4 ms·

Dr. Oz pushes AI avatars as a fix for rural health care

56 points by toomuchtodo 9mo ago

toomuchtodo 9mo ago
https://en.wikipedia.org/wiki/The_Doctor_(Star_Trek) https://en.wikipedia.org/wiki/The_Doctor_(Star_Trek)
- JohnTHaller 9mo ago
  The Doctor is better technology created by socialists for the purpose of benefiting the crew. Anything created by Dr Oz in association with right wing billionaires is gonna be the opposite of that.
AngryData 9mo ago
Listening to DR. Oz is a path to an early paupers grave.
falkensmaize 9mo ago
I wouldn’t trust “Dr” Oz to advise me on which brand of cold medicine to buy, much less the health of myself or my child.
- kingkawn 9mo ago
  Ironic that he is a cardiovascular surgeon offering his opinion on what is a sufficient assessment for OB/GYN care
  - falkensmaize 9mo ago
    It's not really ironic at all. It's entirely possible for someone to be a well-credentialed liar/conman.
- weare138 9mo ago
  Dr. Oz is a con artist, fraud and possibly a pedophile because he was just named in the Epstein files too. No one should be even so much as entertaining anything this man says. The solution is to regulate insurance companies so these communities could actually afford healthcare and expand social programs for rural areas.
rambojohnson 9mo ago
yikes.
mathgladiator 9mo ago
Since I'm dealing with how good claude code is, I gave a research task to claude to help my in-laws (who are psychologists) understand the coming storm at a more visceral level. AI produced this: https://nexivibe.com/future.mental.health.web/index.html https://nexivibe.com/future.mental.health.web/index.html I can't argue with the urgency. I then had claude produce a prompt based on this that I could feed Grok as a project to do therapy, and the result was shockingly good. Obviously, Dr. Oz is going to be a political lightning rod for some people, but if you factor that out and try using AI for therapy... this is coming. This is happening right now.
- hvb2 9mo ago
  Sure, the results CAN be good. The real question is if your health is one of those cases you want to roll the dice with. I don't, but that's up to everyone. Tesla fsd was the same thing. You needed to have people to try it. Some paid for it with their lives. Will it make progress, sure. Do I want to be the one that dies to make that progress? No
  - mathgladiator 9mo ago
    I have rolled the dice with it, and it's been great. I use it to tune fitness and every mental dimension. Time will tell. I will tell you this, using AI is better than using HN and random people who don't know me. I had the best technical conversation of my entire life with AI. I feel like I can handle it, and maybe I will dive into AI psychosis at some point. who knows! I can say that it is better than the silence I've had for years from no community giving two shits about what I wanted to build. I can admit the number of mistakes I've made, but at a certain point - enough is enough.
    - jplusequalt 9mo ago
      >I can say that it is better than the silence I've had for years from no community giving two shits about what I wanted to build It sounds like you were lacking community, then went deeper into isolation.
asveikau 9mo ago
Dr. Oz is in the Epstein files. The email he wrote in October 2019 is especially odd. He reached out to FBI wanting information on interviews of victims. FBI blew him off. (EFTA00037405) Between the lines, this really reads to me like he wants to know if anybody accused him. Someone on an internal email said not to tell Oz anything about the meeting. (EFTA00037407) He met with Epstein on 1/1/16. (EFTA02476629) I believe the meeting was initiated by Oz.
metrix 9mo ago
So we get so worked up over this stuff, and for good reason. But personally I'm taking another stance... let them.. It's not my choice to make someone understand what's best for an individual or as a group. Let them make these decisions, and learn for themselves. Will this cause issues where I am at risk of getting measles? Or that kids could get sick over non pasteurized milk? yes, but we're back in a place where people have to feel the pain. That's not to judge, or belittle or put anyone down. There's people who have views and values that conflict and that's OK.. Even if it's not the best for us a whole.
- mathgladiator 9mo ago
  I agree with this, but think of in more of an evolutionary lens. I've come to the place where every time we think we have solved a problem, we may not have and have created a new tree of problems. I am one of those knuckle heads that decided to give carnivore diet a try, and my wife and I have had amazing results on a number of metrics. We were also not even eating junk food or that much processed food. The sheer complexity of how we live demands humility, and in many ways the skeptics have valids point in many ways. I look to the Amish, for example, as a way that probably not that bad to live considering how much of the modern world has problems. At core, some people choose to be experiments, and some decide to the control. This is the reality I believe, and this is how the whole remains robust over the long term.
- esafak 9mo ago
