, your galvanic response, so they're able to put 0:02:01.320 --> 0:02:04.800 that together with respiration and heartbeat and come up with 0:02:04.840 --> 0:02:07.120 a pretty good assessment of how many calories you're burning 0:02:07.120 --> 0:02:09.079 at any given time, which is like kind of a 0:02:09.120 --> 0:02:12.080 holy grail with this kind of thing right now. Um, 0:02:12.120 --> 0:02:15.200 there's others that check your sleep. There's apps out there 0:02:15.280 --> 0:02:19.800 that let you um check your mood. Um. There's sites 0:02:19.840 --> 0:02:23.400 like Quantified Self which are basically like people trying to 0:02:23.480 --> 0:02:28.040 push wearable technology like this further into the future. There's 0:02:28.240 --> 0:02:31.680 entire websites like share care dot com that are dedicated 0:02:31.720 --> 0:02:38.040 to health information and health um uh support self advocacy. Yeah, 0:02:38.120 --> 0:02:40.920 and there's this. It seems to me, this desire to 0:02:41.080 --> 0:02:43.760 kind of say, hey, this is my health, this is 0:02:43.840 --> 0:02:46.600 my body. I want to know more about it, you know, 0:02:47.280 --> 0:02:50.480 like I don't want to necessarily cut out doctors, but 0:02:51.000 --> 0:02:53.840 I I I want to decide if I should go 0:02:54.160 --> 0:02:56.840 to the doctor, if it's time or not, and I 0:02:56.919 --> 0:03:00.200 want to use data to do that. Yeah. I imagine U. 0:03:00.400 --> 0:03:02.440 I frustrate a lot of doctors because I'm one of 0:03:02.440 --> 0:03:06.120 those obnoxious people that goes in and it's like, well, 0:03:06.160 --> 0:03:08.359 here's what I think I have based on my research. 0:03:09.440 --> 0:03:11.960 There's nothing wrong with that. Yeah, that is what you're 0:03:12.000 --> 0:03:14.679 an informed patient. That's true, exactly what you're supposed to do. 0:03:14.760 --> 0:03:16.960 And if you're getting on your doctor's nerves, then go 0:03:17.040 --> 0:03:21.280 see another doctor. Yeah, I agree. Actually in search of 0:03:21.320 --> 0:03:24.040 a new GP right now for those because and others 0:03:24.040 --> 0:03:28.160 you got on his nerves other reasons too. Really cold 0:03:28.320 --> 0:03:31.880 cold hands like poor bedside man are never seen the doctor, 0:03:31.880 --> 0:03:36.960 like here's my intern from Emory. Yeah, which great. You know. 0:03:37.000 --> 0:03:39.280 I love them getting experienced, but I would like them 0:03:39.280 --> 0:03:41.800 both to be in there, not just like smell you 0:03:41.920 --> 0:03:44.200 later and the doctor leaves. Well that's another thing too. 0:03:44.200 --> 0:03:48.200 It's kind of like, um, doctor, okay, let's let's just 0:03:48.240 --> 0:03:50.000 lay it on on the table here. Yeah, what what 0:03:50.080 --> 0:03:52.960 you've just mentioned and what I was talking about. If 0:03:52.960 --> 0:03:57.680 you put it all together, the medical field physicians in particular, 0:03:58.080 --> 0:04:01.760 are currently in a what's the beginning of what's possibly 0:04:02.480 --> 0:04:06.120 a really pickle of a state for them. I think 0:04:06.160 --> 0:04:09.520 a transition period, yes, but they may be transitioned right 0:04:09.560 --> 0:04:12.200 out of existence in large parts. Yes, some may for sure, 0:04:12.280 --> 0:04:14.640 depending on who you talk to. There's like this whole 0:04:14.680 --> 0:04:19.600 question now, like what is the future of medicine and 0:04:19.680 --> 0:04:21.920 more specifically, in the case of this episode that we're 0:04:21.920 --> 0:04:26.920 talking about, do human physicians factor largely into that future? 