With savvy and health-conscious people taking control of their wellbeing through apps and sites, technology is meeting the desire for individuals' responsibility for their health. But is the day coming soon when doctors will be obsolete, replaced by computers that read our health-related data to treat us? We explore these questions and more in this classic episode.
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You at Lexus their greatest curiosity. Is you because the most amazing machines are inspired by machines, their inspired by people? That's why Lexus ask different questions better questions, more human questions, like can you see with your ears?
and answers or is inspiring as you are, which may leave you with one question: why
raising ideas will inspire. You next discover the answers at Lexus: DOT, com, slash, curiosity, hey everybody! It's me Josh him for this week's s. Why has case Lex? I've chosen we'll computers, replace doctors, it's an episode so dated I still war.
Fifth it when we recorded it nobody seriously. It is a really interesting episode in
even though we recorded at years ago, this stuff that we're talking about still quite hasn't, come to fruition, so sit back and enjoy this peak into the future work
step, you should now protection a radius, hast, Outflanks hay and look into the Pakistan Josh Clark. There's Charles W Chuck Bryant are just pretty sir. No is here yet Jerry Buffer Day from the Christmas break. Kid faint matter again now she's at home, on or buffer day in the freezing cold, because we record these somewhat in advance. We are in the midst of the polar vortex and ruthless taught him I'll call this we're back. It is our first recording yet after the holidays is literally freezing cold. So welcome FBI. Thanks! Welcome back you too, even though this will be what like wage any.
Here. It will be a balmy. Sixteen Elaine, I think the end of the end of January. One is when this one comes out very well. Happy new year have a new unity to unhappy holidays to thinks Chuck. Yes, are you feeling good? You loose you Eddie, I'm loose, so you see this is seen as before here your foot that my fit bit that buzz marketing, not really it's just a really good example about like fitted, I'm not like
necessarily loyal to it or anything like that? Don't pay money to mention began might without can sometimes be like stop staring at me. Did their banal
like it I'm happy with it am. I pointed out, though, because it's part of this to me- and I don't think so-
confirmation by us, it seems like there really is a growing desire, among just average ordinary people to be able to track there, their health, their well being their activity and to do it easily. Yet we have tools now that make it like that thing
Super convenient yet is inflicted not the only one. There's like Nike fuel ban. There's jawbone is another really good wonder. There's others like gum that track your galvanic response there, a bull to put that together with raw respiration and heart, beat and come up
the pretty good assessment of how many calories your burning at any given time here, which is kind of a holy grail with this kind of thing right now, there's others that track your sleep. There's apps,
there. They let you track your mood, I'm their sites like quantified self, which are basically like people trying to push wearable technology like this further into the future.
There's entire websites like share care, dot, com that are dedicated to health, information and health support, yeah self advocacy, yeah and there's a cigar. It seems to me this desire to kind of say
This is my health. This is my body here. I want to know more about it
I want in a surly cut out doctors, but I I I wanted decide if I should go to the doctor, if it's time or not- and I want to use data
to do that yeah. I imagine frustrate alot lot of doctors, because I want this obnoxious people that goes in and it's like
Here's what I think I have based off my research, real there's, nothing wrong with that. Yeah is why you're and inform patient? That's true exactly what you're supposed to do and if he
getting your doctors, nurses and go see another doctor.
Agree actually in search of energy, be right now for those because ends and others you got on his nerves, other reasons to really cold cold hands now, like poor bedside manner, never send a doctor like yours, my intern, firmer Emory yeah, which great you know. I love them getting experience
but I would like them both to be in their turn out dislike smell. You later and the doktor leaves well that's another thing to it's kind of like come a doctor. A careless plus is laid on the table here. What what you just mentioned and what I was talking about, if you put it all together, the medical field, physicians in particular, are currently in a what's the beginning of what possibly a really
pickle of estate for them. I think a transition period, yes, but they may be transition to ride out of existence in large part. Yes, I may for sure, depending on how you talk to there's like this whole question, now like what is the future of medicine and, more specifically, in the case of this episode that we're talking about do human physicians factor largely in
a future near, and the answer is no.
