Skip to content
  • About
  • Contact
  • Contribute
  • Book
  • Careers
  • Podcast
  • Recommended
  • Speaking
  • All
  • Physician
  • Practice
  • Policy
  • Finance
  • Conditions
  • .edu
  • Patient
  • Meds
  • Tech
  • Social
  • Video
    • All
    • Physician
    • Practice
    • Policy
    • Finance
    • Conditions
    • .edu
    • Patient
    • Meds
    • Tech
    • Social
    • Video
    • About
    • Contact
    • Contribute
    • Book
    • Careers
    • Podcast
    • Recommended
    • Speaking

There’s something missing in the doctors vs. AI debate

Robert Centor, MD
Physician
November 17, 2016
Share
Tweet
Share

Over the past two days, listening to separate podcasts, I have heard the same story and now have a better understanding of artificial intelligence. A Freakonomics podcast — The Future (Probably) Isn’t as Scary as You Think:

And in general, what’s happened in the past couple of years is the best chess player on this planet is not an AI. And it’s not a human. It’s the team that he calls centaurs; it’s the team of humans and AI. Because they’re complementary. Because AIs think differently than humans. And the same of the world’s best medical diagnostician is not Watson, it’s not a human doctor. It’s the team of Watson plus doctor.

In this Knowledge Project podcast, the same examples and conclusions develop — Pedro Domingos on Artificial Intelligence.

As I listened to these discussions, an important concept crystallized. Computers and especially AI will provide us the best “peripheral brain”, but they really cannot replace us. Humans have strengths that computers likely will have great difficulty duplicating. Computers do not really think, but their algorithms can reveal connections that we humans do not recognize. So working with algorithms, we can do a better job at diagnosis and treatment.

Recently, we had a wonderful gentleman in his 70s admitted for chest pain. Chest pain occurs for many different reasons. Our human skills are put to a major test in sorting out a precise history. This intelligent, verbal patient kept talking about his heartburn. He pointed to his sternum and described the discomfort as burning. He had no major risk factors for coronary artery disease (CAD) other than his gender and age.

While talking the history, we asked him if he still worked. He told us that he had to stop working as a janitor because of the chest discomfort. He further stated that he had slowed down at first because his regular pace brought on the pain.

We got this history despite having asked him previously what brought on the pain. A different approach clarified the pain in our minds.

His nuclear medicine stress test showed an approximately 10-15 percent perfusion/reperfusion defect in the right coronary artery region.

We called cardiology, who took the history and believed that the patient really had reflux.

One week later when reflux medications and CAD treatment (including beta blocker, statin and ASA) did not relieve the pain, and it actually worsened, a cardiac catheterization showed an isolated 95% right coronary artery lesion. A stent totally relieved his discomfort (which was even occurring at rest).

AI would only work here if it received a proper history. But taking the history required some skill and some intuition. Human diagnosis would only work if we paid attention to the technology. We need to combine an atypical history with other findings. AI would work if a human could interpret a history that was not linear in any way.

So the real question is how do we partner with artificial intelligence? We already partner with Dr. Google and Dr. UpToDate. Partnering with AI in selected cases can help us do our jobs better. Together our patients will benefit.

Robert Centor is an internal medicine physician who blogs at DB’s Medical Rants.

ADVERTISEMENT

Image credit: Shutterstock.com

Prev

Sharing your personal health data? Don’t be scared!

November 17, 2016 Kevin 8
…
Next

Leave my patients’ health data alone!

November 17, 2016 Kevin 5
…

Tagged as: Primary Care

Post navigation

< Previous Post
Sharing your personal health data? Don’t be scared!
Next Post >
Leave my patients’ health data alone!

ADVERTISEMENT

More by Robert Centor, MD

  • When the problem representation and the illness script do not match

    Robert Centor, MD
  • Think of diagnostic excellence as playing smooth jazz

    Robert Centor, MD
  • When constipation pain was worse than cancer pain

    Robert Centor, MD

Related Posts

  • Why do doctors who hate being doctors still practice?

    Kristin Puhl, MD
  • Doctors: It’s time to unionize

    Thomas D. Guastavino, MD
  • Doctors die. But the good ones leave a legacy.

    Jaime B. Gerber, MD
  • When doctors are right

    Sophia Zilber
  • We’re doctors. We signed the book.

