Yes, I am Ann Landers. I re-use old posts whenever I can. But in this case I have a reason for doing so, because a fiction story that I wrote in 2013 has the potential to become less fictional.
The story was called “You will still take a cab to the doctor’s office. For a while.” It described a 95 year old woman named Edith and her May 2023 visit to the doctor’s office. She took a cab there:
Edith had booked and paid for the cab a month before the appointment, using the online Gacepple Calendar service. (Gacepple, of course, was the company that resulted from the merger of Google, Facebook, and Apple – the important merger that saved the tech industry in the United States from extinction. But I digress.) An hour before the appointment, Gacepple Calendar reminded Edith of her appointment, and five minutes later the Toyota in the street let her know that it had arrived. No, not the driver – there was no driver – but the Toyota itself.
Anyway, she gets to the doctor’s office. No doctor or nurse is present, but a voice guides her through the quick and painless examination.
!!!SPOILER ALERT SPOILER ALERT SPOILER ALERT!!!
After everything is done, Edith has a question.
“You’ve been very helpful. But I’ve always wondered exactly WHERE you were. If you were in Los Angeles, or in Mississippi, or perhaps in India or China, or perhaps even in one of the low-cost places such as Chad. If you don’t mind my asking, exactly where ARE you?”
“I don’t mind answering the question,” replied the friendly voice, “and I hope you don’t take my response the wrong way, but I’m not really a person as you understand the term. I’m actually an application within the software package that runs the medical center. But my programmers want me to tell you that they’re really happy to serve you, and that Stanford sucks.” The voice paused for a moment. “I’m sorry, Edith. You have to forgive the programmers – they’re Berkeley grads.”
As time goes by, this scenario is becoming more and more realistic. We are already working on robot doctors that can navigate down the hall to a patient to take readings.
Meanwhile, Vinod Khosla is working on the other part of the scenario – the part where a software package, rather than a human, does the diagnostic work. I’ve mentioned Khosla before – once in regard to “meat”, and once in regard to medicine. Now, prompted by a Scott Nelson share, it’s time to look at a more recent article about Khosla.
When Khosla looks 10 or 15 years into healthcare’s future, he sees a medical landscape seething with data-hungry, intelligent algorithms like Google’s AlphaGo instead of doctors as we know them today.
“Medicine has improved a lot as a practice,” Khosla said. “But I think it’s time to take this practice of medicine and turn it into the science of medicine.”
To make that happen, Khosla thinks we have to hand medical expertise over to the machines.
Specifically, Khosla wants big data and big databases to do the heavy lifting that no single human could do.
Khosla said you can diagnose disease with a single biomarker—the chemical signature of sickness—or you can diagnose disease by looking at 300 biomarkers. You can look at the patient in front of you and compare them to the last few you’ve seen, or you can scan a database of 100 million patients for the last hundred or thousand with the same condition….
According to Khosla, Medicare patients have seven major conditions on average. Wouldn’t it be better to have AI look at those conditions comprehensively—and one doctor, not seven, talk the results over with the patient?
Note that in Khosla’s case, we would still have doctors around, but they would be hired for their empathy skills, and not necessarily for their ability to read every medical journal.
However, I still think that my model, in which there is no doctor at all, is the more accurate one.
Because of how business works.
The average American publicly-traded company, when forced to choose between a 100% computerized system with no doctor and a 100% computerizied system with a doctor, will choose the lower cost option.
After all, if you don’t have any employees, then you don’t have to pay for healthcare.