  People can feel the pain without drawing the right conclusions to rectify the situation. For centuries people thought bad things happened because the gods were displeased. Some still do.
  - pixl97 9mo ago
    And many of those that still do would drag us kicking and screaming back to the days where talking out against the word of god was a capital crime.
- hydrogen7800 9mo ago
  "The common people know what they want, and deserve to get it good and hard."
metalman 9mo ago
rural here, raised in a medical family. there is NO rural health care, bare bones self funded "clinics" with no actual doctors. they want doctors here but cant offer competitive compensation, and the governments rural devitalisation plans are working, and demograhics back this up. every few miles there is another failed back to the land dream farm, and then some giant horsey place that will be a third+ home general health care is so rotten that the people hired from India to do the work, FLY back home to India, if they need health care for themselves as it's both faster and cheaper counting all the costs. that we are tumbing towards a crunch point and have no one to blame but the victims, then thats what we will do.
- OutOfHere 9mo ago
  The way healthcare is going in the US, we'll all have to fly to India if we need basic care that: 1. an AI cannot effectively deliver on its own. 2. requires physical testing and actual facilities rather than just prescriptions. If it works for the workers, ...
  - spwa4 9mo ago
    As the article points out, the state of healthcare in rural (and non-rural) communities is entirely a republican choice to make it what it is. This is an attempt to make a lot of money taking over medicine and that little detail that they don't actually deliver reasonable quality care will be "fixed" by sabotaging actual doctors (and everything from hospitals, to nurses, to cleaning staff) But you're kidding yourself. The whole world, including India has a doctor shortage AND is choosing not to train new medical doctors (frankly: especially India, they're not good about this). If flying to India helps, it'll be temporary. Oh and having AI do healthcare goes squarely into what AIs are really bad at: adversarial planning. Your doctor is more like a judge: depending on the situation, it's your doctor's job to push (and occasionally force) you to take certain decisions, AND to sometimes push and force the government to take decisions like the COVID lockdown. Does anyone think for a second Trump will allow for these AIs to be programmed to order him to lock down the country if the situation requires it? Or does he demand they just lie about the situation. I feel like we've seen the answer to this one.
kingkawn 9mo ago
I do not trust Oz et al to make this anything but an unethical grift. But Ironically we already have a lack of continuity of care, providers who are so overburdened that they cannot give any human nuance, and a complete lack of coordination across visits or diagnoses. So, America has done what it usually does; create a problem and then offer to sell the subpar solution. also, the healthcare industry has used impoverished urban areas as guinea pigs for training programs and hypothesis testing for many generations, why not the same benefit/detriment for rural America?
api 9mo ago
AI as a tool to make health care cheaper and more scalable is not an inherently bad idea, but I would not let these fools anywhere near it. Anything they touch is going to be a pure grift.
ok123456 9mo ago
The real problem was allowing the AMA to tightly control the supply of doctors for decades---that this would even be a solution to anything. There is very real opportunism and profiteering among those advocating and providing this "solution." But they didn't create the months of waiting that normal folk have to see routine specialists or PCPs. At the very least, they can get instructions on how to do first aid and when to go to the emergency room. I remember talking to friends who were well-meaning but panicked about the ACA being passed because the system would be inundated with people seeking healthcare, and that it would lead to Soviet-style rationing. The rationing hasn't come from any five-year plan or the like, but simply the supply of doctors not keeping up with the demands of a growing population.
- daveguy 9mo ago
  There should definitely be an independent board like the fed (different decisions per area, maybe different boards per state) that determines need for the next 5 years. This is the way they do hospital beds (state level), but not doctors to address them! Of course we have to boot the fascist asshats to have a chance at it being independent.
  - conover 9mo ago
    See Certificate of Need requirements: https://en.wikipedia.org/wiki/Certificate_of_need https://en.wikipedia.org/wiki/Certificate_of_need
- twoodfin 9mo ago
  As I understand, the throughput bottleneck on training new doctors is the availability of funded residencies. So chiefly on the hospitals and the government (Medicare, mostly) to spend more.
- toraway 9mo ago