Yeah. Depending on how you ask like I said we there's just one God, doktor can't bottles who arm. He feels that GPS might go the way of
ATO and be replaced by a diagnostic computers. Maybe with avatars then there's other people like Forehead Manu is a technical writers. Wife is a pathology.
He thinks not enough. The gps are the ones that are gonna be in business. The specialist are gonna, be out of business, because computers are really good at specializing on one single thing not may be so good at a general practice.
Nothing right, so there's lots of opinions out there on how much
be replaced and who might be replaced either as recline wrote, a column who, basically, he basically said like now. We will still need human
sure, but we mainly need humans to communicate to the other humans and facilitate near the interaction bit
the robots in humans. We are to have the so called nurses or nurse practitioner. Yet he cannot.
As recline as the one that thought that a computer,
avatar, might have a better bedside manner that doctor. What? Let's give that one example theirs is. There was there's an example: I can
finding, while we're doing research for the city had actually in the articles on how stuff works its there was a key ask a medical key.
During a panel called man made mines Cohen, living with thinking, machine
when there's a call in there. You know it's serious the air and it was at the worlds
the first one thousand eleven, and basically this this computerized avatar interacted with.
And whose baby had diarrhoea right and the woman said: hey avatar. My baby has diary
what are you gonna do about it. Yeah an avatar said. Well tell me all the symptoms and all the stuff in avatar decided that the baby's diarrhoea, while present, wasn't severe enough to work
immediate medical attention here. So I went ahead and made an appointment with a human doctor for
Later on that weak,
and the mother said that she preferred the treatment by the avatar to the real life nurses, the hospitals, where she lived in New York yeah. So it is possible that create computers with better bedside manner than say your jp. Well, it's it at the very least, it'll be consists,
and that's one of the things it I'm not poohpooh? And doctors and nurses are many many many many great ones, but have also had some pretty bad experiences in emergency rooms and with doctors and nurses with a computer, at least it's a consistent. You know their programme to display empathy.
No matter what right other, not too busy and they're. Not you now having a bad day exactly so they don't yeah. They don't have any prejudices against you personally or anything like that, their computer, they hate diarrhoea, but humans. Humans respond to even programmed empathy, even synthetic empathy from a computer I could
see that a little bit like I've of Dover into the gaming world enough to know that you know the real
some of the other avatar can be convincing and it's not like you think it's a real person, but it helps to put a human face on a be exactly literally they there. I saw of reference to study that found people who are being treated
For anxiety disorders tended to share more about their experiences and themselves with an avatar them with a human psychiatrist. It's interesting because it like not embarrass the added tell a real person me that makes sense. I might open up more due to a computer right, so so we ve got that part liked bedside manner. It is possible that we can create machines now and are creating machines now that have at least equal, if not better, bedside manner, then some physicians, okay, so bedside manner. One of the big things that doctors bring to the table check computers have it yet it's different now than it was in the old days. I feel like just the whole quality of personal care is gone down ass, not to throw the doktor,
Falters allotted reasons to place the blame, but so like when you were a kid and you feel like you had your family doctor who knew you maybe even gave birth, gave birth very through hell here, my son, he exactly just invested like you got to stick with the same doctor. If you want that kind of care, I think right in there's another benefit besides bedside manner. That comes with that
that kind of care. That kind of personal care is an awareness of your medical history. Yes you're, not just that
Well, your dad died of congenital heart disorder that so you
the higher risk of it totally just that kind of awareness has been typically lost too
even though we have medical histories and their and our charge are there in our files in intimate knowledge of patients, medical history is pretty much lost in today's modern practice of medicine. Yeah, that's another thing that that computers could conceivably top doctor
on which basically falls under the umbrella of diagnosis or diagnostics, mean there's two two sides to this year's diagnoses and
We met and some programmes a little bit of the history. This goes back to the nineteen seventies at the university Pittsburgh. They develops.