    Jonathan Peters, MD
  • Why doctors-in-training need better nutritional education

    Abeer Arain, MD, MPH

More in Physician

  • Inside the heart of internal medicine: Why we stay

    Ryan Nadelson, MD
  • The quiet grief behind hospital walls

    Aaron Grubner, MD
  • a desk with keyboard and ipad with the kevinmd logo

    How to advance workforce development through research mentorship and evidence-based management

    Olumuyiwa Bamgbade, MD
  • The truth about perfection and identity in health care

    Ryan Nadelson, MD
  • Civil discourse as a leadership competency: the case for curiosity in medicine

    All Levels Leadership
  • When a medical office sublease turns into a legal nightmare

    Ralph Messo, DO
  • Most Popular

  • Past Week

    • Forced voicemail and diagnosis codes are endangering patient access to medications

      Arthur Lazarus, MD, MBA | Meds
    • Why specialist pain clinics and addiction treatment services require strong primary care

      Olumuyiwa Bamgbade, MD | Conditions
    • Who gets to be well in America: Immigrant health is on the line

      Joshua Vasquez, MD | Policy
    • When a medical office sublease turns into a legal nightmare

      Ralph Messo, DO | Physician
    • America’s ER crisis: Why the system is collapsing from within

      Kristen Cline, BSN, RN | Conditions
    • FDA delays could end vital treatment for rare disease patients

      GJ van Londen, MD | Meds
  • Past 6 Months

    • Forced voicemail and diagnosis codes are endangering patient access to medications

      Arthur Lazarus, MD, MBA | Meds
    • How President Biden’s cognitive health shapes political and legal trust

      Muhamad Aly Rifai, MD | Conditions
    • Why are medical students turning away from primary care? [PODCAST]

      The Podcast by KevinMD | Podcast
    • The One Big Beautiful Bill and the fragile heart of rural health care

      Holland Haynie, MD | Policy
    • Why “do no harm” might be harming modern medicine

      Sabooh S. Mubbashar, MD | Physician
    • Here’s what providers really need in a modern EHR

      Laura Kohlhagen, MD, MBA | Tech
  • Recent Posts

    • Inside the heart of internal medicine: Why we stay

      Ryan Nadelson, MD | Physician
    • The quiet grief behind hospital walls

      Aaron Grubner, MD | Physician
    • Why peer support can save lives in high-pressure medical careers

      Maire Daugharty, MD | Conditions
    • Bundled payments in Medicare: Will fixed pricing reshape surgery costs?

      AMA Committee on Economics and Quality in Medicine, Medical Student Section | Policy
    • How Project ECHO is fighting physician isolation and transforming medical education [PODCAST]

      The Podcast by KevinMD | Podcast
    • Why clinical research is a powerful path for unmatched IMGs

      Dr. Khutaija Noor | Education

Subscribe to KevinMD and never miss a story!

Get free updates delivered free to your inbox.


Find jobs at
Careers by KevinMD.com

Search thousands of physician, PA, NP, and CRNA jobs now.

Learn more

Leave a Comment

Founded in 2004 by Kevin Pho, MD, KevinMD.com is the web’s leading platform where physicians, advanced practitioners, nurses, medical students, and patients share their insight and tell their stories.

Social

  • Like on Facebook
  • Follow on Twitter
  • Connect on Linkedin
  • Subscribe on Youtube
  • Instagram

ADVERTISEMENT

  • Most Popular

  • Past Week

    • Forced voicemail and diagnosis codes are endangering patient access to medications

      Arthur Lazarus, MD, MBA | Meds
    • Why specialist pain clinics and addiction treatment services require strong primary care

      Olumuyiwa Bamgbade, MD | Conditions
    • Who gets to be well in America: Immigrant health is on the line

      Joshua Vasquez, MD | Policy
    • When a medical office sublease turns into a legal nightmare

      Ralph Messo, DO | Physician
    • America’s ER crisis: Why the system is collapsing from within

      Kristen Cline, BSN, RN | Conditions
    • FDA delays could end vital treatment for rare disease patients

      GJ van Londen, MD | Meds
  • Past 6 Months

    • Forced voicemail and diagnosis codes are endangering patient access to medications

      Arthur Lazarus, MD, MBA | Meds
    • How President Biden’s cognitive health shapes political and legal trust

      Muhamad Aly Rifai, MD | Conditions
    • Why are medical students turning away from primary care? [PODCAST]

      The Podcast by KevinMD | Podcast
    • The One Big Beautiful Bill and the fragile heart of rural health care

      Holland Haynie, MD | Policy
    • Why “do no harm” might be harming modern medicine

      Sabooh S. Mubbashar, MD | Physician
    • Here’s what providers really need in a modern EHR

      Laura Kohlhagen, MD, MBA | Tech
  • Recent Posts

    • Inside the heart of internal medicine: Why we stay

      Ryan Nadelson, MD | Physician
    • The quiet grief behind hospital walls

      Aaron Grubner, MD | Physician
    • Why peer support can save lives in high-pressure medical careers

      Maire Daugharty, MD | Conditions
    • Bundled payments in Medicare: Will fixed pricing reshape surgery costs?

      AMA Committee on Economics and Quality in Medicine, Medical Student Section | Policy
    • How Project ECHO is fighting physician isolation and transforming medical education [PODCAST]

      The Podcast by KevinMD | Podcast
    • Why clinical research is a powerful path for unmatched IMGs

      Dr. Khutaija Noor | Education

MedPage Today Professional

An Everyday Health Property Medpage Today
  • Terms of Use | Disclaimer
  • Privacy Policy
  • DMCA Policy
All Content © KevinMD, LLC
Site by Outthink Group

Leave a Comment

Comments are moderated before they are published. Please read the comment policy.

Loading Comments...