  The meme about AMA artificially limiting the supply of new residency slots turned out to be much more complex the more I read about it (and IMO mostly incorrect, at least as described by the just-so stories on the internet where I first learned about it). The actual limiting factor is federally funded residency positions which are funded by CMMS, and were artificially capped by the Balanced Budget Act of 1997 during a widespread climate of financial austerity after Gingrich had led Republicans to retake the House in 1994 for the first time in decades. At the time, AMA apparently did release a report that included support for reducing the number of residency slots, so that detail is correct. But the decision wasn't made by them, and federal healthcare spending was already on the chopping block (and was a politically attractive area to make cuts given the Clinton's administration failed healthcare reform proposal). As early as 2006 [4], the AMA started releasing policy position statements requesting caps on federal funding to be increased, but it wasn't until the CARES ACT in 2020 that Congress funded 1000 new CMMS funded slots were funded (but limited to small gradual increases each year) and started to be implemented in 2021-2022. And they continue to advocate for increases that so far haven't been adopted. So while there's a kernel of inarguable truth that the AMA and other medical professional groups did support certain caps back in 1997, it has always been, then and now, a policy decision by Congress. With the motivation to set limits driven by concern over federal healthcare spending inflating budget expenditures. But it makes for a simpler, emotionally resonant narrative of a shadowy self-interested group pulling the strings at the expense of the public (that also conveniently redirects outrage away from the people actually empowered to fix the problem, or that federal spending is a crucial lever to fix the problem). [1] https://www.ama-assn.org/press-center/ama-press-releases/ama-fund-graduate-medical-education-address-physician-shortages https://www.ama-assn.org/press-center/ama-press-releases/ama... [2] https://washingtonian.com/2020/04/13/were-short-on-healthcare-workers-why-doesnt-the-u-s-just-make-more-doctors/ https://washingtonian.com/2020/04/13/were-short-on-healthcar... [3] https://www.openhealthpolicy.com/p/medical-residency-slots-congress https://www.openhealthpolicy.com/p/medical-residency-slots-c... [4] https://pmc.ncbi.nlm.nih.gov/articles/PMC1785175/ https://pmc.ncbi.nlm.nih.gov/articles/PMC1785175/
tehjoker 9mo ago
In China, when they didn't have enough medical personnel, they sent the half-trained barefoot doctors to the rural areas to give even basic medical care. Over time they trained more and more people in allopathic medicine and increased the level of care and expertise. Our elites care so little for us that they won't even bother to send real people, just a sop to tell us to shut up. Expectations rise with the level of development. No excuses in America.
techsocialism 9mo ago
[flagged]
zmmmmm 9mo ago
> "AI can't read facial expressions, tone of voice, or body language," she said. "And those things matter. That's where the relationship between a patient and provider is built — in the nuance." It's amazing how, no matter how dramatic the breakthroughs are, people will still totally fail to understand the concept and can't even extrapolate correctly to N+1. There's absolutely nothing fundamental about current AI tech it that limits it from reading facial expressions and tone of voice and even body language to the extent it can see it. And then, already there are studies showing that patients find AI responses more empathetic than actual doctors. There's a big question whether people will accept it such empathy as genuine, but my money is on people attaching to these things like crazy.
- jplusequalt 9mo ago
  >There's a big question whether people will accept it such empathy as genuine, but my money is on people attaching to these things like crazy Is that something we should cultivate in our society? Being emotionally attached to balls of linear algebra controlled by massive corporations?
  - zmmmmm 9mo ago
    I honestly don't really know. Notice they can't even actually say "human", they say "provider" above. So they are pretty much admitting, the alternative isn't that you get a life long relationship with a person. You're getting a lifelong attachment to a corporate entity either way. People become sentimentally attached to inanimate objects all the time. It's all about what it means to them. There really isn't a rule book here, we have to figure it out.
    - thepotatodude 9mo ago
      "Provider" and not "physician". Big tell.
thepotatodude 9mo ago
As a current medical student, there's no way I'm living in a rural area for anything other than an insane paycheck. Even then, I'm out after a few years. Urbanization is the solution. And physicians won't stand idly by as you replace their jobs. Enough pressure and the strikes begin. If that's what it will take for the value to be recognized, so be it. Big Tech isn't going to deliver us a healthcare utopia, but it will accelerate the enshittification of healthcare.

