3 ms·

Not if they're trained to work through the problem each time they encounter it and stay up with their clinical training. The day the new classification drops ma

Not if they're trained to work through the problem each time they encounter it and stay up with their clinical training. The day the new classification drops many have already heard about it. You also assume that all the models in use will in fact be retrained. Generally, this position flies in the face of lived experience. AI is in fact stifling adoption of new things across many industries.

kaonwarb 2y ago
My position is informed by my own experience; I am not a physician, but have worked closely with a large number of them in a healthcare-oriented career. I've repeatedly noted long-term resistance of many physicians to updating their priors based on robust new evidence. There are definitely many physicians who do take in the latest developments judiciously. But I find the long tail of default resistance to be very, very long.
- shermantanktop 2y ago
  I was just explaining to a UK colleague about how the American health care system makes getting treatment (and getting it paid for) into a DIY project. And so as a medical shopper, if I’m getting a very standard established treatment I might go for the older experienced doctor, but if it’s a new thing I’d opt for someone more recently graduated. I’m sure the same thing applies worldwide.
- throwbmw 2y ago
  It's not bad actually, considering how many times the new shiny thing has turned out to be quite dangerous a few years later. In a field as high stake as healthcare you want the whole spectrum, from early adopters to die hard skeptics. Especially since we know the reproducibility problem of research, the influence of big pharma and big insurance on healthcare, etc etc
gibspaulding 2y ago
> You also assume that all the models in use will in fact be retrained. And that deploying the retrained models won’t require a costly and time consuming recertification process. This is medicine after all.
dsign 2y ago
Where I live, specialists can't even speak English, so I doubt very much that they are up to date on anything. And I live in a first-world country.
- jajko 2y ago
  On a first glance this may look like bad comment but there is sound reasoning, I see it with friends who are top notch doctors and surgeons in french part of Switzerland. Many articles and conferences are in english, often dont get translated (well), and one friend who is urology surgeon specifically mentioned this as an issue in his (former) department in Switzerland's biggest hospital (HUG in Geneva). They simply lag behind bleeding edge a bit. Can't comment on other languages/cultures, but french speaking folks and english often dont pair well together.
  - cbg0 2y ago
    I'm also in a country where English isn't the first language and for the doctors that do wish to stay up to date on what's going on, there are ways for them to do it, and translation technology is pretty top-notch already. Aside from time constraints and perhaps no incentive to stay up to date, we do have to remember that some of these new discoveries always take time to find their way into becoming SOTA treatments everywhere, due to costs, regulations needing updates, special training or equipment being required, as well as sometimes only being marginally better than existing treatment options.
afpx 2y ago
There's no way that doctors in the US continue their training. I suffer from a chronic illness. I saw 5 different specialists over the past 2 years, and each one gave me different treatment. A couple even relied on information from the 70s and 80s. One even put me in the ER because he changed my treatment after I explicitly told him not to. Another example: Back in my 20s, I injured my back. I took my MRI results to six different doctors - and I'm serious here, every one gave me a different diagnosis. In the end, I fixed it myself by doing my own research and treatment (2 years of physical therapy). One doctor said I had pain because spine fragments were lodged in my spinal cord (not true). Two of the doctors were even pushing me into invasive surgeries, and I'm so glad I told them no. I don't understand the praise for doctors. If I had to generalize, I'd guess the majority give up learning after achieving wealth and status. seems like an art and not a science. I will emphatically welcome AI treatment.
- jayd16 2y ago
  If you don't respect the field in general, why do you think an AI amalgamation of that field to be better?
  - afpx 2y ago
    I respect the research and researchers - but medical researchers are far removed from medical practitioners.
- PaulHoule 2y ago
  Continuous improvement is the norm in cancer treatment, not in other areas where diseases are ill-defined and have a huge psychogenic component: back pain is the index case for that, so is TMJ dysfunction. In either case you might go from disabled to 'I have a bad day once a month' with a 20% change in habits and 80% change in attitude. My dad, who worked in construction, got disabling back pain just in time for the Volcker-Freedman recession [1] His doc wanted to give him surgery which had the risk of being even more disabling, he said he'd go to a chiropractor, his doc said "if you don't do that then don't see me". I remember him taking me along for his chiropractor visits and getting a waterbed (bad idea.) He was on workman's comp at the time but got better around the time the economy got better and work was available again. Not to say he was consciously malingering, but work-associated pain has a lot to do with how you feel about your work. [1] https://en.wikipedia.org/wiki/Early_1980s_recession https://en.wikipedia.org/wiki/Early_1980s_recession

kaonwarb 2y ago

My position is informed by my own experience; I am not a physician, but have worked closely with a large number of them in a healthcare-oriented career. I've repeatedly noted long-term resistance of many physicians to updating their priors based on robust new evidence. There are definitely many physicians who do take in the latest developments judiciously. But I find the long tail of default resistance to be very, very long.

