The Future of AI in Healthcare: No Doctors Required

By Kathryn Ziden

Robotics and artificial intelligence (AI) are changing the field of healthcare. Doctors are seemingly open to this change, as long as there still is a place for them in the system. But is this a reality? Will we need doctors in the future? In the short term, yes. In the long term, not likely.

A recent study by the market research firm Frost & Sulllivan estimates the AI market in healthcare will exceed $6 billion by 2021. AI is already making big advances in automated soft-tissue surgery, medical imaging, drug discovery, and perhaps its biggest success so far: using big data analytics to diagnose and treat disease. IBM’s Watson is already being used at 16 cancer institutes, and recently correctly diagnosed a rare form of leukemia in a Japanese woman, after conventional (human) methods had failed.

However, on the question of where this leads in the long term, there is a disconnect between technology forecasts and doctors’ opinions. Article after article on the future of AI in healthcare quotes doctors and healthcare professionals as predicting that computers/robots/AI will never be able to replace them. The reasoning of these professionals seem to fall into one of the following arguments, and reflects a we-are-too-big-to-fail attitude or a god complex on behalf of the doctors:

#1.) Doctors will always be needed to give that special, reassuring human factor. One doctor claims that she could never be replaced by a computer because patients routinely leave her office saying how much better they feel after just talking to her. Another doctor adds, “Words alone can heal.”

Rebuttal: Although the human factor may be vital, it does not require a medical degree to provide comfort or solace to a patient. Social workers, nurses or psychologists can fill this role.

#2.) Only doctors can pick up on nuanced subtleties of a patient’s mood, behavior or appearance to make a diagnosis. For example, one doctor posits that if a woman has ovarian pain or a missed menstrual period, a computer would never be able pick up on the fact that it could be caused by anxiety, stress, depression, a lack of sleep or over-mediation– the way a doctor can.

Rebuttal: AI systems could almost certainly be able to probe for these types of secondary causes through a patient’s facial cues, bloodwork and a line of questioning, the same way a doctor currently does.

#3.) Doctors will be assisted by AI in calculating diagnoses and treatment plans, but doctors will still be needed to make the final decision. A doctor’s decision-making process can account for additional variables.

Rebuttal: An AI framework has already been shown to make better medical decisions than human doctors. Doctors are prone to biases and human error; their decisions can be based on emotions, influenced by fatigue from a long day, and limited by the brain’s capacity to store and recall data.

#4.) Computers will never have a doctor’s intuition. Doctors have a “sixth sense” used in their diagnoses. Practicing medicine is an art.

Rebuttal: Intuition is pattern recognition; something computers are much better at. Medicine is an applied science that requires decision making (i.e. the “art” part). AI algorithms are already better at making medical decisions than doctors.

#5.) Doctors will still be needed to perform physical examinations.

Rebuttal: The idea of having a physical exam by a doctor is already going by the wayside. As one doctor puts it, “The physical exam was critical when it was all we had.” And in cases where a physical exam is needed, there is already a robotic glove that can perform a physical exam.

In the next 10 to 20 years, I believe we will see a human-AI hybrid healthcare system, where individuals will be more in control of their own healthcare. Successful doctors will need to change their practices and attitudes to cope with the emergence of new technologies. In the long term, however, our entire healthcare system will likely undergo an AI-ification, and the idea of human doctors and surgeons will be obsolete. But perhaps there will be an increased market for homeopathy or alternative medicine by patients who aren’t ready for this future either.

Doctors’ reluctance or inability to see a future in which they are not needed is a form of optimism bias and is something that all of us are susceptible to. A 2016 PEW Research Center study showed that 65% of respondents thought that robots and computers will take over jobs currently done by humans within the next 50 years; however, 80% of people said that it won’t be their job that is taken over. There is a disconnect. Nothing is more powerful than human delusion… except perhaps the efficiency and skillfulness of your future AI doctor.


What Personalized Medicine is to Me

Charles Mueller

I hate our current medical system and I hate that industry runs it. I hate it because the medical field and medical industry all abide by a central dogma that “the answer to failures of a biological system (the human body) is a pill.” No. The answer to biological system failures is a biological system solution. It is learning how to manipulate your entire biological system and not just the one part you are concerned about. It is about learning to use the body’s systems to fix itself.

This is our fundamental problem with understanding disease. We subscribe to the belief that a diseased liver is an isolated problem and all you need to focus on is the liver. We forget the body is connected and we do not even explore solutions that might involve unorthodox approaches that manipulate entire systems rather than organs. We need a new dogma in medicine and the idea of personalized medicine might be just what we need.

There is a lot of talk right now about personalized (or precision) medicine after the President revealed his Precision Medicine Initiative. I think this initiative fails to recognize what personalized medicine really is and what is needed to make it real.

To me, personalized medicine is understanding how all the cells of the body communicate and respond to changes in the environment. The question though is how do you figure this out?

The first step is to identify the key metrics you need to understand the connectivity of the body’s systems. Once you figure this out, the next step is to monitor these in groups of people. Why groups of people? We cannot perform all of the controlled human experiments that would help us understand the body as a system because they would be morally and ethically wrong. So instead, it is about acknowledging that everyone makes choices that cause changes in their body. Your life is one giant experiment. Many people are probably similar to you and make similar choices. Many are similar at the biological level and make different choices. People are running around experimenting on themselves all of the time and nobody is asking them to come in so we can take some measurements and figure out what they are doing to themselves. This is the key. Let people be themselves and use Big Data analytics on the massive amount of data that is created from monitoring them. Monitor what the best available science tells us is important, group people into categories based on their metrics and life choices, and then figure out how different choices within a group result in health endpoints.

This is how collective monitoring results in personalized medicine. With such an approach, you will begin to really understand the system level of the body and how it responds to different life choices and the mechanisms for how those life choices alter human health.  Then it is just a matter of looking at you and what you have done to make highly informed predictions about the future of your health. You cannot just study one person in detail for the same reason that you cannot study one bacterial cell and say now you know everything that that strain does.

The President’s Precision Medicine Initiative plays into the existing dogma that I loathe. It fails to see the forest for the trees. It is primed to use Big Data analytics on personal data, like genetics, to identify which pill works best for you. There is reason they chose the word precision rather than personal. “Personal” would imply a new dogma, one that really focused on you and not one that focused on the precise pill for you.