56 points by toomuchtodo 9mo ago

toomuchtodo 9mo ago

https://en.wikipedia.org/wiki/The_Doctor_(Star_Trek) https://en.wikipedia.org/wiki/The_Doctor_(Star_Trek)

JohnTHaller 9mo ago
The Doctor is better technology created by socialists for the purpose of benefiting the crew. Anything created by Dr Oz in association with right wing billionaires is gonna be the opposite of that.

AngryData 9mo ago

Listening to DR. Oz is a path to an early paupers grave.

falkensmaize 9mo ago

I wouldn’t trust “Dr” Oz to advise me on which brand of cold medicine to buy, much less the health of myself or my child.

kingkawn 9mo ago
Ironic that he is a cardiovascular surgeon offering his opinion on what is a sufficient assessment for OB/GYN care
- falkensmaize 9mo ago
  It's not really ironic at all. It's entirely possible for someone to be a well-credentialed liar/conman.
weare138 9mo ago
Dr. Oz is a con artist, fraud and possibly a pedophile because he was just named in the Epstein files too. No one should be even so much as entertaining anything this man says. The solution is to regulate insurance companies so these communities could actually afford healthcare and expand social programs for rural areas.

rambojohnson 9mo ago

yikes.

mathgladiator 9mo ago

Since I'm dealing with how good claude code is, I gave a research task to claude to help my in-laws (who are psychologists) understand the coming storm at a more visceral level. AI produced this: https://nexivibe.com/future.mental.health.web/index.html https://nexivibe.com/future.mental.health.web/index.html I can't argue with the urgency. I then had claude produce a prompt based on this that I could feed Grok as a project to do therapy, and the result was shockingly good. Obviously, Dr. Oz is going to be a political lightning rod for some people, but if you factor that out and try using AI for therapy... this is coming. This is happening right now.

hvb2 9mo ago
Sure, the results CAN be good. The real question is if your health is one of those cases you want to roll the dice with. I don't, but that's up to everyone. Tesla fsd was the same thing. You needed to have people to try it. Some paid for it with their lives. Will it make progress, sure. Do I want to be the one that dies to make that progress? No
- mathgladiator 9mo ago
  I have rolled the dice with it, and it's been great. I use it to tune fitness and every mental dimension. Time will tell. I will tell you this, using AI is better than using HN and random people who don't know me. I had the best technical conversation of my entire life with AI. I feel like I can handle it, and maybe I will dive into AI psychosis at some point. who knows! I can say that it is better than the silence I've had for years from no community giving two shits about what I wanted to build. I can admit the number of mistakes I've made, but at a certain point - enough is enough.
  - jplusequalt 9mo ago
    >I can say that it is better than the silence I've had for years from no community giving two shits about what I wanted to build It sounds like you were lacking community, then went deeper into isolation.

asveikau 9mo ago

Dr. Oz is in the Epstein files. The email he wrote in October 2019 is especially odd. He reached out to FBI wanting information on interviews of victims. FBI blew him off. (EFTA00037405) Between the lines, this really reads to me like he wants to know if anybody accused him. Someone on an internal email said not to tell Oz anything about the meeting. (EFTA00037407) He met with Epstein on 1/1/16. (EFTA02476629) I believe the meeting was initiated by Oz.

metrix 9mo ago

So we get so worked up over this stuff, and for good reason. But personally I'm taking another stance... let them.. It's not my choice to make someone understand what's best for an individual or as a group. Let them make these decisions, and learn for themselves. Will this cause issues where I am at risk of getting measles? Or that kids could get sick over non pasteurized milk? yes, but we're back in a place where people have to feel the pain. That's not to judge, or belittle or put anyone down. There's people who have views and values that conflict and that's OK.. Even if it's not the best for us a whole.