Where to diagnose problems. Mass general, since the eighty has been working on their de ex plan, which provides ranked list of diagnoses, whereas the was the computer, the M Watson Watson, who who wanted jeopardy yeah, that's more based. It looks like on treatment options. Then diagnosis at this point it so the real need for well yeah, but they said it's not they haven't. I don't think they wanna leave it alone, with diagnosis yet know, and to do its thing. There there's already something out there for diagnosis that meant to support physicians
What I understand with Watson, if there is a doctor of the future, its Watson near he, has a lot of advantages over noticed human doctors, but other artificial intelligence, health care machines. I guess yet you couldn't clumsily, call it
He has a knack for natural language, so let's say: there's like a structured formula or formulaic type of language that the medical field is supposed to use right. Yes, health records. Don't always necessarily contain that language. They might contain natural language, which is really confusing for computers to take in and absorb yeah. You know that humans can pick up on meanings of things that
about and in software, cannot write like inferences and we might be using sarcasm, although there's probably not criminally under her chasm in your medical record here, but like figurative language and stuff, like that right, computers, languages, a big part of the problem or learn or more to the point where it with the diagnosis patient says he feels like he has an a hive of bees in his stomach.
Will there might be something to you or me, but to a computer like ghostly while, as you all know, the banks- and I believe they re watson- has the advantage of saying: ok, where there's a sensation of bees in the stomach, there's not actually bees in the stomach. So it's figure this out right, then, Watson or anything that that he eventually becomes at war will be able to go through medical records. Current medical research, the patient's medical history, diagnostic tests that we're done blood work, come instrument test and put it all together and spit out
list of diagnoses with different confidence level, so that one of the top is the one that Watson says is that he is ninety eight point: nine, seven percent yours what's wrong with this patient near and as a diagnostician, that's pretty impressive and that's using all the available data. That's that's available also do human physicians, but they say I really don't have the time to take it all in ya. Think us on researcher that eighty percent of doktor spend less than five hours a week. Reading medical,
journals a month a month near here, so that these things can read thousands in seconds. So it's
What is the matter of of efficiency really and you, like? Doctors, don't have time to read all this stuff
I know we we looked into this one sort of a savant dag, no Sir Edward
Agnes station diagnostician, you doctor
Dolly Wall in San Francisco he's
of legendary for diagnosing things to the point where he does it
stage is almost like a parlor trick. I'd love to see, I would do they give him a forty five minutes and in a bunch of,
symptoms, basically like really confusing cause. They you're trying to stump em right in general,
he comes out on top of it. He even uses a programmer diagnostic program called Isabel.
Right, that's the one I said earlier that already here yeah, so doctors are using needs to help themselves out, but he says that he's never
Isabel offer, diagnosis that he has met right, but he's like the dude any also admit it is like, like I'm, a freak of nature right, good quiz me exactly. He also reads like case histories,
for fine that Canada he's not really but he's not a normal physician, easy, complete and total outlier yeah if he were
if every physician we're like this guy, then they're they're, probably wouldn't be this commerce
and going on right near the right, but most physicians aren't- and it's not just with current medical research
just not aware because they have had time to pick up the lancet the last few months yeah, but it's also their training to like of doctors in practice. For twenty years, the brain in the human brain tends to create habits,
because it likes to expand a little energy is possible. It's trying to be as efficient as possible, and I think the same thing happens with medical practice. Europe,
ain't. You understand you come out of medical school with a lot of book learning and then you put into practice in you can find your niche
and along the way. You forget a lot of stuff thing we haven't done in twenty years or have learned about twenty or so as not to current stuff. It's old stuff, too, and if you feed the physicians desk reference in the Watson, her one of his his compatriots yeah, like all that knowledge can be quickly index in research, is to try to spit out a more accurate diagnosis. Yeah, I think that's a great ideas like partnering up with computers is early replacing, but what they're doing with Watson is is very much moving toward replant doctors in that sense. Well, here's a scary step. One in five diagnoses in the United States are incorrect or incomplete one in five and a lot of times. It's not that the doctors jerk or not any good, but, like you said they
Maybe haven't seen these cases that were written about in some obscure medical journal that the computer has scanned and index right and Dolly, while doktor, Dolly while himself at Freak Diagnostician Dolly, would have required, which is a wonderful place further. I know you evaluate doktor, Dolly Wall himself,
a lot. Even with me. A lot of it is intuition and intuition
can be wrong. That's a criticism.
