Can AI ever replace genuine doctors?
Dr. P K Sasidharan
There is too much hype on application of AI in medicine which is unwanted and uncalled for
True, it may partially only replace certain kind of doctors that too sometimes only in certain activities – but it can never replace true doctors
It is because crux of medical profession lies in preventing disease, promoting health and identifying health problems, either early or late, and not just treating them.
Prevention of diseases needs societal interventions that too with the help of competent primary care team.
AI will never help any competent doctor to identify disease, especially in the early or undifferentiated stages of diseases.
Genuine medical practice is primary care, which is needed for more than 90 percent of the patients. AI may sometimes be of be help in some limited sub specialty care only, that too in the hospital setting in some limited situations.
Even for diagnosis in a hospital setting we need doctors with clinical skill( internal medicine/pediatrics)and not an AI for diagnosis
In my hospital based practice, even now, I continue to see diagnostic problems only- I mean those patients referred by other doctors – that too after multiple consultations- they invariably come with a bundle of investigation reports but not having any diagnosis
90 percent of diagnosis in these kind of complicated problems too is got from proper history and physical examination alone
Which AI can do these jobs of doctors? These genuine activities use tremendous humane skills most importantly communication skill and common sense. AI will never acquire individualised communication skills and can never provide the emotional component involved in patient care, without which it is not a true medical practice
The incompetent ones might think that AI will offer correct diagnosis and they can use it as the gold standard for diagnosis and management in future
This is because the incompetent doctors are on the increase these days, AI is now becoming an icon in the eyes of such doctors. Unfortunately such doctors with skewed vision are made to lead the profession too.
It is true, AI can give suggestions on some computer generated images as microscopic pictures or radiological images etc
Even that would depend on the data fed into the computer by good pathologists or radiologists
But interpretation of such images or the patient-complaints fed directly into AI alone will never give complete or accurate diagnosis in any clinical scenario, or it will not give any useful diagnosis to offer effective and proper person-centred care
My experience and assessment regarding usefulness of telemedicine while at Calicut medical college too was disappointing.
Even with the patient and his doctor available at the other end, I could never make useful or complete diagnoses without finally seeing those patients directly. At the same time after proper clinical evaluation and after making a complete and correct diagnosis, telemedicine can sometimes be used to avoid occasional future review consultations.
Even in such patient-reviews, satisfaction to patients is a big zero, as it is not possible to address the emotional component with telemedicine, simply because, the compassionate touch and reassuring body language of the doctor is missing in it.
Imagine a patient who feeds his symptoms into an AI equipment/computer and expecting it to give a diagnosis, it is bound to fail almost always. In real life practice genuine doctors will cross check every complaint of the patient to verify what exactly he/ she meant by the complaint.
Computer or AI can’t find out what the patient meant by a given complaint. For example numbness as told by the patient can be weakness in some, or it could be pain causing inability to use that side, or an in-coordination and rarely only it is true loss of sensation.
But AI has a role in some limited places, that too in certain aspects of patient care only.
AI helps very rarely in genuine medical profession but the hype created is disappointingly high.
‘Garbage in garbage out’ is the principle of any such computer generated data and application
Remember that making diagnoses and counselling patients is the primary job of the most important doctors -that is general medicine and primary care doctors
AI can avoid fatigue in handling huge volume of data as in analysis of patient data for research purposes or for policy making- Please realise data generation cannot be done by any kind of artificial intelligence.
THUS EVERYONE SHOULD CLEARLY KNOW THAT AI WILL NEVER REPLACE FAMILY DOCTORS, INTERNAL MEDICINE and other clinical DOCTORS
Probably AI can be useful in some specific situations- Pathologists and Radiologists it could probably replace
Dermatologist to some extent
That too when the computer is programmed with adequate and appropriate data. But unfortunately it is projected as a substitute for remote area consultations – if we can afford to bring AI to remote areas we can easily bring the more useful family doctors to remote areas rather than offering something at a huge cost with something is better than nothing kind of attitude
Primary care in India is distorted with huge volumes of patients wherever genuine doctors sit and to address that inadequacy we are offering the least important but most expensive solution that too to say that we do something for the failure in healthcare
Large volume of patients is due to a wrong system- let us rectify the ills rather than fooling the public with costly eyes-wash solutions
Analysis of data which is already entered in computer networks is a different issue and it can be done by AI
But doctors should not depend on the incomplete data analysis. Data is incomplete primarily due to absence of a good health system with enough primary care doctors in the periphery feeding genuine and most relevant patient- data into the computers
Now we look at a family medicine practice, which is not there in India or it happens in the most inappropriate manner it can be done
Let us work for the voiceless majority and let us have what we need to have in place genuinely for the people before we discuss AI.
Artificial Intelligence (AI) and Medical Professionals