mathgladiator 9mo ago
I agree with this, but think of in more of an evolutionary lens. I've come to the place where every time we think we have solved a problem, we may not have and have created a new tree of problems. I am one of those knuckle heads that decided to give carnivore diet a try, and my wife and I have had amazing results on a number of metrics. We were also not even eating junk food or that much processed food. The sheer complexity of how we live demands humility, and in many ways the skeptics have valids point in many ways. I look to the Amish, for example, as a way that probably not that bad to live considering how much of the modern world has problems. At core, some people choose to be experiments, and some decide to the control. This is the reality I believe, and this is how the whole remains robust over the long term.
esafak 9mo ago
People can feel the pain without drawing the right conclusions to rectify the situation. For centuries people thought bad things happened because the gods were displeased. Some still do.
- pixl97 9mo ago
  And many of those that still do would drag us kicking and screaming back to the days where talking out against the word of god was a capital crime.
hydrogen7800 9mo ago
"The common people know what they want, and deserve to get it good and hard."

metalman 9mo ago

rural here, raised in a medical family. there is NO rural health care, bare bones self funded "clinics" with no actual doctors. they want doctors here but cant offer competitive compensation, and the governments rural devitalisation plans are working, and demograhics back this up. every few miles there is another failed back to the land dream farm, and then some giant horsey place that will be a third+ home general health care is so rotten that the people hired from India to do the work, FLY back home to India, if they need health care for themselves as it's both faster and cheaper counting all the costs. that we are tumbing towards a crunch point and have no one to blame but the victims, then thats what we will do.

OutOfHere 9mo ago
The way healthcare is going in the US, we'll all have to fly to India if we need basic care that: 1. an AI cannot effectively deliver on its own. 2. requires physical testing and actual facilities rather than just prescriptions. If it works for the workers, ...
- spwa4 9mo ago
  As the article points out, the state of healthcare in rural (and non-rural) communities is entirely a republican choice to make it what it is. This is an attempt to make a lot of money taking over medicine and that little detail that they don't actually deliver reasonable quality care will be "fixed" by sabotaging actual doctors (and everything from hospitals, to nurses, to cleaning staff) But you're kidding yourself. The whole world, including India has a doctor shortage AND is choosing not to train new medical doctors (frankly: especially India, they're not good about this). If flying to India helps, it'll be temporary. Oh and having AI do healthcare goes squarely into what AIs are really bad at: adversarial planning. Your doctor is more like a judge: depending on the situation, it's your doctor's job to push (and occasionally force) you to take certain decisions, AND to sometimes push and force the government to take decisions like the COVID lockdown. Does anyone think for a second Trump will allow for these AIs to be programmed to order him to lock down the country if the situation requires it? Or does he demand they just lie about the situation. I feel like we've seen the answer to this one.

kingkawn 9mo ago

I do not trust Oz et al to make this anything but an unethical grift. But Ironically we already have a lack of continuity of care, providers who are so overburdened that they cannot give any human nuance, and a complete lack of coordination across visits or diagnoses. So, America has done what it usually does; create a problem and then offer to sell the subpar solution. also, the healthcare industry has used impoverished urban areas as guinea pigs for training programs and hypothesis testing for many generations, why not the same benefit/detriment for rural America?

api 9mo ago

AI as a tool to make health care cheaper and more scalable is not an inherently bad idea, but I would not let these fools anywhere near it. Anything they touch is going to be a pure grift.

ok123456 9mo ago

The real problem was allowing the AMA to tightly control the supply of doctors for decades---that this would even be a solution to anything. There is very real opportunism and profiteering among those advocating and providing this "solution." But they didn't create the months of waiting that normal folk have to see routine specialists or PCPs. At the very least, they can get instructions on how to do first aid and when to go to the emergency room. I remember talking to friends who were well-meaning but panicked about the ACA being passed because the system would be inundated with people seeking healthcare, and that it would lead to Soviet-style rationing. The rationing hasn't come from any five-year plan or the like, but simply the supply of doctors not keeping up with the demands of a growing population.

