VC legend Vinod Khosla believes that medicine will go mobile and most doctors will be out of a job

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Tech-hype by someone who has to profit from tech-hype. Sure, doctors need to keep better data, keep current on research... basically, as much as I hate to say it, evidence based medicine. Technology will aid in our decision making, not replace it.
 
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My favorite part: "Making no apologies for having picked some losers, including some of his high-profile bets on clean tech, he declared, 'I don’t mind failing, but if I am going to be successful, it better be consequential.'" My opinion is that the guy is full of hot air.
 
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He's right in the sense that medicine will go largely mobile; his error lies in that he thinks medicine is a static entity. It's slower to change than tech, but it changes. The data from mobile equates to bigger play of data science and insights into medicine.
 
Dock1234 said:
http://www.technologyreview.com/news/529056/more-phones-fewer-doctors/

So is this just tech-hype or are we making bad mistake by studying medicine?
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To put it simply, he's wrong. Whether studying medicine is a bad mistake, that is an individual decision.

His cardiologist study is stupid bc deciding treatment is individualized. It's not algorithmic science like tech and putting in code. Not to mention malpractice. With fools like him medicine has nothing to worry about.
 
If he's a legend how come no one knows about him
 
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I'm surprised he didn't go spend some time with actual doctors seeing real patients. I read his point of view about tech replacing doctors, and then I think about the patients I saw today. 100% not worried about our job security. Stand in any ED for 20 minutes, and THEN tell me there's an app for that.
 
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operaman said:
I'm surprised he didn't go spend some time with actual doctors seeing real patients. I read his point of view about tech replacing doctors, and then I think about the patients I saw today. 100% not worried about our job security. Stand in any ED for 20 minutes, and THEN tell me there's an app for that.
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It's bc he thinks patients fit into algorithms like the tech world relies on. He's a complete fool. When it doesn't work, he'll blame doctors for not adopting his techie stuff and that's why it doesn't work.
 
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DermViser said:
It's bc he thinks patients fit into algorithms like the tech world relies on. He's a complete fool. When it doesn't work, he'll blame doctors for not adopting his techie stuff and that's why it doesn't work.
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To be fair, a lot of people in medicine rely on algorithms, as we previously established in another thread... especially midlevels who only know algorithms.
 
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tdram said:
To be fair, a lot of people in medicine rely on algorithms, as we previously established in another thread... especially midlevels who only know algorithms.
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Yeah, they're called MIDLEVELS, not physicians. They don't have independent practice for a reason.
 
DermViser said:
Yeah, they're called MIDLEVELS, not physicians. They don't have independent practice for a reason.
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NPs do have independent practice in > 18 states.

Even when they don't technically practice independently, they are often effectively independent because there's very little real supervision going on.
 
tdram said:
NPs do have independent practice in > 18 states.

Even when they don't technically practice independently, they are often effectively independent because there's very little real supervision going on.
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Due only to lobbying and political pressure. And yes, they are "supervised" bc of chart review and due to physician taking additional malpractice risk.
 
DermViser said:
Due only to lobbying and political pressure. And yes, they are "supervised" bc of chart review and due to physician taking additional malpractice risk.
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My point was that there are plenty of practitioners out there that are working effectively independently and relying completely on algorithms. Not the best way to do it, but it does work.

I've seen this "chart review". It's pretty bogus. The docs I've seen sign off without even reading.
 
tdram said:
My point was that there are plenty of practitioners out there that are working effectively independently and relying completely on algorithms. Not the best way to do it, but it does work.
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And they are free to risk their medical malpractice and their assets on it.
 
@tdram ... I agree that chart review is bogus... I bet 90%+ of physicians don't read what the NP/PA do after working with them for 1+ year... I think we should let NPs be fully independent and carry their own malpractice so we can see where that goes...
 
BestDoctorEver said:
@tdram ... I agree that chart review is bogus... I bet 90%+ of physicians don't read what the NP/PA do after working with them for 1+ year... I think we should let NPs be fully independent and carry their own malpractice so we can see where that goes...
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They do if they care about their malpractice. Docs have been sued for **** that their PAs did bc they fall under them.
 
DermViser said:
They do if they care about their malpractice. Docs have been sued for **** that their PAs did bc they fall under them.
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I don't know what to say, man. Tons of docs are still basically letting their PAs/NPs do whatever they want and it's not causing them all to be sued out of business, and the independent NPs out there are managing to keep people alive too. The algorithmic approach to medicine does work in a lot of cases. Of course it's not the best, but it does work. Now if I had the choice between a computer and a human to follow an algorithm, I'd choose the computer, because at least it's not going to get the algorithm wrong.
 
tdram said:
I don't know what to say, man. Tons of docs are still basically letting their PAs/NPs do whatever they want and it's not causing them all to be sued out of business, and the independent NPs out there are managing to keep people alive too. The algorithmic approach to medicine does work in a lot of cases. Of course it's not the best, but it does work. Now if I had the choice between a computer and a human to follow an algorithm, I'd choose the computer, because at least it's not going to get the algorithm wrong.
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It doesn't necessarily "work", man. Just bc no one doesn't notice any difference or doesn't sue doesn't mean the algorithm worked. Things can get better sometimes despite bad treatment.
 
