Context: I’m a second year medical student and currently residing in the deepest pit in the valley of the Dunning-Kruger graph, but am still constantly frustrated and infuriated with the push for introducing AI for quasi-self-diagnosis and loosening restrictions on inadequately educated providers like NP’s from the for-profit “schools”.
So, anyone else in a similar spot where you think you’re kinda dumb, but you know you’re still smarter than robots and people at the peak of the Dunning-Kruger graph in your field?
I am a person whose parents were medical-professionals, whose dad was a medical-researcher & doctor.
I have been gaslit by doctors all my life.
IF diagnosis IS evidence-based decision-tree,
THEN an expert-system can do it, without the bias of human-doctors.
However…
IF diagnosis ISN’T evidence-based decision-tree,
THEN authority-based-medicine is the only valid medicine, as doctors hold to be true, while claiming that their authority-based medicine is “evidence based” medicine.
I’m not the only person to have noted that doctors don’t allow evidence-based medicine to threaten authority-based medicine:
https://www.edge.org/response-detail/25433
That article got turned into a chapter in the book, edited by John Brockman, “This Idea Must Die”.
( I do not agree with all the articles in that book, but that particular one is both right & too-soft )
EITHER Davidson’s & Harrison’s Medicine textbooks are valid basis for diagnosis, in which case an expert-system MUST be capable of doing objectively-valid diagnosis,
https://www.amazon.com/Davidsons-Principles-Practice-Medicine-Penman/dp/070208347X/
https://www.amazon.com/Harrisons-Principles-Internal-Medicine-Twenty-First/dp/1264268505/
XOR doctor-authority has some “special non-deterministic magic/sorcery” that an expert-system cannot replicate.
There IS no escape from logic & fact.
PS: you can read the Residency subreddit to see an ocean of evidence for medical-residency being a year-long identity-forming hazing-ritual, as it objectively damages doctor-learning, doctor-performance, doctor-health, doctor-empathy ( iirc there are several PubMed items on that one ), etc, yet it is still being enforced, in spite of how it measurably produces opposite-to-claimed changes.
You can also read how the researchers Logan, King, & Fischer-Wright discovered that doctor-culture is the exemplar of narcissitic-culture, and gave the simple test that there was only 1 hospital ( when they wrote their simplified-language-for-business-people book “Tribal Leadership”, to cause change ) in the US which didn’t have narcissistic-culture ruling it:
https://www.amazon.com/Tribal-Leadership-Leveraging-Thriving-Organization/dp/0061251321/
Walk into any hospital, & see if human-validity/human-dignity has been sooo eradicated from the lower staff, that they consistently won’t meet your gaze, as a professional entering the hospital.
I forget the name of the hospital which had demonstrated that human-validity CAN live below doctors, but their research earned much from that particular one.
Of course, for anyone to accept the points I raise, would require that they hold-to evidence-based knowing, instead of authority-based-“knowing”, wouldn’t it?
Feel free to downvote me to oblivion, for my testable-facts.
PPS: I’m not attacking you, I am attacking an ideology-addiction/prejudice-addicion in the culture you are being indoctrinated into embodying.
There is a book “Doctored” on the disillusionment of an American physician, and there are many, many, many, books out now, on different aspects of the ideology/prejudice that Western Medicine has become, including perhaps “Money-Driven Medicine”, “In Shock”, and others whose names I don’t happen to remember this moment.
I wish I somehow had the leverage to make Western Medicine become evidence-based medicine, but that would require supernatural-powers, at this point.
It would certainly be healthier for the people in Western Medicine.
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An expert system can’t learn or increase the complexity of its decision making in real time. A human can. The fact that healthcare is a science doesn’t mean the science has already discovered every fact in existence. In fact, that’s the opposite of what science means. Automated systems will always fail to account for nuance while they are driven by profit seeking and cost cutting.
For example, I’m nonbinary and intersex. Patient intake forms often ask if I’m male or female. I check neither box, as I’m neither. If I tell a human nurse or receptionist this, they’ll usually understand. They might even draw in a third box.
An expert system screening for different types of cancer might only look for breast cancer if the patient is female, and only look for prostate cancer if the patient is male. But I have the possibility of developing either. A human doctor can understand this and adapt to the situation easily. But an expert system will only check both possibilities if its designers were intersex-accepting.
The problem with AI and poorly educated professionals is not the ability to diagnose and treat based on evidence-based medicine. The problem is that you have to know enough about medicine, and enough about real human people to know what kinds of questions to ask in the first place. If nothing else, there is a massive amount of information gained from a patient’s body language, mannerisms, behavior, and the physical exam itself that would be extremely hard to quantify in a meaningful way for someone without the background education and experience to come to any useful conclusions.