0:04:27.680 --> 0:04:31.960 And the answer is I don't know, yeah, depending on 0:04:32.000 --> 0:04:34.480 who you ask, Like I said, um, we there's this 0:04:34.520 --> 0:04:39.560 one guy, Dr Kent Bottles, who um he feels that 0:04:40.279 --> 0:04:43.400 GPS might go the way of the DODO and be 0:04:43.520 --> 0:04:49.279 replaced by diagnostic computers, maybe with avatars. Then there's other 0:04:49.320 --> 0:04:52.760 people like Farhad Manjou's a technical writer, his wife as 0:04:52.800 --> 0:04:55.760 a pathologist. He thinks, no, no no, no, the gps are 0:04:55.760 --> 0:04:57.560 the ones that are going to be in business. The 0:04:57.600 --> 0:05:00.080 specialists are gonna be out of business because computers are 0:05:00.080 --> 0:05:03.480 really good at specializing on one single thing, not maybe 0:05:03.480 --> 0:05:08.080 so good at a general practitioner thing. So there's lots 0:05:08.080 --> 0:05:11.120 of opinions out there on how much they'll be replaced 0:05:11.120 --> 0:05:14.000 and who might be replaced. Right then, As Reclined wrote 0:05:14.040 --> 0:05:17.680 a column who basically he basically said like no, like 0:05:17.839 --> 0:05:20.720 we we will still need humans, but we mainly need 0:05:20.839 --> 0:05:25.200 humans to communicate to the other humans and facilitate the 0:05:25.200 --> 0:05:27.360 the interaction between the robots and the humans. And we 0:05:27.400 --> 0:05:31.080 already have this. They're called nurses or nurse practitioners. Yea. 0:05:31.120 --> 0:05:33.359 But he kind of as Reclined is the one that 0:05:33.440 --> 0:05:36.919 thought that a computer avatar might have a better bedside 0:05:36.920 --> 0:05:39.440 manner than a doctor. Well, let's give that one example. 0:05:39.480 --> 0:05:42.200 There's this, there was there's an example I kept finding 0:05:42.240 --> 0:05:44.440 while we were doing research for the sentence. Actually in 0:05:44.440 --> 0:05:48.480 the article on how stuff works. Um, it's uh. There 0:05:48.560 --> 0:05:52.039 was a kiosk, a medical kiosk, during a panel called 0:05:52.080 --> 0:05:56.000 man Made Minds colon living with thinking machines. When there's 0:05:56.000 --> 0:05:59.159 a colon in there, you know it's serious stuff. Um. 0:05:59.200 --> 0:06:00.920 And it was at the World Science Festival in two 0:06:00.920 --> 0:06:06.400 thousand eleven, and basically this, this computerized avatar UM interacted 0:06:06.480 --> 0:06:11.520 with a woman whose baby had diarrhea, and the woman said, hey, Avatar, 0:06:12.200 --> 0:06:14.840 my baby has diarrhea. What are you gonna do about it? 0:06:15.440 --> 0:06:18.080 And the avatar said, well, tell me all the symptoms 0:06:18.080 --> 0:06:22.080 and all this stuff, and avatar decided that the baby's diarrhea, 0:06:22.160 --> 0:06:26.360 while present, wasn't severe enough to warrant immediate medical attention, 0:06:26.720 --> 0:06:29.520 so it went ahead and made an appointment with a 0:06:29.640 --> 0:06:33.039 human doctor for later on that week. And the mother 0:06:33.200 --> 0:06:37.719 said that she preferred the treatment by the avatar to 0:06:37.800 --> 0:06:41.040 the real life nurses at the hospitals where she lived 0:06:41.040 --> 0:06:44.359 in New York. Yeah. Uh, so it is possible to 0:06:44.400 --> 0:06:49.320 create computers with better bedside manner than say, your g P. Well, 0:06:49.400 --> 0:06:51.960 it's at the very least it will be consistent. And 0:06:52.000 --> 0:06:55.040 that's one of the things that I'm not poopooing. Doctors 0:06:55.080 --> 0:06:58.000 or nurses are many, many, many, many great ones, but 0:06:58.240 --> 0:07:01.400 I've also had some pretty bad experiences, as in emergency 0:07:01.480 --> 0:07:03.600 rooms and with doctors and nurses with a computer. At 0:07:03.680 --> 0:07:07.880 least it's a consistent you know, their program to display 0:07:07.880 --> 0:07:11.400 empathy no matter what. You know, they're not too busy 0:07:11.480 --> 0:07:14.320 and they're not you know, having a bad day, so 0:07:14.520 --> 0:07:17.320 they they don't you know, they don't have any prejudices 0:07:17.360 --> 0:07:20.320 against you personally or anything like that. They're a computer. 