daveguy 9mo ago
There should definitely be an independent board like the fed (different decisions per area, maybe different boards per state) that determines need for the next 5 years. This is the way they do hospital beds (state level), but not doctors to address them! Of course we have to boot the fascist asshats to have a chance at it being independent.
- conover 9mo ago
  See Certificate of Need requirements: https://en.wikipedia.org/wiki/Certificate_of_need https://en.wikipedia.org/wiki/Certificate_of_need
twoodfin 9mo ago
As I understand, the throughput bottleneck on training new doctors is the availability of funded residencies. So chiefly on the hospitals and the government (Medicare, mostly) to spend more.
toraway 9mo ago
The meme about AMA artificially limiting the supply of new residency slots turned out to be much more complex the more I read about it (and IMO mostly incorrect, at least as described by the just-so stories on the internet where I first learned about it). The actual limiting factor is federally funded residency positions which are funded by CMMS, and were artificially capped by the Balanced Budget Act of 1997 during a widespread climate of financial austerity after Gingrich had led Republicans to retake the House in 1994 for the first time in decades. At the time, AMA apparently did release a report that included support for reducing the number of residency slots, so that detail is correct. But the decision wasn't made by them, and federal healthcare spending was already on the chopping block (and was a politically attractive area to make cuts given the Clinton's administration failed healthcare reform proposal). As early as 2006 [4], the AMA started releasing policy position statements requesting caps on federal funding to be increased, but it wasn't until the CARES ACT in 2020 that Congress funded 1000 new CMMS funded slots were funded (but limited to small gradual increases each year) and started to be implemented in 2021-2022. And they continue to advocate for increases that so far haven't been adopted. So while there's a kernel of inarguable truth that the AMA and other medical professional groups did support certain caps back in 1997, it has always been, then and now, a policy decision by Congress. With the motivation to set limits driven by concern over federal healthcare spending inflating budget expenditures. But it makes for a simpler, emotionally resonant narrative of a shadowy self-interested group pulling the strings at the expense of the public (that also conveniently redirects outrage away from the people actually empowered to fix the problem, or that federal spending is a crucial lever to fix the problem). [1] https://www.ama-assn.org/press-center/ama-press-releases/ama-fund-graduate-medical-education-address-physician-shortages https://www.ama-assn.org/press-center/ama-press-releases/ama... [2] https://washingtonian.com/2020/04/13/were-short-on-healthcare-workers-why-doesnt-the-u-s-just-make-more-doctors/ https://washingtonian.com/2020/04/13/were-short-on-healthcar... [3] https://www.openhealthpolicy.com/p/medical-residency-slots-congress https://www.openhealthpolicy.com/p/medical-residency-slots-c... [4] https://pmc.ncbi.nlm.nih.gov/articles/PMC1785175/ https://pmc.ncbi.nlm.nih.gov/articles/PMC1785175/

tehjoker 9mo ago

In China, when they didn't have enough medical personnel, they sent the half-trained barefoot doctors to the rural areas to give even basic medical care. Over time they trained more and more people in allopathic medicine and increased the level of care and expertise. Our elites care so little for us that they won't even bother to send real people, just a sop to tell us to shut up. Expectations rise with the level of development. No excuses in America.

techsocialism 9mo ago

[flagged]

zmmmmm 9mo ago

> "AI can't read facial expressions, tone of voice, or body language," she said. "And those things matter. That's where the relationship between a patient and provider is built — in the nuance." It's amazing how, no matter how dramatic the breakthroughs are, people will still totally fail to understand the concept and can't even extrapolate correctly to N+1. There's absolutely nothing fundamental about current AI tech it that limits it from reading facial expressions and tone of voice and even body language to the extent it can see it. And then, already there are studies showing that patients find AI responses more empathetic than actual doctors. There's a big question whether people will accept it such empathy as genuine, but my money is on people attaching to these things like crazy.

jplusequalt 9mo ago
>There's a big question whether people will accept it such empathy as genuine, but my money is on people attaching to these things like crazy Is that something we should cultivate in our society? Being emotionally attached to balls of linear algebra controlled by massive corporations?
- zmmmmm 9mo ago
  I honestly don't really know. Notice they can't even actually say "human", they say "provider" above. So they are pretty much admitting, the alternative isn't that you get a life long relationship with a person. You're getting a lifelong attachment to a corporate entity either way. People become sentimentally attached to inanimate objects all the time. It's all about what it means to them. There really isn't a rule book here, we have to figure it out.
  - thepotatodude 9mo ago
    "Provider" and not "physician". Big tell.

thepotatodude 9mo ago

As a current medical student, there's no way I'm living in a rural area for anything other than an insane paycheck. Even then, I'm out after a few years. Urbanization is the solution. And physicians won't stand idly by as you replace their jobs. Enough pressure and the strikes begin. If that's what it will take for the value to be recognized, so be it. Big Tech isn't going to deliver us a healthcare utopia, but it will accelerate the enshittification of healthcare.