DermViser said:
It doesn't necessarily "work", man. Just bc no one doesn't notice any difference or doesn't sue doesn't mean the algorithm worked. Things can get better sometimes despite bad treatment.
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If it's being done on a wide scale and people are doing well, is it bad treatment?
 
tdram said:
The proof is the outcome. If the outcomes are good, how is it bad medicine?
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You've been reading too many NP studies that they're equivalent to docs. If the outcome is the pt. didn't die, that doesn't make it good medicine.
 
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DermViser said:
You've been reading too many NP studies that they're equivalent to docs. If the outcome is the pt. didn't die, that doesn't make it good medicine.
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First off I'm actually on your side. I'm just saying what the opposition argument is. They have studies showing good outcomes measuring a lot of different endpoints. We don't have studies showing that their approach doesn't work. The only thing we keep saying is that we know more. We need some real proof that knowing more actually makes a significant difference.
 
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more like poorly designed studies paid for by groups with vested interests, looking at soft outcomes that don't actually measure anything significant. then they say "studies show that care is equivalent"
 
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Psai said:
more like poorly designed studies paid for by groups with vested interests, looking at soft outcomes that don't actually measure anything significant. then they say "studies show that care is equivalent"
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Pretty much. You can define "outcomes" however you want in a study.
 
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yesdee said:
Matter of fact is computer will have some part in medical decision making.

"As IBM scientists continue to train Watson to apply its vast stores of knowledge to actual medical decision-making, it's likely just a matter of time before its diagnostic performance surpasses that of even the sharpest doctors."

http://www.businessinsider.com/ibms...best-doctor-in-the-world-2014-4#ixzz3AOHfMD9K
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While this is great, an analogy that comes to mind is IT: they look like they do nothing all day but watch cartoons, but their six figure salary is justified when s### hits the fan. It's not the "anyone can do" bits of the job that you are paying a physician so much for; it's when things are bad, or catching the subtleties of when things are bad.
 
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DermViser said:
Pretty much. You can define "outcomes" however you want in a study.
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Why don't we have a study with better defined outcomes to prove our point? We have to fight studies with studies. How come I can't find any?
 
tdram said:
Why don't we have a study with better defined outcomes to prove our point? We have to fight studies with studies. How come I can't find any?
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Bc physicians have better things to do and bc either way docs will be demonized for "picking" on nurses.
 
DermViser said:
Physicians don't write scope of practice laws.
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Physicians are the only people who know enough to properly inform the writers of these laws, and the public. They don't know any better.
 
tdram said:
Physicians are the only people who know enough to properly inform the writers of these laws, and the public. They don't know any better.
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Yes, and politicians are influenced by money, not policy position.
 
it is very truth, robots will overtake us
 
Kahreek said:
it is very truth, robots will overtake us
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overtake?
Fry_And_Lucy_Liu.jpg
 
DermViser said:
:lame:; Yes and the donate to their specific medical specialty society.
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Why don't the physicians donate to the cause of protecting the public from the unchecked expansion of 'bad medicine' as you put it? Do they not care about patient safety? How about donating to fund the studies we talked about, or oppose these scope of practice expansion laws? Physicians are really the only group of people that can do this, because they are the ones that have a true understanding of medicine and have the financial means. Could it be that physicians don't care about patient safety at all?

Physicians were quick to pile on Dr Oz, but are silent towards this much more dangerous threat?
 
tdram said:
Why don't the physicians donate to the cause of protecting the public from the unchecked expansion of 'bad medicine' as you put it? Do they not care about patient safety? How about donating to fund the studies we talked about, or oppose these scope of practice expansion laws? Physicians are really the only group of people that can do this, because they are the ones that have a true understanding of medicine and have the financial means. Could it be that physicians don't care about patient safety at all?

Physicians were quick to pile on Dr Oz, but are silent towards this much more dangerous threat?
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This is a political battle not a scientific battle. In fact many of the "famous" physicians that talk on tv about health policy, etc. want to heavily incorporate NPs and PAs doing care (esp. in primary care). It's a lot of what Obamacare is built on.
 
DermViser said:
This is a political battle not a scientific battle. In fact many of the "famous" physicians that talk on tv about health policy, etc. want to heavily incorporate NPs and PAs doing care (esp. in primary care). It's a lot of what Obamacare is built on.
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How can they justify giving more and more free reign to providers of inferior care?
 
tdram said:
How can they justify giving more and more free reign to providers of inferior care?
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Bc they don't actually practice clinical medicine full time. They're more figure heads, thought leaders, etc.
 
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