0:07:20.480 --> 0:07:25.600 They don't hate diarrhea. But humans, humans respond to even 0:07:25.760 --> 0:07:31.040 programmed empathy, even synthetic empathy from a computer. I could 0:07:31.120 --> 0:07:36.120 see that a little bit. Like I've dove into the 0:07:36.160 --> 0:07:40.440 gaming world enough to know that, you know, the realism 0:07:40.520 --> 0:07:44.280 of a of a avatar can be convincing, and it's 0:07:44.320 --> 0:07:45.840 not like you think, oh, it's a real person, but 0:07:45.960 --> 0:07:47.720 it helps to put a human face on it, you know, 0:07:48.000 --> 0:07:52.480 exactly literally. Um, they saw a reference to a study 0:07:52.480 --> 0:07:57.080 that found um, people who are being treated for anxiety 0:07:57.120 --> 0:08:02.560 disorders tended to share more about their experiences and themselves 0:08:02.800 --> 0:08:06.240 with an avatar them with a human psychiatrists. Oh that's 0:08:06.280 --> 0:08:10.720 interesting because they're like not embarrassed to tell a real person. Yeah, 0:08:10.800 --> 0:08:12.440 that makes sense. I might open up more to to 0:08:12.520 --> 0:08:14.840 a computer. Right, So so we've got that part, like 0:08:14.880 --> 0:08:18.080 the bedside manner, it is possible that we can create 0:08:18.120 --> 0:08:22.360 machines now and are creating machines now that have at 0:08:22.400 --> 0:08:26.920 least equal, if not better bedside manner than some physicians. Yeah, okay, 0:08:26.960 --> 0:08:29.440 so bedside manner one of the big things that doctors 0:08:29.440 --> 0:08:32.960 bring to the table. Check computers have that. Yeah, it's 0:08:33.040 --> 0:08:35.200 it's different now than it was in the old days. 0:08:35.240 --> 0:08:38.960 I feel like just the whole quality of personal care 0:08:39.120 --> 0:08:41.800 is gone down. It's not necessarily the doctor's falts. There's 0:08:41.800 --> 0:08:44.480 a lot of reasons to place the blame, but it's 0:08:44.480 --> 0:08:45.840 not like when you were a kid and you feel 0:08:45.880 --> 0:08:48.240 like you had your family doctor who knew you, maybe 0:08:48.280 --> 0:08:55.440 even gave birthth you're my son exactly. Um, it just 0:08:55.520 --> 0:08:58.200 invested like you gotta stick with the same doctor if 0:08:58.200 --> 0:08:59.800 you want that kind of care, I think, right, And 0:09:00.080 --> 0:09:03.760 is another benefit besides bedside banner um that comes with 0:09:03.880 --> 0:09:06.760 that that kind of care, that kind of personal care 0:09:07.120 --> 0:09:11.280 is an awareness of your medical history. Not just that 0:09:11.320 --> 0:09:14.920 but oh well, your dad died of congenital heart disorders 0:09:15.320 --> 0:09:18.480 like that, so you may be at higher risk of it. 0:09:18.080 --> 0:09:22.199 To just that kind of awareness has been typically lost too. 0:09:22.679 --> 0:09:24.520 Even though we have medical histories and they're in our 0:09:24.559 --> 0:09:27.600 charts that they're in our files UM, and intimate knowledge 0:09:27.760 --> 0:09:33.559 of a patients UM medical history is pretty much lost 0:09:33.920 --> 0:09:38.480 in today's modern practice of medicine. UM. That's another thing 0:09:38.520 --> 0:09:44.679 that that computers could conceivably top doctors on UM, which 0:09:44.720 --> 0:09:49.240 basically falls under the umbrella of diagnosis or diagnostics. Yeah. 0:09:49.240 --> 0:09:51.719 I mean there's two two sides to this. There's diagnoses 0:09:51.760 --> 0:09:56.200 and treatment and some UH programs. A little bit of 0:09:56.200 --> 0:09:59.920 the history this UM goes back to the nineteen seventy 0:10:00.120 --> 0:10:03.720 is at the University of Pittsburgh. They develop software to 0:10:03.760 --> 0:10:07.760 diagnose problems. UM. MASS General since the eighties has been 0:10:07.800 --> 0:10:12.800 working on their d X plan, which provides ranked lists 0:10:12.840 --> 0:10:18.640 of diagnoses, whereas the what's the computer the Watson Watson 0:10:18.679 --> 0:10:21.760 who who won a Jeopardy Yeah, that's more based UM. 0:10:21.840 --> 0:10:25.880 It looks like on treatment options than diagnosis at this point. 