4 ms·

Access to doctors is limited by the AMA which functions as a cabal or traditional guild: controlling the supply of doctors to maintain high salaries by insulati

Access to doctors is limited by the AMA which functions as a cabal or traditional guild: controlling the supply of doctors to maintain high salaries by insulating them from supply and demand (while also controlling or at least pretending to control quality). In my opinion being 100,000x lower cost gives such a system some leeway in being worse and I think most patients would agree.

SamoyedFurFluff 3y ago
> In my opinion being 100,000x lower cost gives such a system some leeway in being worse and I think most patients would agree. I would heavily disagree with this. We had an AI counselor actively encouraging disordered eating and triggering people into relapse on an eating disorder helpline from logic like this.
- AbrahamParangi 3y ago
  While I understand that some will disagree, it’s not like there’s an objective standard against which we are measuring both the AI and the human counselors to begin with. Without a standard it’s just anecdotes and with a standard there’s clarity on when the increased costs no longer justify the lower access and potentially higher quality. I suspect that if we instituted an objective standard we would find that AI is already capable of meeting or exceeding some proportion of people currently employed in the role today.
  - SamoyedFurFluff 3y ago
    This cannot possibly be the case when there was a clear A/B test scenario here. AI was dropped in, nothing else changed about the website, suddenly cases of relapse and worsening conditions went up.
    - AbrahamParangi 3y ago
      I think you're confusing my statement that "it could be done well" with "your team did it well"
- explaininjs 3y ago
  And I’m very familiar with AMA-certified (TM) “doctors” who have done the same.
  - SamoyedFurFluff 3y ago
    In this case there’s a fairly clear A/B test where if we dropped in an AI instead of hired counselors, the number of negative outcomes went up.
0xcde4c3db 3y ago
I've read that it's largely the residency system (which, from the outside, feels more like hazing than training) that limits positions, and I don't think that's under any direct control by the AMA. Wikipedia says it's mostly funded by Medicare.
- dontupvoteme 3y ago
  The residency system is insane, iirc was founded by a guy who was constantly on coke and then took heroin to sleep. Then that became the standard.
  - xigency 3y ago
    It’s an incredibly dangerous and unethical practice that is universal in US hospitals.
- AbrahamParangi 3y ago
  The AMA lobbies to keep the supply of residency slots restricted* in 1997 the AMA successfully lobbied to freeze the funding for new residency slots at 1996 levels. Lobbying by the AMA is also no small part of why it's so hard for a foreign-born doctor to practice medicine in the US. *although in the face of the incredible pressure they're about to face from AI they may be opening up

SamoyedFurFluff 3y ago

> In my opinion being 100,000x lower cost gives such a system some leeway in being worse and I think most patients would agree. I would heavily disagree with this. We had an AI counselor actively encouraging disordered eating and triggering people into relapse on an eating disorder helpline from logic like this.

AbrahamParangi 3y ago
While I understand that some will disagree, it’s not like there’s an objective standard against which we are measuring both the AI and the human counselors to begin with. Without a standard it’s just anecdotes and with a standard there’s clarity on when the increased costs no longer justify the lower access and potentially higher quality. I suspect that if we instituted an objective standard we would find that AI is already capable of meeting or exceeding some proportion of people currently employed in the role today.
- SamoyedFurFluff 3y ago
  This cannot possibly be the case when there was a clear A/B test scenario here. AI was dropped in, nothing else changed about the website, suddenly cases of relapse and worsening conditions went up.
  - AbrahamParangi 3y ago
    I think you're confusing my statement that "it could be done well" with "your team did it well"
explaininjs 3y ago
And I’m very familiar with AMA-certified (TM) “doctors” who have done the same.
- SamoyedFurFluff 3y ago
  In this case there’s a fairly clear A/B test where if we dropped in an AI instead of hired counselors, the number of negative outcomes went up.

0xcde4c3db 3y ago

I've read that it's largely the residency system (which, from the outside, feels more like hazing than training) that limits positions, and I don't think that's under any direct control by the AMA. Wikipedia says it's mostly funded by Medicare.

dontupvoteme 3y ago
The residency system is insane, iirc was founded by a guy who was constantly on coke and then took heroin to sleep. Then that became the standard.
- xigency 3y ago
  It’s an incredibly dangerous and unethical practice that is universal in US hospitals.
AbrahamParangi 3y ago
The AMA lobbies to keep the supply of residency slots restricted* in 1997 the AMA successfully lobbied to freeze the funding for new residency slots at 1996 levels. Lobbying by the AMA is also no small part of why it's so hard for a foreign-born doctor to practice medicine in the US. *although in the face of the incredible pressure they're about to face from AI they may be opening up