Generational differences in Medical Practice?

Agracier: I've read about AI and it seems that AI trained on how people do things will simply absorb the biases of the training set (e.g. if the training set has few black patients they may treat them improperly).

But, right, an AI may be less likely to engage in moralistic discussion.

The aim will then be to train AI's in the most thorough manner possible and make sure the informational input is as diverse as possible from as many different sources as possible.

That way one could be more certain that AI's will diagnose patients in the most objective way possible, since they will have received input/training from x number of sources.

People on the other hand, no matter what they are taught, will often revert to their default prejudices and antipathies once they graduate, often without even being aware or even with good intentions. People will also absorb social/cultural/corporate stimuli and internalize these without knowing.

Therefore one could say/predict that AI health providers, provided they are programmed as objectively as possible and regularly monitored and checked/controlled, could very well be more bias-free than a typical human.

I think the next phase of medicine will combine AI with human elements, just as a previous phases included the addition of lab tests, and then increasingly sophisticated imaging. The value of the human element is to be personable and human, as well as assist in interpretation. However, AI is now extending to humanity too with virtual companions, partners etc...

It should be no surprise that role of AI in medicine will mirror that in wider society, just as the role of clinicians has mirrored wider societal changes such as a move away from hierarchy and paternalism, and emergence of 'google experts'.

The use of Robotic surgery has been in use for the last 11 years in the UK . The da Vinci Xi robots, created by the California-based Intuitive Surgical has been used in the UK for procedures like cystectomy. . Around 50 per cent of the 2,000 people in the UK who require bladder removal each year are now operated on robotically.

In the 11 years since the NHS bought its first da Vinci – the Royal Marsden took receipt of one in 2007, to help with tumour removal – there are now 74 such machines on duty around the country, being used to perform prostate, bladder, kidney, womb and tumour removals. Yet, after a decade of trials, robots will this year 2018, take on an even greater roles in Britain’s operating theatres.

This is not a fully automated process, so no AI is completely responsible for the surgery. The surgeon has his eyes pressed to a 3D screen and is controlling the robot’s every move using not only his hands, but also his bare feet.

People think of a robot coming in and doing surgery. The surgeon actually moves the instruments just as you would in open surgery. But you do it through a console that gives you much finer control and precision. However in the future with the greater use of AI, I expect it will be fully automated in which an AI has full control and will completely.

There has been research in the US that have used a fully automated system. To see if robots could successfully complete surgical tasks on their own, the researchers created the Smart Tissue Autonomous Robot (STAR), which consists of a robotic arm, suturing tool and imaging technologies.

The robot uses a computer program informed by best surgical practices to determine where and how to place a stitch.

First, the researchers tested STAR’s ability to stitch together two pieces of tissue harvested from pigs. The autonomous robot generally outperformed human surgeons and currently-available robots.

Then the investigators compared the skills of STAR and human surgeons for reconnecting an interrupted intestine in live pigs. The outcomes of the operations by STAR were consistent with the outcomes of a skilled surgeon.

Autonomous robotic surgery still a long way to go before it’s ready for prime time, however.

So the future for a fully AI system looks to have started its long road , only time will tell if we will completely have a fully automated AI administering our medical needs.

So The Doctor, an Emergency Medical Hologram Mark I (or EMH for short) may not be as far fetched as we imagine .

RN

I suspect there are still some younger doctor out there devoted to their careers and do physicals as they've always pictured them. I would think that they would offer kids small sized gowns once they reach about 5 or 6 years old.

@JoeSag87 You bring up an excellent point. Kids should have gowns too. I mean why only adults.

We use gowns at work for almost everyone from age like 6 up to adults. My old pediatrician used gowns from when i turned like age 6 up till i stopped seeing her 2 years ago.

I’ve noticed older doctors are less concerned with modesty in general. Younger doctors are more concerned with time efficiency and seeing as many people as possible, since removing clothing takes longer they won’t make you do it as much.

I remember being in only underwear for physicals up to maybe ten or eleven. After then it was always in a gown.

I think it's not so much generational as much as the age and sex of the patient, and if there is a parent present. I was stripped to my underwear for all my pediatrician visits, and never minded in the least. As far as gowns go, I've found them cumbersome and prefer not to wear them.

A doctor friend of my recently told me that you can NOT examine a patient who is covered up, because then you are unable to get a visual assessment of the patient (look), layers of cloth can impede adequate auscultation (listen), and even a t-shirt can rub against the skin, impeding percussion and palpation (feel).

At the pediatrician, it was usually just lift up as you go. I do recall a couple of times as a young teen that I was in underwear (no gown), but don’t think I was ever completely naked for the whole time.

What an interesting topic I guess I never really thought about it before. I remember being young and you started with clothes on for height eye test hearing test. As the preliminary exam started pants pulled down for temp. then shirt off for heart or chest checks with the stethoscope. If it was a yearly physical possible down to underwear to start. I only remember a few times the pediatrician had gloves on and they were not rubber more like plastic bag with just a thumb and pointer finger. My first time with a gown was much later in life like early 1990's it was made of paper and wasn't too covering one size fits all. It was at the same time at that point in life rubber gloves were a standard I remember the first new female doctor gave the cough test and she didn't put gloves on and was sitting on a rolling stool I thought kind of odd??? Moving forward in life a variety of different gowns or clothes off to a certain degree. What fries my nose is when you check in and they weigh you fully clothed and write down said weight. I recently had an appointment and the nurse medical assistant was very nice but took my weight fully clothed and said you have gained a few pounds???? I said to her are you Fffiing kidding me you are off by 10 lbs I weighed myself this morning. work boots sweat shirt and pant's ??? the previous weight was in gown???

What fries my nose is when you check in and they weigh you fully clothed and write down said weight. I recently had an appointment and the nurse medical assistant was very nice but took my weight fully clothed and said you have gained a few pounds???? I said to her are you Fffiing kidding me you are off by 10 lbs I weighed myself this morning. work boots sweat shirt and pant's ??? the previous weight was in gown???

I am laughing my ass off. I typically weigh about 8 lbs more in the doctor office and that is leaving any permitted weapons and my wallet in the car. I'm sure you can request a nude weigh in if you must but as long as you wear the same thing every time they can see if you are gaining or losing.

I am laughing my ass off. I typically weigh about 8 lbs more in the doctor office and that is leaving any permitted weapons and my wallet in the car. I'm sure you can request a nude weigh in if you must but as long as you wear the same thing every time they can see if you are gaining or losing.

@Moppys_jalopy. I started laughing when I read your response because I am exactly 8 pounds more at my primary care doc's office than I am on my scale at home. I have never requested a nude weigh-in, as the scale is in the hall outside the exam rooms, but my doc has a good sense of humor and he might just say, "go for it."