0:10:26.480 --> 0:10:29.600 So well, yeah, but they said it's not They haven't. 0:10:29.920 --> 0:10:31.320 I don't think they want to leave it alone with 0:10:31.360 --> 0:10:34.520 diagnosis yet. No, and to do its thing there there's 0:10:34.559 --> 0:10:41.120 already something out there for diagnosis that's meant to support physicians. 0:10:41.160 --> 0:10:44.440 From what I understand with Watson, if there is a 0:10:44.559 --> 0:10:49.120 doctor of the future, it's Watson. Yeah. UM, he has 0:10:49.160 --> 0:10:52.360 a lot of advantages over not just um human doctors, 0:10:52.400 --> 0:10:58.720 but other artificial intelligence healthcare machines. I guess you could 0:10:59.120 --> 0:11:03.920 clumsily call he has a knack for natural language. So 0:11:04.040 --> 0:11:10.160 let's say there's like a structured formula or formulaic type 0:11:10.200 --> 0:11:17.120 of language that the medical field is supposed to use, right, yes, okay, um, 0:11:17.120 --> 0:11:21.320 health records don't always necessarily contain that language. They might 0:11:21.360 --> 0:11:25.640 contain natural language, which is really confusing for computers to 0:11:25.720 --> 0:11:30.120 take in an absorb. Yeah. You know, humans can pick 0:11:30.200 --> 0:11:34.280 up on meanings of things that robots and and software cannot, 0:11:35.080 --> 0:11:38.920 like inferences, and we might be using sarcasm, although there's 0:11:38.920 --> 0:11:42.160 probably not going to be any sarcasm in your medical records. Yeah, 0:11:42.160 --> 0:11:44.880 but like figurative language and stuff like that. But computers 0:11:45.200 --> 0:11:46.920 a language is a big part of the problem. Or 0:11:47.760 --> 0:11:50.720 more to the point, with the diagnosis, patient says he 0:11:50.760 --> 0:11:54.319 feels like he has a hive of bees in his stomach. 0:11:55.200 --> 0:11:57.520 Like that might mean something that you or me, but 0:11:57.559 --> 0:12:01.240 to a computer it's like followed the two bees or something. Right, 0:12:01.520 --> 0:12:04.240 Watson has the advantage of saying, Okay, well there's a 0:12:04.280 --> 0:12:07.920 sensation of bees in the stomach, there's not actually bees 0:12:07.920 --> 0:12:10.960 in the stomach. So let's figure this out then, Watson 0:12:11.520 --> 0:12:17.160 or anything that that he eventually becomes. UM, Well, we'll 0:12:17.200 --> 0:12:21.360 be able to go through medical records, current medical research, UM, 0:12:21.440 --> 0:12:26.360 the patient's medical history, uh, diagnostic tests that were done, 0:12:26.400 --> 0:12:30.760 blood work, instrument tests, and put it all together and 0:12:30.760 --> 0:12:36.160 then spit out a list of diagnoses with different confidence levels. 0:12:36.160 --> 0:12:37.560 So the one at the top is the one that 0:12:37.600 --> 0:12:42.880 Watson says is he is ninety eight point percent sure 0:12:42.960 --> 0:12:48.240 is what's wrong with this patient? And UM as a diagnostician, 0:12:48.640 --> 0:12:51.880 that's pretty impressive. And that's using all the available data 0:12:51.920 --> 0:12:57.240 that's that's available also to human physicians, but they simply 0:12:57.360 --> 0:13:01.200 don't have the time to make it all in. Yeah. 0:13:01.200 --> 0:13:04.560 I think some research said that eighty percent of doctors 0:13:04.640 --> 0:13:08.559 spend less than five hours a week reading medical journals 0:13:08.600 --> 0:13:12.880 a month a month. Yeah, so