Computers are getting smarter, better, and more personable, there’s no doubt about it. Will there ever come a time, however, when computers get so good at human interaction that even the highest-skilled in the work force — primary care physicians (PCPs) — go the way of the travel agent?
I began wondering this a few months ago after listening to Dr. Martin Kohn, a physician who works at IBM Research and works on integrating the Watson supercomputer (of Jeopardy! fame) in healthcare. He spoke about computer technology changes, their history, and their integration with healthcare.
Could computers be the biggest disruptors of healthcare delivery (and my career as primary care physician)? Here are five reason why, one day, primary care physicians could possibly be replaced by computer…
1. Computers are able to understand language!
How frustrating is it when we send and receive texts recorded from voice that come out all wrong. Technology can’t even get speech recognition right!
The computers in our phone, however, are light years behind computer systems like Watson. One of the coolest things I learned from Dr. Kohn, who is working on the Watson supercomputer platform and integrating it into healthcare, is that not only are computers able to recognize speech, but are now able to understand language. This was a critical factor in Watson’s Jeopardy! victory.
According to Dr. Kohn, a lot of time was spent on teaching Watson to understand language — the nuances of what we actually mean when we say what we say — and much of it was trial and error. Utilizing sophisticated internet search protocols, Watson would hear a question, interpret the question, look for an answer, and learn if it was right or wrong. Eventually, the correct interpretations became more and more frequent until it was able to surpass humans in a quiz show.
Understanding language — written, verbal, body — is key to a computer interpreting patient symptoms, complaints, and needs. We’re almost there.
2. The practice of medicine is getting more protocol based
What was once purely an art is now, thankfully, becoming standardized.
The care, treatments, and studies one receives from his or her primary care physician are more and more vetted through evidence-based protocols. Whether it’s diagnosing pulmonary emboli (blood clots in the lungs) or managing CHF (congestive heart failure), providers are getting much needed help to best evaluate and manage complicated diseases and patients.
Additionally, electronic health records are building more “decision-support” systems so that the best, evidence-based screenings (like age-based cancer screenings) and treatments (aspirin for patients at risk for heart disease) are offered our patients.
No one expects a computer to be an artist, especially when making life-and-death decisions. But even a computer can follow a protocol.
3. We’re all on-line consumers
Like many people, on certain evenings after my family is fed and daughter is put to bed, I might find myself shopping online. Our experience as consumers, from books and music to airline tickets and bank accounts, have transformed in the last decade.
Not only are we ok with shopping without interacting with a sales associate, but having to actually go to a physical store location has become viewed as such a painful and a noxious experience for so many of us. Cashiers with attitudes; unruly kids with screaming parents; the item you need out of stock. There are reasons why stores haven’t been able to keep up. We’re used to getting more and more services online, and the online world is replacing bookstores and transforming banking.
What if, after the family is fed and kids put to sleep, you could log into your interactive computer doctor and review your test results, get nutrition counseling to help manage the diabetes, and discuss the risks and benefits of getting a screening mammogram? Or access your interactive computer doctor at 5 in the morning to see if your cough is a routine cold and you can go to work or influenza and best that you stay at home? Phone apps are already able to check pulse, temperature, and blood oxygenation. It’s only a few more pieces of hardware and software interface before they’re listening to our lungs and looking at our ear drums and the back of our throats too.
4. Occipital Lobe Syndrome
Clerks, medical assistants, and doctors with attitudes; unruly and contagious kids with screaming parents in the waiting room; the vaccine you need out of stock. No wonder people want to go to the doctor’s office even less than department stores! Many would jump on the opportunity for an online alternative.
I wrote a while back about the “Occipital Lobe Syndrome,” your physician more focused on the computer screen and all the boxes he or she needs to click on the electronic health record rather than focused on you, the patient. Throughout the majority of the time in the room, you the patient stare at the the back of his or her head where the occipital lobe of the brain is located which, ironically, processes vision.
Health delivery in our country is going through a phase of really impersonal care. How many would rather just get health services from a computer screen with that nice female British accent that reads our directions today, instead of from the back of a stressed out primary care physician’s head?
5. There’s precedence (on TV)
Yes, I’m one of those nerds who grew up watching Star Trek: Voyager from the first to last episode. Even though we may never realize faster-than-light travel or transporting ourselves (each and every atom) from space to a planet’s surface, we’ve already surpassed the original series’ vision or tricorders and communication devices.
After the spaceship Voyager was flung across the galaxy and lost its physician, the computer hologram “Doctor” went live and provided care for the ship’s remaining crew. He had to learn to be more personable and interpret humanoid interactions, but eventually became the accepted family doctor for the crew.
Will that too come off the pages of sci fi and into real life application?
As Watson-style technology becomes affordable to the masses, human-computer interactions grow even more sophisticated, and the public demands it (if the healthcare industry doesn’t get it’s act together and learn to be consumer-friendly), your primary care doctor might one day get replaced by your computer.