I don't think there will be a replacement in 10 years, but the potential good that can come of AI would be wonderful. Imagine scanning through every PubMed article and medical text book ever published in a second. I think that AI can help physicians make percentile diagnoses based upon the data that they enter during a patient assessment. For example, they enter all of the data and laboratory values from the patient encounter and then a list of possible diagnoses is generated. The physician then combs through the list and enters additional differential information to get an accurate diagnosis. If it is the wrong diagnosis, the AI has the ability to correct itself. Also, all of the computerized data can be linked on a network and improve its accuracy based on outcomes. What if this technology merged with an advanced DaVinci robot?
Since you’re a pre-med student this sounds like an amazing idea. When you become a physician you’ll realize how difficult, murky, and subjective medicine really is.
History is very important. Only humans can give their history and that’s why is so confoundingly subjective. And only doctors (not a computer) can take a history which is putting that information through another subjective filter. Patients lie all the time. The exaggerate symptoms or they minimize symptoms. An experienced physician can often (but not always) get to the truth of the matter. But even when he does....how is that physician going to put that historical narrative into a computer in a meaningful way? How do we quantify symptoms so they are compatible with symptoms that another physician is putting into the computer?
Physical examination is crucial. A computer or robot is never going to be able to perform a physical examination. Can anyone imagine how that could ever even possibly work? Ok, maybe if there is a suspicious skin lesion a specific scan could be deployed that may rule in or out malignancy. But how would a computer/robot ever look at a patient and get a sense of overall health? Check under the tongue for signs of subtle jaundice? Palpate the liver for hepatomegaly? Or pick up the faint smell of cigarette smoke on the patients clothes after he’s already lied about not being a smoker?
Ok, now we are at the real data! Laboratory findings! Surely we have some objective findings that a computer could really use, right? Well, not so fast. There’s plenty of times that a doc will look at a lab report and see a lab result that is an outlier. Sometimes it’s meaningful and sometimes it’s spurious. You see a glucose of 800 in a healthy thin marathon runner and you’re going to say that’s an error, let’s run those labs again...you see it in the sick dehydrated guy in the ER and you know he’s in diabetic ketoacidosis. This happens to me in dermatology all the time. I do a biopsy of a skin lesion that looks like a deep fungal infection and the dermatopathologist calls me and says hey this looks like squamous cell carcinoma. Well, as dermatologist who has studied pathology I know that a deep fungal infection can exhibit pseudoepitheliomatous hyperplasia that can simulate squamous cell carcinoma. My clinical correlation tells me that cancer is a red herring (clinically that did not look like cancer) so I tell the pathologist to cut further into the specimen and he ends up seeing the infectious organisms. The pure, rote pattern recognition of a computer reading pathology would have a hard (actually impossible) time making that call...
I won’t even discuss the issues that could possibly arise from an AI perusing the medical literature. How would it know which papers are of historical interest only? I know the surgeon personally who wrote those papers on surgical margins was on a crusade and frankly full of **** and nobody really believes that...how is the AI going to have that context?
As someone said before...medicine is a human endeavor. It’s truly an art, not a science. Yes we wield science as a tool, but you cannot quantify the art and put it into a computer and make that work. It just won’t.
So frankly, a DaVinci robot armed with PubMed and dubious input of symptoms and physical examination (again, how do you quantify that stuff?) and devoid of human experience and intuition actually sounds like a dystopian nightmare.