that's these things can 0:13:12.920 --> 0:13:16.320 read thousands in seconds. So it's it's sort of a 0:13:16.320 --> 0:13:20.520 matter of of efficiency really, and like if doctors don't 0:13:20.520 --> 0:13:23.280 have time to read all this stuff, I know, we 0:13:23.280 --> 0:13:26.480 we looked into this one. Uh sort of a savant 0:13:26.640 --> 0:13:33.679 diagnoser is that a word? Diagnostician? Uh? Doctor uh Dolly 0:13:33.720 --> 0:13:38.600 Wall in San Francisco. He's sort of legendary for diagnosing things, 0:13:38.640 --> 0:13:40.920 to the point where he does it on stage as 0:13:40.960 --> 0:13:44.200 almost like a parlor trick would do. They give him 0:13:44.400 --> 0:13:48.880 forty five minutes and and a bunch of symptoms basically 0:13:49.040 --> 0:13:52.280 like really confusing because they're trying to stump him, and 0:13:52.600 --> 0:13:56.040 generally he comes out on top. But he even uses 0:13:56.080 --> 0:13:59.280 a program, a diagnostic program called Isabelle. Right, that's the 0:13:59.320 --> 0:14:02.800 one I said every here that's already here. So doctors 0:14:02.840 --> 0:14:05.360 are using these to help themselves out. But he says 0:14:05.440 --> 0:14:09.240 that he's never had Isabelle offer a diagnosis that he 0:14:09.360 --> 0:14:12.680 has missed. Right, But he's like the dude that yeah, 0:14:12.720 --> 0:14:15.080 And he also admits that he's like like I'm a 0:14:15.120 --> 0:14:18.400 freak of nature. Go ahead, quiz me exactly. He also 0:14:18.440 --> 0:14:22.040 reads like case histories, like for fun, that kind of stuff. 0:14:22.080 --> 0:14:24.920 He's not, he's not a normal physician. He's a complete 0:14:24.920 --> 0:14:30.440 and total outlier. Um, if he were. If every physician 0:14:30.440 --> 0:14:34.120 were like this guy, then they're there probably wouldn't be 0:14:34.160 --> 0:14:38.080 this conversation going on right now. But most physicians aren't. 0:14:38.320 --> 0:14:41.240 And it's not just with current medical research that they're 0:14:41.280 --> 0:14:43.040 just not aware of because they haven't had time to 0:14:43.040 --> 0:14:45.760 pick up the lancet the last few months, but it's 0:14:45.760 --> 0:14:47.720 also their training to Like, if a doctor is in 0:14:47.760 --> 0:14:51.120 practice for twenty years, the brain, and the human brain 0:14:51.200 --> 0:14:54.840 tends to create habits because it likes to expend as 0:14:54.880 --> 0:14:57.680 little energy as possible. It's it's trying to be as 0:14:57.680 --> 0:15:00.440 ficient as possible. And I think the same thing happens 0:15:00.480 --> 0:15:03.640 with medical practice. You're trained, you understand, you come out 0:15:03.680 --> 0:15:06.680 of medical school with a lot of book learning, and 0:15:06.720 --> 0:15:08.360 then you put it to practice and you kind of 0:15:08.400 --> 0:15:10.600 find your niche and along the way you forget a 0:15:10.640 --> 0:15:12.640 lot of the stuff that you haven't done in twenty 0:15:12.720 --> 0:15:14.600 years or haven't learned about in twenty years. So it's 0:15:14.640 --> 0:15:17.680 not just current stuff, it's old stuff too. And if 0:15:17.680 --> 0:15:20.480 you feed the physician's desk reference into Watson or one 0:15:20.520 --> 0:15:24.800 of his his compatriots, like all of that knowledge can 0:15:24.800 --> 0:15:27.920 be quickly index and research to try to spit out 0:15:28.280 --> 0:15:32.160 a more accurate diagnosis. Yeah, I think that's a great idea. 0:15:32.200 --> 0:15:36.440 It's like a partnering up with computers. It is sarily replacing, 0:15:36.920 --> 0:15:39.880 but what they're doing with Watson is is very much 0:15:39.920 --> 0:15:42.560 moving towards replacing doctors in that sense. Well, here's a 0:15:42.600 --> 0:15:45.640 scary stat um one in five diagnoses in the United 0:15:45.640 --> 0:15:50.400 States are incorrect or incomplete one in five and a 0:15:50.440 --> 0:15:52.520 lot of times. It's not that the doctor's a jerk 0:15:53.000 --> 0:15:54.920 or not any good, but like you said, they just 0:15:55.080 --> 0:15:59.280 maybe haven't seen these cases that were written about in 0:15:59.320 --> 0:16:02.800 some obscure medical journal that the computer has scanned an index. 