Comment by giantg2

We need more doctors.

Yes, unfortunately we've made doctors the gatekeepers and they don't want more doctors because that will eat into their income. This happens with every single licensed occupation where the license body is run by members of the occupation, with the possible exception of bar associations.

My theory on that one is that the more lawyers you have in society the more lawyers you need because lawyers do a great job creating work for one another (both through litigation but also through legal documentation which needs to be read and interpreted by other lawyers).

In my opinion we need to elevate doctors and invest heavily into more nurse practitioners and the like. I don't think you need to see a doctor all the time, for procedures or surgery yes, or if you need someone to actually investigate something.

But there is no point in pretending doctors are going to surge, the current administration is trying to make being a doctor harder, not easier. Doctors also avoid certain fields because it doesn't pay enough. The supply is also artificially restricted. It's a system so fucked that it's better to ignore it and pump out PRNs

At this rate, it might be easier to train ChatGPT for better diagnostics performance and give it access to health records than to untangle decades worth of legislative and institutional inertia that prevents "more doctors".

We need more of all healthcare professionals. Nurses and CNAs are getting run ragged just the same.

>Up to 25% of women have endo, in some communities at least.

I feel like that's a relatively novel insight. These days I hear about endometriosis once a month or so, mostly because of outspoken women advocates. I could swear I've never heard of endo before 2020.

As an example, the Australian National Action Plan for endometriosis is from 2018. Perhaps the currently practising generation of doctors did not have this kind of awareness during their training, and the next generation will fix it?

The studies are wild. The reported range of affected individuals is 2-50% depending on which study you look at. While genetics are the main risk factor, there are all sorts of environmental risk factors that have been linked to it, especially in uetero. Many of those things are highly common such as BPA, PFAS, dioxins, and cosmetic use.

[dead]

I discovered a friend’s chronic medical issue that two VA specialists and a PCP couldn’t figure out using an LLM health project that had been posted here. Works when it works, n=1. Certainly, don’t trust the robot, but it doesn’t hurt to rubber duck debug with it to find blind spots. Fancy search engine sometimes is right (although it can lie too!).

(Bone tuberculosis)

I think a great use case for AI is to act as triage for a new case so that it can send you to the right specialist and have them evaluate you. It could potentially remove the need to see a GP for a referral to a specialist, thus freeing the GP up to spend more time treating others.

Why "beat"? Why not "augment" or "improve"?

What would you propose as an alternative? Healthcare costs are already high. Imposing step therapy requirements to try cheaper treatments first is one of the few ways that insurers have to control costs. And the cheaper treatments do work well for many patients (or they recover on there own just due to time).

AI would be deployed to behave like the median doctor (at best - or maybe the lowest-common-denominator) to avoid blowing up costs with 99%-likely-to-turn-up-nothing hunts for super-rare conditions.

Today you can try to cajole your human doctor into listening more, or ordering more tests, or considering things you heard online or from acquaintances. AI will be guided to take that into account less because a doctor being more sympathetic and bypassing "standard practice" is an expense caused by humanity that the machine can be trained to avoid.

Today you can go across town and try your luck with another doctor. If it's all AI, you'll just repeat your story to the same basic model and get the same basic dismissal.

The problem arose from trying to make people behave like machines in order to save money. Making a machine behave like a machine ain't gonna help.

You need to shift the goal from "saving money" to "helping people." AI doesn't do that.

Any AI will most certainly reflect the biases of the bureaucracies responsible for their creation.

> Yep this is something that only AI can solve.

How? I'd expect them to already have standardized lists of the most useful next thing to investigate given what's already known, and a modern "AI" would actually be worse at that than some sort of solver engine with a database of costs/risks (for tests) and conditional probabilities.

Maybe if they're still using (digitized versions of) paper flowcharts things could be improved, but the most powerful tech should be old-school stuff rather than modern "AI".

>Yep this is something that only AI can solve.

[citation needed]