shermantanktop 2y ago
I was just explaining to a UK colleague about how the American health care system makes getting treatment (and getting it paid for) into a DIY project. And so as a medical shopper, if I’m getting a very standard established treatment I might go for the older experienced doctor, but if it’s a new thing I’d opt for someone more recently graduated. I’m sure the same thing applies worldwide.
throwbmw 2y ago
It's not bad actually, considering how many times the new shiny thing has turned out to be quite dangerous a few years later. In a field as high stake as healthcare you want the whole spectrum, from early adopters to die hard skeptics. Especially since we know the reproducibility problem of research, the influence of big pharma and big insurance on healthcare, etc etc

gibspaulding 2y ago

> You also assume that all the models in use will in fact be retrained. And that deploying the retrained models won’t require a costly and time consuming recertification process. This is medicine after all.

dsign 2y ago

Where I live, specialists can't even speak English, so I doubt very much that they are up to date on anything. And I live in a first-world country.

jajko 2y ago
On a first glance this may look like bad comment but there is sound reasoning, I see it with friends who are top notch doctors and surgeons in french part of Switzerland. Many articles and conferences are in english, often dont get translated (well), and one friend who is urology surgeon specifically mentioned this as an issue in his (former) department in Switzerland's biggest hospital (HUG in Geneva). They simply lag behind bleeding edge a bit. Can't comment on other languages/cultures, but french speaking folks and english often dont pair well together.
- cbg0 2y ago
  I'm also in a country where English isn't the first language and for the doctors that do wish to stay up to date on what's going on, there are ways for them to do it, and translation technology is pretty top-notch already. Aside from time constraints and perhaps no incentive to stay up to date, we do have to remember that some of these new discoveries always take time to find their way into becoming SOTA treatments everywhere, due to costs, regulations needing updates, special training or equipment being required, as well as sometimes only being marginally better than existing treatment options.

afpx 2y ago

There's no way that doctors in the US continue their training. I suffer from a chronic illness. I saw 5 different specialists over the past 2 years, and each one gave me different treatment. A couple even relied on information from the 70s and 80s. One even put me in the ER because he changed my treatment after I explicitly told him not to. Another example: Back in my 20s, I injured my back. I took my MRI results to six different doctors - and I'm serious here, every one gave me a different diagnosis. In the end, I fixed it myself by doing my own research and treatment (2 years of physical therapy). One doctor said I had pain because spine fragments were lodged in my spinal cord (not true). Two of the doctors were even pushing me into invasive surgeries, and I'm so glad I told them no. I don't understand the praise for doctors. If I had to generalize, I'd guess the majority give up learning after achieving wealth and status. seems like an art and not a science. I will emphatically welcome AI treatment.

jayd16 2y ago
If you don't respect the field in general, why do you think an AI amalgamation of that field to be better?
- afpx 2y ago
  I respect the research and researchers - but medical researchers are far removed from medical practitioners.
PaulHoule 2y ago
Continuous improvement is the norm in cancer treatment, not in other areas where diseases are ill-defined and have a huge psychogenic component: back pain is the index case for that, so is TMJ dysfunction. In either case you might go from disabled to 'I have a bad day once a month' with a 20% change in habits and 80% change in attitude. My dad, who worked in construction, got disabling back pain just in time for the Volcker-Freedman recession [1] His doc wanted to give him surgery which had the risk of being even more disabling, he said he'd go to a chiropractor, his doc said "if you don't do that then don't see me". I remember him taking me along for his chiropractor visits and getting a waterbed (bad idea.) He was on workman's comp at the time but got better around the time the economy got better and work was available again. Not to say he was consciously malingering, but work-associated pain has a lot to do with how you feel about your work. [1] https://en.wikipedia.org/wiki/Early_1980s_recession https://en.wikipedia.org/wiki/Early_1980s_recession