0:16:03.240 --> 0:16:06.440 Ya and Dolly Wall Dr Dolly Wall himself at Freak 0:16:06.520 --> 0:16:10.880 Diagnostication Dollywood, Yeah, pretty close, which is a wonderful place. 0:16:10.880 --> 0:16:16.840 By the way, um Dr Dolly wall Uh himself says 0:16:16.880 --> 0:16:19.960 a lot even with me, A lot of it is intuition, 0:16:20.960 --> 0:16:24.680 and intuition can be wrong. That's a criticism though, of 0:16:25.040 --> 0:16:29.520 computers as doctors. They lack intuition. Like there's kind of 0:16:29.560 --> 0:16:33.880 even a larger even larger than this computer's replacing doctor's 0:16:33.880 --> 0:16:38.320 conversation going on. It's kind of a conversation or a 0:16:38.440 --> 0:16:43.120 debate over whether intuition or data. Yeah, Trump's one or 0:16:43.160 --> 0:16:47.400 the other. Which one is the right way to go? Yeah? 0:16:47.400 --> 0:16:49.840 This one step too, it says according to an expert, 0:16:49.840 --> 0:16:52.040 I'm not sure what that means. That sounds sinky, but 0:16:52.080 --> 0:16:55.520 they said, only of the knowledge of physicians use to 0:16:55.720 --> 0:17:01.960 diagnose is evidence based, so that means intuition, which which 0:17:02.120 --> 0:17:05.280 also jibs in dovetails with that one in five being 0:17:05.320 --> 0:17:08.880 wrong or one in five being right. I'd like the 0:17:08.920 --> 0:17:11.720 idea of intuition to a certain degree, for sure, but 0:17:11.800 --> 0:17:15.359 there's also got to be like data backing it up. Sure, 0:17:15.920 --> 0:17:18.919 you know so in your perfect world. Then it sounds 0:17:18.920 --> 0:17:21.000 like we still have physicians, but they go back and 0:17:21.040 --> 0:17:24.960 double check themselves using a program. Yeah, but I could 0:17:25.000 --> 0:17:29.240 also be down with um simple what is it? What 0:17:29.240 --> 0:17:33.440 do they call it in here? Um? Something based diseases, 0:17:35.480 --> 0:17:39.600 rules based chronic diseases. Yeah, like minor things that are 0:17:39.640 --> 0:17:42.399 pretty easy to diagnose, so they're not even necessarily minor. 0:17:42.480 --> 0:17:45.840 We just understand them so fully that we say type 0:17:45.840 --> 0:17:48.920 two diabetes is going to behave and present itself like this. Yeah, 0:17:48.920 --> 0:17:51.720 but I wouldn't mind going like it seems like once 0:17:51.760 --> 0:17:53.919 a year I get, like an upper respiratory infection. It's 0:17:53.920 --> 0:17:55.919 been three or four years in a row, and I 0:17:55.960 --> 0:17:57.960 know what the treatment is, I know how it feels. 0:17:58.400 --> 0:18:00.480 It would be great to go and to a machine 0:18:00.640 --> 0:18:03.919 and have them take some stats and blow into it 0:18:04.040 --> 0:18:08.640 and hear my wheezing and give me a a steroid 0:18:08.680 --> 0:18:12.200 shot and a Z pack and a breathing treatment and 0:18:12.320 --> 0:18:14.200 send me on my way. So it's always what clears 0:18:14.200 --> 0:18:15.960 it up. Would you care if it was a robot 0:18:16.520 --> 0:18:21.040 that gave you that shot? Not at all, um, but 0:18:21.160 --> 0:18:23.720 I definitely would want more personal care if it was something. 