Though of computers as doctors. They lack intuition like
there is kind of even a larger, even
larger than this computers, replacing doctors conversation going on, it's kind of it
precision, earth debate over whether intuition or data yeah trumps, one or the other, while which
One is the right way to go this one step too. It says, according to an expert, I'm not sure what that means. It's I'm thinking,
But they said only twenty percent of the knowledge of physicians use to diagnose is evidence based. So I means eighty percent is intuition, which which also gibes and dovetails with that one in five year being wrong
eminent or one in five being right. I'd like the idea of intuition to a certain degree for sure yeah, but there's also gotta, be like data backing it up sure right now, so in your perfect world than it sounds like we still have, physicians are, but they go back and double check themselves using a programme yet, but I could also be it down with a simple: what is it? What do they call it in here? Something base diseases.
Rules based chronic diseases here, like minor things that are pretty easy to diagnose, uniting and necessarily minor. We just understand them so well. We ensure that we say type. Two diabetes is going to behave in present itself,
this year, but I wouldn't mind going like it seems like once a year I get like an upper respiratory infections, men, three or four years in a row
and I know what the treatment is. I know how it feels it be great to go and to a man
gene and haven't take some stats and blow into it in here my wheezing in Gimme, a
a stairway, shot, rosy pack and breathing treatment and send me on my way, raisins, always clear data.
You care, if it was a robot now that gave you that shot not at all, but I definitely would want more personal care if it was something
but if it was a robot with a nice avatar sexy avatar friendly one year, there was a little girl would touch your form here. There might be a la creevy, really yeah, if you like, it was an old timey doctor you like gave me some APEC. If you had tiger yet
listen to you on your way right, drink a coke, but it wouldn't send you on your way, give you a pack and then it wouldn't let go of your forearm. Is so strong, well, surgical, robots! That's it that's a thing I mean we're getting around, but they've been perform
They ve been performing, robotic surgery since thoroughly eighties, doktor, assisted until
two thousand ten. Where there were in Montreal, they perform the first fully robotic surgeries eye when they removed a prostate, with a fully robotic surgeon and fully robotic anesthesiologist
doktor mixed sleeping, doktor, Mc Sleepy yeah, that's the real name. The robot surgeon was divinity, which is like be basically gold standard for robotic, surgical research.
Go: robots yeah. They had the two thousand thirteen three hundred, fifty thousand robotic surgeries performed in the. U S! Oh it's! It's big! It is an dumb, but the dementias adieu
you're, basically sitting in a little looks like a ban, arcade game here and
using robotic arms to mimic his or her movements on more microscopic levels.
So. The robot has more precise movements. Yet I make smaller movements than the doktor its tell it's in with opposite of telescoping, going downward in scale
however, that is taking the movements of the doktor in reducing them in scale of Scott Reverse telescope in reverse telescoping. Those movements, which is a pretty awesome achievement in and of itself the doctors being fed three d, graphics of what the robot is seeing. You in this kind of working from their war were moving towards, apparently, is fully robot assize surgeries talking to Joe Mccormick from forward thinking. Yes, and he was saying that there was there's something.
All the raven, for I believe I am basically to say this is going to be a gallbladder surgery on a six foot, six male age. We know whatever here's his here's. The cat scan of his abdomen, so Gore moves goblet,
and you press enter. Anything goes in their unlike removes the guy's gallbladder and so small that fully robotic. Like fully autonomous.
