Yves here. Chuck L suggested that this recent comment by IM Doc warranted being hoisted as a stand-alone post. The notion that AI administered medicine amounts to medicine is a horrorshow, particularly for those with sub-clinical conditions and patterns that are out of band (which yours truly has in more than one specialist category).
It may be possible to throw a lot of sand in the gears of these schemes if enough patients get behind it. A potential point of leverage is the plan to video and record patient visits. Any entertainer or prominent person should be freaked out about the idea of recordings of them being taken and potentially hacked or otherwise misused. If this implementation can be blocked in a couple of pro-patient states, such as California and New York (the New York Department of Financial Services, which regulates medical insurers, is not tolerant of insurer grifting and run-arounds), that would throw a huge spanner in the project, since having different versions in different markets would be difficult and therefore not appealing.
A related way to throw sand in the gears is invoking patient rights to not be recorded in two-party consent states, where all parties have to consent to a meeting being recorded. They are:
California
Delaware
Florida,
Illinois
Maryland
Massachusetts
Montana
Nevada
New Hampshire
Pennsylvania
Washington
While there needs to be an official sighting that these “services” are indeed being developed (say a discussion in a trade publication or a conference), one way to start pushing back, if you are in any of the all-party consent states, is to notify your doctors that you do not consent to having your visits recorded and you want that noted in your records. You will probably need to remind them at the time of scheduling and when you walk in for the exam. Patient resistance before this even gets off the ground could slow or limit uptake.
From IM Doc:
For starters – and I understand this is already in beta format – I have heard about it through the grapevine from doctors already involved.
There will be cameras and microphones in the exam room. Recording both the audio and video of everything that is done. The AI computer systems will then bring up the note for the visit from thin air – after having watched and listened to everything in the room. Please note – I believe every one of these systems is done through vast web services like AWS. That means your visit and private discussions with your doctor will be blasted all over the internet. I do not like that idea at all. This is already being touted to “maximize efficiency” and “improve billing”. My understanding from those that have been experimented upon as physicians, that as you are completing the visit, the computer will then begin demanding that you order this or that test because its AI is also a diagnostician and feels that those tests are critical. It will also not let you close the note until you have queried the patient about surveillance stuff – ie vaccines and colonoscopy, even for visits for stubbed toenails. And unlike now when you can just turn that stuff off, it is in control and watching and listening to your every move. The note will not be completed until it has sensed you discussing these issues with your patient and satisfied that you pushed hard enough.
I understand also that there is a huge push to begin the arduous task of having AI take over completely things like reading x-rays and path slides. Never mind the medicolegal issues with this – ie does the AI have malpractice insurance? Does it have a medical license? Who does the PCP talk to when there is sensitive material to discuss with a radiologist, as in new lesions on a mammogram etc? Are we to discuss this with Mr. Roboto?
There are other examples I have heard but they are so outlandish that they should probably wait for another day for further confirmation.
The glee with which the leaders of this profession are jumping into this and soon to be forcing this upon us all gives one a very sick feeling. Complete disregard for the ethics of this profession dating back centuries. I had a very similar sick reaction to the glee exhibited in the days of Oxy-Contin and the COVID vaccines.
There are days I am so so glad I am going to likely retire long before all of this really comes to fruition. All I can say is live as healthy a life as you can. Your medical system is very soon going to throw a rod.