0:18:24.080 --> 0:18:26.080 What if it was a robot with a nice avatar, 0:18:26.960 --> 0:18:30.720 sexy avatar or just a friendly one. Yeah, that was 0:18:30.760 --> 0:18:32.520 a little, a little, a little it would touch your 0:18:32.520 --> 0:18:36.480 forearm here there. Yeah, well that might be a little creepy. Yeah, 0:18:36.680 --> 0:18:38.760 it's like it was an old timey doctor who like 0:18:38.800 --> 0:18:41.760 gave you some epocac if you had diarrhea, just send 0:18:41.800 --> 0:18:44.040 you on your way, drink a coke. But it wouldn't 0:18:44.040 --> 0:18:45.680 send you on your way to give you ip acac 0:18:45.720 --> 0:18:49.760 and then it wouldn't let go of your forearm. Yeah. Well, 0:18:50.280 --> 0:18:52.520 surgical robots, that's a that's a thing. I mean, we're 0:18:52.560 --> 0:18:57.240 getting around, but they've been performing they've been performing robotic 0:18:57.280 --> 0:19:02.399 surgery since the early eighties. Um doctor assisted until two 0:19:02.440 --> 0:19:04.840 thousand ten, where they were in Montreal. They performed the 0:19:04.880 --> 0:19:10.440 first fully robotic surgeries when they removed a prostate with 0:19:10.560 --> 0:19:17.240 the fully robotic UH surgeon and fully robotic anentusiologist Dr 0:19:17.320 --> 0:19:20.320 mc sleepy Dr mc sleepy. Yeah, and then that's the 0:19:20.359 --> 0:19:22.800 real name the robot surgeon was da Vinci, which is 0:19:22.840 --> 0:19:28.560 like the basically gold standard for robotic surgical or surgical robots. Yeah, 0:19:28.640 --> 0:19:33.240 they had in two thousand, thirteen fifty thousand robotic surgeries 0:19:33.280 --> 0:19:37.840 performed in the US. So it's it's big and um. 0:19:37.880 --> 0:19:41.199 But the da Vinci is a doctor basically sitting in 0:19:41.240 --> 0:19:44.439 a little uh it looks like an arcade game and 0:19:44.680 --> 0:19:49.639 using um robotic arms to mimic his or her movements 0:19:50.280 --> 0:19:53.920 on more microscopic levels. Right, So the robot has more 0:19:53.960 --> 0:19:58.119 precise movements and can make smaller movements, um than the doctor. 0:19:58.200 --> 0:20:02.280 It's tell it's and what's the opposite of telescoping, like 0:20:02.359 --> 0:20:06.439 going downward in scale? Whatever that is. It's taking the 0:20:06.520 --> 0:20:09.400 movements of the doctor and reducing them in scale. Let's 0:20:09.400 --> 0:20:13.800 call it reverse telescoping, reverse telescoping those movements, um, which 0:20:13.880 --> 0:20:16.639 is a pretty awesome achievement in and of itself. That 0:20:16.760 --> 0:20:21.479 doctors being fed three d um graphics of what the 0:20:21.600 --> 0:20:26.800 robot is seeing, uh, and just kind of working from there. Uh. 0:20:26.840 --> 0:20:32.639 What we're moving towards apparently is fully robotic size surgeries. 0:20:32.880 --> 0:20:36.119 I was talking to Joe McCormick from Forward Thinking, and 0:20:36.200 --> 0:20:39.760 he was saying that, um, there was there's something called 0:20:39.800 --> 0:20:44.160 the Raven four, I believe. Uh. And basically you just say, 0:20:44.280 --> 0:20:46.720 this is going to be a gall bladder surgery on 0:20:46.800 --> 0:20:51.280 a six ft six male age, you know whatever, and 0:20:51.720 --> 0:20:56.159 here's his here's the cat scan of his abdomen um. 0:20:56.359 --> 0:21:00.159 So go removes gallbladder and you press enter, and thing 0:21:00.280 --> 0:21:02.399 goes in there and like removes the guy's gallbladder and 0:21:02.440 --> 0:21:08.000 sews him up. Yeah, that's fully robotic, like fully autonomous 0:21:08.240 --> 0:21:10.960 robotic surgery. Press the button and it does it. You're 0:21:11.000 --> 0:21:14.439 not actually controlling a machine that does it exactly the 0:21:14.480 --> 0:21:18.320 machines doing it at your behest, but you're not controlling it. Yeah. Um, 0:21:18.359 --> 0:21:20.280 and we're right on the cusp of that, and apparently 0:21:20.320 --> 0:21:25.119 it's already happening. Uh yeah, but there are some issues. Um. 0:21:25.200 --> 0:21:27.520 I looked into it and found that a lot of 0:21:28.119 --> 0:21:32.640 injury reporting and robotic surgery is um not being reported. 