Robotic surgery you presently button, then it does it you're, not actually controlling a machine that does it exactly the machines doing it at your behest, but you're not controlling it
and we're right on the cusp of that? Apparently, it's already happening.
However, there are some issues I looked into it. In fact,
a lot of injury, reporting and robotic surgery is not being reported. It's it's substandard and
this woman, China, Wilson had robotic surgery for hysterectomy and two thousand thirteen, and apparently this intuitive surgical system had there had
a bunch of injuries that she didn't know about, and she had her rectum burned badly. Oh
instead of outer known that this system had these issues would not have elected to take power
in it. So there's a lot of under reporting. The FDA,
have no authority to force a doctor to do this.
And apparently there is every reason
in every link in the chain, not to report these things you know and the FDA not enforcing this kind of thing. Not enforcing reporting is ridiculous. Yeah, you know the thing: is it things like that happen in theirs under reporting with you
in surging surgeons. As well, I m sure I just robot it's like overall, apparently, surgical, injury and accident reporting is not compulsory. Yet, and here is a few points, though counter points,
Ass is one it's not always the robotic component of the surgery that was the cause of your own.
To a lot of times. They say they don't know about this until like a lawsuit has filed, so could be weeks or months later with the
this doesn't know about it or the patient, the FDA,
Might now I heard on it like six months later, you file a lawsuit nor outcomes delight, but the end,
If one concerned and are supposedly working to improve this fast, very concerned and their very concerned
in another problem. To that same article, a lot of these robotic surgical systems. You thought to have the correct amount of training and the feeling of some experts is dead.
At least this one guy Enrico Ebene, daddy, he's ahead of surgery at the inertia of Illinois. Chicago says a lot of it. Just comes back to training these some. These doctors aren't getting adequately trained in these machines enough to perform the surgery
What happens when I do this? Oh that happens. It's not good!
I've got another alarming staff for you to allow on. Before that, I still message breaker
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Tell me your alarming set are at Johns Hopkins Industry,
they found, as many as forty thousand patients die in intensive care eight each year in the? U S, two misdiagnosis, forty three
man and another study found that system related factors like like a teamwork and communication, or just poor processes, were involved and sixty five percent of diagnostic error and cognitive factors, and seventy five percent with premature closure is the most common, which is basically just sticking to that initial diagnosis in that,
being open minded to other, like second having India. So there's this thing called anchoring bias there was in
New York Times article yet after dollar, while the guy who created this programme that now around to support diagnostics, aware of physician will say, I think it's this, but let me put in the symptoms and ask Isabel here, which is the name of the programme and its named after the guy, who created the programmes
order, a man that's where is rough. Now, when she was three took her to the hospital and the doktor said. Well, she has chicken Pox
she did indeed have chicken pox, but that's all they look that they come
We missed a pretty nasty case, neck retiring Fashionitis Year, which we talked about before flushing bacteria and she almost died from whose was disfigured from it as real, so that
her father? Who is a money manager said I'm going to take whatever computer programming, because I haven't put it toward this programme, Isabel, which is meant to say yes, you're right with this diagnosis, I agree with you or have you considered these other
I ignore sees near and he said like had Isabel been around in his daughters, doctors consulted it. They would not have missed the neck retiring fashionitis will make sense as an assist you now, there's a company called life com. That said in clinical trials that if you use a medical die,
ass the programme as an assist those Indians or ninety one percent accurate without using exams,
imaging or labs even really just symptoms, yeah, that's crazy!
