The cover story of the March print edition of The Atlantic is “The Robot Will See You Now”, which explores the various ways that technology is queued to disrupt the medical establishment. IBM’s Watson is now working through case histories from Memorial Sloan-Kettering, a step toward a much more sophisticated diagnostic and treatment recommendation tool than symptom searches in medical databases.
While I don’t undervalue the talent of an experienced doctor to perceive symptoms that may not be mentioned as complaints and put them together into a better diagnosis, I found myself nodding when one physician on Watson’s training team mentioned the problem of “anchoring bias”, in which one symptom is given priority and others are ignored or seen as unimportant. That can be multiplied with other prejudices, such as the implicit and explicit bias against fat people that was shown in a study released a few months ago (this post from Jezebel describes the situation well), making it more difficult for members of some populations to receive a valid diagnosis.
The article also discusses the improvements in monitoring technology that are being pioneered by the enthusiasts in the quantified self movement that I’ve posted about previously. It may soon be possible to wear a monitor that reports regularly and wirelessly to your doctor on an important statistic that is being tracked: blood pressure or heart rate, for example. A scale or blood sugar tester could share data every time it’s used in the same way.
Potential changes in the career paths of medical workers are considered and decreased contact between doctors and patients for routine issues seems likely. This could boost the already strong prospects for nurses and physician assistants and — as the article states — allow “everyone to practice at the top of their license.”
This article comes out the same time as a study of robot-assisted hysterectomies determined they are increasing in prevalence despite costing 100-200% more than the standard surgery. There is little evidence of any improvement in outcome and the suggestion is that the surgery is becoming more widespread due to marketing, not only to the medical establishment but also to patients. We’ll be wise to remember that new and high-tech doesn’t always mean it’s better for patient care, as Monty Python tried to show us decades ago:
Addition: For a half hour audio discussion of this topic, take a listen to Talk of the Nation with Ira Flatow from June 1, 2012. Flatow speaks with guests Dr. Eric Topol, author of The Creative Destruction of Medicine, Dr. Reed Tuckson, head of UnitedHealth Group, and Dr. Arnold Relman, former editor-in-chief of the New England Journal of Medicine.