Always Replacing Us

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This just in from CNN:

The new machine that could one day replace anesthesiologists sat quietly next to a hospital gurney occupied by Nancy Youssef-Ringle. She was nervous. In a few minutes, a machine — not a doctor — would sedate the 59-year-old for a colon cancer screening called a colonoscopy

But she had done her research. She had even asked a family friend, an anesthesiologist, what he thought of the device. He was blunt: “That’s going to replace me.”

One day, maybe. For now, the Sedasys anesthesiology machine is only getting started, the leading lip of an automation wave that could transform hospitals just as technology changed automobile factories. But this machine doesn’t seek to replace only hospital shift workers. It’s targeting one of the best-paid medical specialties, making it all the more intriguing — or alarming, depending on your point of view.

Today, just four U.S. hospitals are using the machines, including here at ProMedica Toledo Hospital. Device maker Johnson & Johnson only recently deployed the first-of-its-kind machine despite winning U.S. Food and Drug Administration approval in 2013. The rollout has been deliberately cautious for a device that hints at the future of health care, when machines take on tasks once assumed beyond their reach.

They are always trying to get rid of us.  The problem is that being a doctor is more than computer algorithms.  There is intuition and non linear thinking.  There is an art to medicine.  Machines can never do that and will never do that (at least in my lifetime).  Until Skynet takes over and Terminators rule the land I think we are safe.  Why is it that they never look to automate administrators?  All they have to do is have the machines keep saying things like:

  • “I hear you”
  • “It’s not in the budget”
  • “You have to meet your quality metrics”
  • “Let’s engage some more”

Sure we will ignore the Adminibots but we ignore them now anyway!

Douglas Farrago MD

Douglas Farrago MD is a full-time practicing family doc in Forest, Va. He started Forest Direct Primary Care where he takes no insurance and bills patients a monthly fee. He is board certified in the specialty of Family Practice. He is the inventor of a product called the Knee Saver which is currently in the Baseball Hall of Fame. The Knee Saver and its knock-offs are worn by many major league baseball catchers. He is also the inventor of the CryoHelmet used by athletes for head injuries as well as migraine sufferers. Dr. Farrago is the author of four books, two of which are the top two most popular DPC books. From 2001 – 2011, Dr. Farrago was the editor and creator of the Placebo Journal which ran for 10 full years. Described as the Mad Magazine for doctors, he and the Placebo Journal were featured in the Washington Post, US News and World Report, the AP, and the NY Times. Dr. Farrago is also the editor of the blog Authentic Medicine which was born out of concern about where the direction of healthcare is heading and the belief that the wrong people are in charge. This blog has been going daily for more than 15 years Article about Dr. Farrago in Doximity Email Dr. Farrago – [email protected] 

  6 comments for “Always Replacing Us

  1. Bridget Reidy MD
    May 15, 2015 at 2:39 am

    I wonder what the robot that replaces me will do when after letting a patient talk their fill, it asks them a question and they start talking about something else entirely. Or how if it asks if they are short of breath or wheezing, it will be able to tell – as I do from the relaxed, clueless tone of a healthy looking patient saying “yes”- that a prolonged definition of those terms with repeated questions will result in them saying they’ve never had anything like that.

  2. Steve O'
    May 13, 2015 at 1:10 am

    “The chess master sees many moves; the grandmaster, only one.” Anyone can solve a medical problem that is diced up and handed to them. The famous Cabot Cases of the New England Journal of Medicine lay out their puzzles with all the possible moves, good and bad, analyzed many steps out. Every laboratory test possible is offered to the clinician.
    Today, I enjoyed my job. First thing in my clinic, a man came in who had been nursing a chest pain for twelve hours. I did an EKG, gave him (of course) aspirin and nitroglycerin, brought his blood pressure down a bit, and sent him on his way to the hospital. What’s so hard about that? Of course, anyone can do that.
    But all of the folks who love to talk about how easy a doctor’s job is – why, they were curiously absent from the floor. They didn’t want to get trapped in a position of responsibility.
    “All that matters on the chessboard is good moves.” – Bobby Fischer That EKG showed a first-degree block that was new (and progressed); Q in III, T-wave inversions in aVL. Not formulaic, but enough to see an inferior wall MI. He was lucky – it was stuttering. By the time he got to the hospital he was pain-free, but thank God! the ER attending didn’t give him some Maalox and send him home. Five hours after I first saw him, he had TIMI 3 flow to his distal RCA. He had been nursing the chest pain for twice as long before he came in to see me; he was lucky. He probably won’t lose myocardium.
    Yes, if you dice it up and spoon-feed it to the baby bird, they can eat it. That is what medical school and residency is all about. If I had a medical student, I’d patiently walk her/him through the pertinent facts, and avoid the distractions and red herrings. But now, they imagine that the iPhone 7 will put me out of a job. Even though this patient had the internet and could google “crushing chest pain,” he nursed it for 10 hours before he came in.
    The point is getting all the right moves, and only the right moves, at the right time. MI’s, you’ll get them correct eventually – leave it to the pathologist to discover on the autopsy.
    I trained a long time, because “oh shit..my bad, sorry!” doesn’t come out of my mouth very often. When the machine makes a blunder and loses a life, naturally we can’t blame it – it’s just a machine! Things happen.
    A level of diligence that’s not good enough for my professional self esteem, is suddenly good enough in public medicine. Mediocrity is the best we’ll get for a while – until it turns worse. “Shit-sorry!” will be the new saying in the high-tech temples with their clever doc’bots.
    Bring it on!

  3. Sir Hakum of Hugo
    May 12, 2015 at 9:07 pm

    Wait Doug, my administrator just used the phrase “I hear you”. Are you saying he wasn’t sincere, just another of Dr. Evil’s Adminobots?

    My faith in the modern corporate health care system has been shattered.

    And I thought he cared….

  4. Perry
    May 12, 2015 at 2:07 pm

    Dr Hal will see you now.

  5. Ken
    May 12, 2015 at 1:06 pm

    I guess that is one of the perks about being an FP, they won’t be able to replace us with a machine.
    After Ms Jones inputs her 30 item review of systems (all positive) asks for a work note, family leave form, 120 Norco, and then discusses her daughters medical problems with the computer, the self-destruct mode would be activated; and after a week of buying new computers daily, admin would realize its just cheaper to have an FP.

  6. Pat
    May 12, 2015 at 12:32 pm

    I’ll bet Michael Jackson wished he could’ve bought one of those.

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