That's really really really good. Yeah, like that's a S head, that's a allow a it still an eye, but as an assistant I think it's you know it's kind of a no brainer, dining, no yeah. I think so. I dont know why I
All I can think of is possibly worrying about feeding the beast that will take your job chair or just having too much of a case load to take the time to double check your work,
computer would be the only reasons why doctors aren't using their while the smartphone
becoming a potential self diagnosis, others all these cool things
the horizon, the you can use your your phone for others, one called alive core, which you can take your own easy g test and potentially for the costs of
one easy g in a hospital. You could send a years worth of daily easy jeez. You took yourself to your doctor
Then you carry all that info and all of your other medical infer from all of your apps that will eventually be integrated into one or two acts that will follow, become pre loaded on your Iphone in the next couple years, and you ve got your medical history right there. Yet
Most of these require like a little clip on like gum, something called cell scope
it's like you slip it onto your little camera lens essentially, and it's like out of the little magnifier the lights, a doctorate used to look in your ears and eyes. Yeah looks like one of those who had done.
Your Iphone and it produces even do imaging.
Four skin malls and rashes an ear infections are they have one called
I naturally the eco potentially give your own eyes the get your own like glasses,
Corruption done that's me and then you just yonder it online if one or another that information to some website- and they say your glasses,
and then this one called adamant that smells your breath. It smells gases in your breath, yeah they could detect like
lung cancer. Even yet, apparently you have real metabolic changes to the smell of your breath area when you have different types of cancer, not just long like bees can detect breast cancer. With you breathe into like this, Sir special class fear with bees around they can be trained to detect lung cancer in the
Come back with the correct result. A lot of the time while so are these are on the horizon. They're not like in heavy rotation, yet no bite, but it's pretty need all of em reveal this
idea that no one cares about your particular health and well being more than you,
unless you one of those dudes who doesn't really care, then you're, your wife does have you might see her and weep. I care more about me than me right by their stir. The point is the doktor the inference,
company there. The hospital here are, they are all in the field because they do care about your health. Of course they can
possibly care about it more than you or you loved one. Does so the idea of giving you the ability to keep all that information yourself in easily handed over to them or potentially down the road, a computer version of them
I can't think of any any better revolution in medicine right now than that the creed, I think it's pretty exciting. I think we're going to live into the triple digits, buddy yeah and, I think, will always be a need for doctors and nurses. I don't think anyone will be wholly replaced, but a little robot
Yeah, ok, mad! Let me make one more point there, so you ve heard of genomics. Yes, there is also this thing called Protein Army, which is basically your protein version of you're you're gonna. Do your genome and it's all of the proteins in your body.
That you have that your manufacturing that you're losing and all the changes and fluctuations in Amerika and the idea is that you can get a full work up of Europe, protein NOME and your genome, and eventually you can add that to your medical history as well. What you're? U cagey readings, been over
past year. The any way you may have gained or lost, or anything like that. What your breath smells like metabolic speaking there
and not only have your current state of health but personalized you version of that personalized down to your genes and proteins in your body, so a treatment could be specifically tailored to you. Well, if it's going to be really tough for a hue.
This and to do that on their own. The top that yeah big did the amount of data available already is overwhelming human doctors year. When you add this other kind of stuff on, it is pulling away from them more and more yet and medical record keeping is than others been issues with that in digitizing that and keeping up with medical records, and if you could be yourself advocate and keep up with your own medical record right. Let me canonize yet so I feel agree answered the question, which is
no more doctors. I don't know, I think, in the future. I will always have humans to interact between us. I think because
he's going to want somebody yell at or be like what is this robot doing? Can you help me this robots? Give me some if a cat can won't let go of my arm or burn my rectum? Yes,
always going to need humans. It's just. I don't know where we need physicians and if we do will they be super specialised, like just the Supreme Court of Physicians. Here, who knows,
an exciting, but we will see this change one way or another in the next fifteen years. Under my prediction, totes, it's happening. Yeah! Ok,
chuck em in view of the new year really
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I have one called. We cannot fight club, hey guys, just finished the podcast on deep referred
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And something about eating, weeds and asked a somewhat rhetorical.
And what are weeds anyway, just plants, we say or bad remind me.
Some today's common some that sum of today's common noxious weeds, how they got their reputation.
Not so long ago. Lines were perfect Linz.
Mr Ryan Kentucky Bluegrass else included many times
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Transcript generated on 2020-01-05.