By The Medical Futurist Team for The Medical Futurist
The medical community should not fall for the fearmongering around A.I.
At the dawn of the Fourth Industrial Revolution, automation and digitization are turning the job market upside down. Many fear that robots, A.I., and automation, in general, will take their jobs without alternatives. The same anxieties emerged in healthcare about artificial intelligence taking the place of radiologists, robots surpassing the skills of surgeons, or taking jobs in pharma.
A renowned voice in tech, Kai-Fu Lee, founder of venture capital firm Sinovation Ventures told CNBC that A.I. will be bigger than all other tech revolutions, and robots are likely to replace 50 percent of all jobs in the next decade. Silicon Valley-investor Vinod Khosla even said that machines will substitute 80 percent of doctors in the future in a healthcare scene driven by entrepreneurs, not medical professionals. In late 2016, Prof Geoffrey Hinton, the godfather of neural networks, said that it’s “quite obvious that we should stop training radiologists” as image perception algorithms are very soon going to be demonstrably better than humans. Radiologists are, he said, “the coyote already over the edge of the cliff who hasn’t yet looked down.”
They’re just plain wrong. All of them. Although many signs are pointing towards the fact that A.I. will completely move the world of medicine, and many other technologies will also have a transformative effect on the industry, stating that the majority of medical professionals will disappear, is fearmongering and irresponsible. For example, it could scare off medical students from becoming a radiologist. In his presentation at the GPU Tech Conference in San Jose in May 2017, Curtis Langlotz, Professor of Radiology and Biomedical Informatics at Stanford University, mentioned how he received an e-mail from one of his students saying he was thinking about going into radiology but does not know whether it is a viable profession anymore.
Healthcare will need humans in the future
The author believes that investors such as Vinod Khosla do not entirely understand the healthcare sector, and thus his vision will not shape up. Ever. According to a report by Carl Benedikt Frey and Michael A. Osborne from the University of Oxford, medical transcriptionists, medical records and health information technicians and medical secretaries are the most likely jobs to be computerized in the future, but physicians and surgeons have a 0.42 percent chance for their professions being automated.
Don’t get me wrong, A.I. will appear in healthcare in the next 10-15 years. Hugh Harvey, radiologist and clinical academic for example estimates that in 10 years A.I. will be routine in NHS practice. Anna Fernandez, Health Informatics/Precision Medicine Lead at Booz Allen Hamilton told The Medical Futurist in 2017 that within three years we’ll have many machine learning algorithms in active clinical pilot testing and approved use in the US.
Moreover, A.I. will transform the meaning of what it means to be a doctor: some tasks will disappear while others will be added to the work routine. However, there will never be a situation where the embodiment of automation, either a robot or an algorithm will take the place of a doctor. Let me tell you five reasons why.
1) We cannot replace empathy
Even if the array of technologies will offer brilliant solutions, it would be difficult for them to mimic empathy. Why? Because at the core of empathy, there is the process of building trust: listening to the other person, paying attention to his needs, expressing the feeling of compassion and responding in a manner that the other person knows he was understood.
At present, you would not trust a robot or a smart algorithm with a life-altering decision or even with a decision whether or not to take painkillers, for that matter. Take the example of the NHS and their experiment to ease the burden on their health lines with chatbots. Patients participating in the trial indicated that they would play the system to get an appointment with the doctor quicker instead of taking the recommendations of a chatbot. That might change in the future in case of simpler health questions and patients taking more responsibilities in their care, but we might never be able to imagine healthcare without human empathy. We will need doctors holding our hands while telling us about a life-changing diagnosis, their guide through therapy and their overall support. An algorithm cannot replace that. Ever.
2) Physicians have a non-linear working method
There was an episode in House M.D. where the team couldn’t figure out how a young boy could have been poisoned. They considered many options: drugs, food poisoning, pesticide poisoning. For every possible diagnosis, they suggested a different treatment option. Each one of them made the patient worse – until they figured out, by accident, that the boy picked up phosmet, a type of insecticide from the jeans that he bought from a street vendor who kept the trousers in a truck. The boy didn’t wash the piece of clothing before wearing it, that’s how his skin could absorb the poison.
No algorithm could have made that diagnosis. Although data, measurements and quantitative analytics are a crucial part of a doctor’s work – and it is going to be even more critical in the future (you know, data is the new oil or bacon) – setting up a diagnosis and treating a patient is not a linear process. It requires creativity and problem-solving skills that algorithms and robots will never have.
Patients and their lifestyles vary to the degree that people differ. Diseases have the same feature. Thus, no case is the same; every one of them requires the attention of human physicians. Until the emergence of complex, digital solutions, doctors translated data coming from simple medical devices into medical decisions. In the future, the task will be the same – they will only use more complicated technologies.
3) Complex digital technologies require competent professionals
More and more sophisticated digital health solutions will require the competence of qualified medical professionals. No matter whether it’s about robotics or A.I. Take the example of the most commonly known surgical robot, the da Vinci Surgical System. It features a magnified 3D high-definition vision system and tiny wristed instruments that bend and rotate far greater than the human hand. However, surgeons have to learn how to operate it, and it takes practice to master it.
Likewise, look at IBM Watson. Its unique program for oncologists – we interviewed one of the professors working with it – provides clinicians evidence-based treatment options. Nonetheless, it’s only doctors together with their patients who can choose the treatment, and only physicians can evaluate whether the smart algorithm came up with potentially useful suggestions. No robot or algorithm could clearly interpret complex, multi-layered challenges – involving the psyche. While they will provide the data, interpretation will always remain a human territory.
4) There will always be tasks algorithms and robots can never complete
Physicians, nurses and other members of the medical staff have plenty of cumbersome monotonous and repetitive tasks to complete every single day. A study says that in the United States, the average doctor spends 8.7 hours per week on administration. Psychiatrists spent the highest proportion of their working hours on paperwork (20.3%), followed by internists (17.3%) and family/general practitioners (17.3%). These types of tasks and procedures can be automated – and they should be.
However, there are responsibilities and duties which technologies cannot perform. While IBM Watson can sift through millions of pages of documents in seconds, it will never be able to do the Heimlich maneuver. There will always be tasks where humans will be faster, more reliable – or cheaper than technology.
5) It has never been tech vs. human
The consistent and constant enemy image building should stop once and for all. It has never been technology versus humans – a sort of them versus us – since technological innovations always serve the purpose to help people. We are playing on the same team. No matter whether it’s A.I., robotics, augmented or virtual reality, we should accept that they have a massive influence on the way healthcare operates, and then start utilizing their power. Imagine what healthcare could be capable of if the creativity and problem-solving skills of were combined with the infinite computing power and cognitive resource of technology.
Collaboration between humans and technology is the ultimate response. A study for identifying metastatic breast cancer through deep learning shows something similar. When the deep learning system’s predictions were combined with the human pathologist’s diagnoses, the image classification, as well as the tumor localization score, increased significantly. Moreover, the human error rate decreased 85 percent. The findings show that artificial intelligence and humans are the most potent when they cooperate.