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One thing that I think people need to understand is the distinction between science and the practice of medicine. The practice of medicine is not science. The

One thing that I think people need to understand is the distinction between science and the practice of medicine. The practice of medicine is not science. The practice of medicine can be informed by science - to a degree that is almost entirely up to the practitioner. ; but it remains more art than science. The distinction is similar to that between an aviation maintenance and aerospace engineering. Sometimes doctors are just out of their depth.

kzrdude 3y ago
Do doctors know this? We need to tell them they need to practice at the art, to get better at it.
- KRAKRISMOTT 3y ago
  They are bound by regulations and liability, your typical GPs and even the specialists can't greenlight experiments outside of big research hospitals. Medicine and clinical diagnosis are heavily regulated. That's also why you rarely see single author papers in practical clinical medicine. Doctors are busy people, with horrendous work life balance. Most software engineers have it way easier, you get to choose your tools and you get to choose where you want to work. In the business of software engineering, a sufficiently senior engineer can get away with a lot of nonsense without risk of lawsuits.
- mensetmanusman 3y ago
  HIPPA doesn’t allow it (yet?), you have to do it yourself.
Cpoll 3y ago
> aviation maintenance and aerospace engineering Which is which though? As I understand it, aviation maintenance is quite rigorous, systematic, and informed by and taking into account every mistake made in the past.
- daddylongstroke 3y ago
  Absolutely right! Maybe the most regulated industry in the US, but not positive.
mpsprd 3y ago
Doctors are technicians. Technicians with a large toolkit, but technicians nonetheless. When you compare their behaviors to IT it all starts making sense.
- talonx 3y ago
  Add to that the fact that experience matters a lot too. The more variety of cases a doctor sees, the more the chances are that their diagnosis is going to be useful.
  - Turskarama 3y ago
    Yes and no, the more a doctor sees a particular diagnosis the less likely they are to consider anything else. Honestly of all the professions that could be enhanced by AI, medicine has the most to gain. An AI can remember a much larger data set than any human and look for correlations among many more dimensions.
    - xbmcuser 3y ago
      Yes that's what I think as well. And it's sad that medical data being weaponized against you is the thing that takes more sound bytes than how medical data collection can improve diagnosis and healthcare. But with the way medical industry, insurance industry etc are we cant blame people for worrying about data collection specially in a country like the US where you can become destitute without medical insurance
    - Aerbil313 3y ago
      The great thing is even LLMs who only take text input still can yield better results than doctors. Think about a healthcare system which utilizes transformers working on images etc.
- matheusmoreira 3y ago
  Being a doctor is like debugging a unique humongous software application with thousands of years of organic patchwork added by a godlike AI which just generates random code and watches the failed experiments die, no source code to any of it just the final binary, no debugger that lets you kill the process and dump its memory or trace its execution, just a bunch of test cases that cost lots of money to run and may yield false positives and false negatives making every bug some sort of heisenbug which may or may not show up when you try to reproduce it and reduces you to guessing with some percentage of certainty fuzzy logic, and even if you do manage to figure anything out in your desperate attempt to fix it you're reduced to essentially inserting event objects into the software's internal event system and hoping it produces the desired effects as it circulates throughout the entire system while hoping it won't adversely affect anything else and it's not even guaranteed to make anything better, or alternatively you pry the program open very carefully while it's running and cut code sections which grew tumorous or stitch together other sections which are leaking precious data or remodel the pipes so the data flows more efficiently, all to hopefully fix the problem while praying to god your attempt to fix it didn't actually make it worse because some malware randomly made it into the program while you worked on it.
wpietri 3y ago
For sure. A friend of mine went to med school and chose the general practitioner path. One time I was hanging out at their place, so I leafed through some of the GP journals on the coffee table. It seemed much more akin to car repair than to science.
- Firmwarrior 3y ago
  yeah, I was just thinking about this today. Doctors seem less like engineers and more like QA testers or PMs trying to fix bugs since there's nobody better suited to the job available. Hopefully medical science will keep advancing rapidly here..
  - josephg 3y ago
    I doubt doctors will get better at this in our lifetimes. As we discover ever more about the human body, how are doctors expected to keep up with the research on top of everything else? I’m hoping AI systems can help. A good medical AI should be able to stay abreast of all the research, know your personal medical history and suggest and evaluate any and all medical tests that are needed. Doctors will hate it, but I expect AIs will give much more accurate diagnoses than humans before long.
    - daddylongstroke 3y ago
      I agree. Doctors' performance will remain the same as it has for thousands of years: overall, not so good. But, they've been using AI systems for well near a decade, especially in triage and real-time transcriptions. I haven't met many that don't love AI already in their day to day work.
    - com 3y ago
      Just some statistics can help. My family doctor has some kind of awful green screen practice software but amazingly it has prognosis statistics for certain lab diagnostic results. Makes for better discussion about treatment plans.

kzrdude 3y ago

Do doctors know this? We need to tell them they need to practice at the art, to get better at it.