0:21:32.640 --> 0:21:37.320 It's it's substandard. And uh, this woman, Sheina Wilson, had 0:21:37.480 --> 0:21:41.480 robotic surgery for a hysterectomy in two thousand thirteen and 0:21:41.560 --> 0:21:46.160 apparently this uh intuitive surgical system had there had been 0:21:46.160 --> 0:21:48.960 a bunch of injuries that she didn't know about, and 0:21:49.040 --> 0:21:53.639 she had her wrectum burned badly and said, if I 0:21:53.640 --> 0:21:57.000 would have known that this system had these issues, would 0:21:57.040 --> 0:21:59.640 not have elected to take part in it. So there's 0:21:59.640 --> 0:22:03.240 a lot of under reporting. UM. The f d A, UM, 0:22:03.280 --> 0:22:06.080 they have no authority to force a doctor to do this, 0:22:06.880 --> 0:22:10.200 and apparently there's every reason in every link in the 0:22:10.280 --> 0:22:14.639 chain not to report these things, you know, and the 0:22:14.800 --> 0:22:17.439 f d A not enforcing this kind of thing, not 0:22:17.600 --> 0:22:23.080 enforcing reporting is ridiculous. Yeah, you know. The thing is 0:22:23.119 --> 0:22:27.119 that things like that happen, and there's under reporting um 0:22:27.200 --> 0:22:31.040 with human surg surgeons as well. Sure, not just robotic, 0:22:31.080 --> 0:22:35.840 it's like overall apparently surgical injury and accident reporting is 0:22:35.880 --> 0:22:38.720 not compulsory. Yeah, and here's here's a few points though. 0:22:39.040 --> 0:22:43.200 Counterpoints I guess is one, it's not always the robotic 0:22:43.240 --> 0:22:47.480 component of the surgery that was the cause to a 0:22:47.520 --> 0:22:49.159 lot of times they say they don't know about this 0:22:49.320 --> 0:22:52.359 until like a lawsuit is filed, so it could be 0:22:52.400 --> 0:22:55.159 weeks or months later with the physician doesn't know about it, 0:22:55.560 --> 0:22:58.320 the f d A might not get report on it, 0:22:58.440 --> 0:23:00.680 and like six months later you follow lawsuit and that's 0:23:00.680 --> 0:23:03.639 how it comes to light. UM. But the FDA is 0:23:03.640 --> 0:23:07.920 definitely concerned and are supposedly working to improve this. That's 0:23:08.000 --> 0:23:12.280 very concerned. They're very concerned. H And another problem too 0:23:12.480 --> 0:23:16.480 in that same article, a lot of these robotic surgical systems, 0:23:17.160 --> 0:23:19.439 you still have to have the correct amount of training 0:23:20.040 --> 0:23:24.000 and UH. The feeling of some experts is that UM 0:23:24.119 --> 0:23:27.359 or at least this one guy, Enrico Benedetti, he's a 0:23:27.400 --> 0:23:30.680 head of surgery at the University of Illinois, Chicago, says 0:23:30.720 --> 0:23:32.320 a lot of it just comes back to training these 0:23:32.400 --> 0:23:35.240 some of these doctors aren't getting adequately trained in these 0:23:35.320 --> 0:23:38.520 machines enough to perform the surgery. Like what happens when 0:23:38.520 --> 0:23:43.360 I do this? Oh, that happens. That's not good. I've 0:23:43.359 --> 0:23:45.639 got another alarming stat for you to hold on. Hold on, 0:23:45.720 --> 0:23:55.800 hold on. Before that, let's do a message break rel okay, 0:23:56.160 --> 0:23:59.760 tell me you're alarming stat alright. JOHNS. Hopkinsider study that 0:23:59.800 --> 0:24:03.840 found as many as forty thou patients die in intensive 0:24:03.840 --> 0:24:08.280 care each year in the US due to misdiagnosis MAN 0:24:08.600 --> 0:24:12.840 and UM. Another study found that system related factors like UH, 0:24:13.280 --> 0:24:17.119 lack of teamworking, communication, or just poor processes were involved. 0:24:17.160 --> 0:24:24.040 In six of diagnostic error and cognitive factors in with 0:24:24.160 --> 0:24:27.480 premature closure is the most common, which is basically just 0:24:27.520 --> 0:24:30.560