KRAKRISMOTT 3y ago
They are bound by regulations and liability, your typical GPs and even the specialists can't greenlight experiments outside of big research hospitals. Medicine and clinical diagnosis are heavily regulated. That's also why you rarely see single author papers in practical clinical medicine. Doctors are busy people, with horrendous work life balance. Most software engineers have it way easier, you get to choose your tools and you get to choose where you want to work. In the business of software engineering, a sufficiently senior engineer can get away with a lot of nonsense without risk of lawsuits.
mensetmanusman 3y ago
HIPPA doesn’t allow it (yet?), you have to do it yourself.

Cpoll 3y ago

> aviation maintenance and aerospace engineering Which is which though? As I understand it, aviation maintenance is quite rigorous, systematic, and informed by and taking into account every mistake made in the past.

daddylongstroke 3y ago
Absolutely right! Maybe the most regulated industry in the US, but not positive.

mpsprd 3y ago

Doctors are technicians. Technicians with a large toolkit, but technicians nonetheless. When you compare their behaviors to IT it all starts making sense.

talonx 3y ago
Add to that the fact that experience matters a lot too. The more variety of cases a doctor sees, the more the chances are that their diagnosis is going to be useful.
- Turskarama 3y ago
  Yes and no, the more a doctor sees a particular diagnosis the less likely they are to consider anything else. Honestly of all the professions that could be enhanced by AI, medicine has the most to gain. An AI can remember a much larger data set than any human and look for correlations among many more dimensions.
  - xbmcuser 3y ago
    Yes that's what I think as well. And it's sad that medical data being weaponized against you is the thing that takes more sound bytes than how medical data collection can improve diagnosis and healthcare. But with the way medical industry, insurance industry etc are we cant blame people for worrying about data collection specially in a country like the US where you can become destitute without medical insurance
  - Aerbil313 3y ago
    The great thing is even LLMs who only take text input still can yield better results than doctors. Think about a healthcare system which utilizes transformers working on images etc.
matheusmoreira 3y ago
Being a doctor is like debugging a unique humongous software application with thousands of years of organic patchwork added by a godlike AI which just generates random code and watches the failed experiments die, no source code to any of it just the final binary, no debugger that lets you kill the process and dump its memory or trace its execution, just a bunch of test cases that cost lots of money to run and may yield false positives and false negatives making every bug some sort of heisenbug which may or may not show up when you try to reproduce it and reduces you to guessing with some percentage of certainty fuzzy logic, and even if you do manage to figure anything out in your desperate attempt to fix it you're reduced to essentially inserting event objects into the software's internal event system and hoping it produces the desired effects as it circulates throughout the entire system while hoping it won't adversely affect anything else and it's not even guaranteed to make anything better, or alternatively you pry the program open very carefully while it's running and cut code sections which grew tumorous or stitch together other sections which are leaking precious data or remodel the pipes so the data flows more efficiently, all to hopefully fix the problem while praying to god your attempt to fix it didn't actually make it worse because some malware randomly made it into the program while you worked on it.

wpietri 3y ago

For sure. A friend of mine went to med school and chose the general practitioner path. One time I was hanging out at their place, so I leafed through some of the GP journals on the coffee table. It seemed much more akin to car repair than to science.

Firmwarrior 3y ago
yeah, I was just thinking about this today. Doctors seem less like engineers and more like QA testers or PMs trying to fix bugs since there's nobody better suited to the job available. Hopefully medical science will keep advancing rapidly here..
- josephg 3y ago
  I doubt doctors will get better at this in our lifetimes. As we discover ever more about the human body, how are doctors expected to keep up with the research on top of everything else? I’m hoping AI systems can help. A good medical AI should be able to stay abreast of all the research, know your personal medical history and suggest and evaluate any and all medical tests that are needed. Doctors will hate it, but I expect AIs will give much more accurate diagnoses than humans before long.
  - daddylongstroke 3y ago
    I agree. Doctors' performance will remain the same as it has for thousands of years: overall, not so good. But, they've been using AI systems for well near a decade, especially in triage and real-time transcriptions. I haven't met many that don't love AI already in their day to day work.
  - com 3y ago
    Just some statistics can help. My family doctor has some kind of awful green screen practice software but amazingly it has prognosis statistics for certain lab diagnostic results. Makes for better discussion about treatment plans.