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		<title>Physicians Aren’t Becoming Obsolete, The Standards Of Care Are</title>
		<link>https://medika.life/physicians-arent-becoming-obsolete-the-standards-of-care-are/</link>
		
		<dc:creator><![CDATA[John Nosta]]></dc:creator>
		<pubDate>Wed, 01 Mar 2023 01:04:51 +0000</pubDate>
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		<guid isPermaLink="false">https://medika.life/?p=17789</guid>

					<description><![CDATA[<p>AI is changing our expectations of knowledge and outcomes in medicine. So, what will tomorrow’s accepted best practices be?</p>
<p>The post <a href="https://medika.life/physicians-arent-becoming-obsolete-the-standards-of-care-are/">Physicians Aren’t Becoming Obsolete, The Standards Of Care Are</a> appeared first on <a href="https://medika.life">Medika Life</a>.</p>
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<p>Today’s provocative discussions about technology’s replacement of the physician are both interesting and relevant. But the context this for discussion may extend to outside of the walls of the hospital to include the courtroom.&nbsp;</p>



<p>Medical malpractice “standards of care” are the generally accepted norms and practices that healthcare professionals are expected to follow when providing medical treatment to patients. These standards are based on the medical community’s collective knowledge and experience, as well as on established medical guidelines, protocols, and best practices. It’s the basis for our expectation of quality care, or at least average care.</p>



<p>The specific standards of care that apply to a particular case depend on various factors, such as the patient’s medical condition, the nature of the treatment being provided, and the relevant laws and regulations. For example, a doctor performing surgery would be expected to follow established surgical protocols and guidelines, while a psychiatrist treating a patient with depression would be expected to follow established guidelines for the treatment of mental illness. In any instance, if often is a human standard — as a personal judgment or interpretation of an aspect of technology.</p>



<p>This leads to a fundamental medical and legal question: How do we define and debate the evolving standards of care in the context of available medical technology—particularly artificial intelligent and platforms like ChatGPT?&nbsp;</p>



<p>The first and critical perspective is the liability for using artificial intelligence and machine learning in medicine. While certainly in flux and given the rapid emergence of GPT, the concerns are significant and relevant. And even papers published only months ago fall short for a comprehensive and timely discussion. A 2021 <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8452365/" target="_blank" rel="noreferrer noopener">paper</a> provides a succinct analysis.</p>



<p><em>The relatively unsettled state of AI/ML and its potential liability provide an opportunity to develop a new liability model that accommodates medical progress and instructs stakeholders on how best to respond to disruptive innovation.</em></p>



<p>These issues are arriving quickly than expected and the inertia of progress will demand action. But it’s essential to look beyond this point in time and consider the trajectory of AI in medicine. There’s little doubt that AI will become “augmented intelligence” that will expand the cognitive domain of all clinicians. Artificial intelligence and language models like GPT have the potential to advance the practice of medicine by helping clinicians make more accurate and informed decisions. AI can assist in medical imaging, clinical diagnosis, and other areas where data analysis is critical.&nbsp;</p>



<p>In fact, one can argue that AI in medicine is here. Even <a href="https://hbr.org/2019/10/ai-can-outperform-doctors-so-why-dont-patients-trust-it" target="_blank" rel="noreferrer noopener">Harvard Business School</a> recognizes the fundamental reality of AI in medicine today.</p>



<p><em>Medical artificial intelligence (AI) can perform with expert-level accuracy and deliver cost-effective care at scale. IBM’s </em><a href="https://www.nytimes.com/2016/10/17/technology/ibm-is-counting-on-its-bet-on-watson-and-paying-big-money-for-it.html" target="_blank" rel="noreferrer noopener"><em>Watson diagnoses</em></a><em> heart disease better than cardiologists do. </em><a href="https://techcrunch.com/2017/01/04/babylon-health-partners-with-uks-nhs-to-replace-telephone-helpline-with-ai-powered-chatbot/?renderMode=ie11" target="_blank" rel="noreferrer noopener"><em>Chatbots dispense medical advice</em></a><em> for the United Kingdom’s National Health Service in lieu of nurses. Smartphone apps now </em><a href="https://academic.oup.com/annonc/article/29/8/1836/5004443" target="_blank" rel="noreferrer noopener"><em>detect skin cancer</em></a><em> with expert accuracy. </em><a href="https://www.nature.com/articles/s41746-018-0040-6" target="_blank" rel="noreferrer noopener"><em>Algorithms identify eye diseases</em></a><em> just as well as specialized physicians. Some forecast that medical AI will </em><a href="https://www.forbes.com/sites/reenitadas/2016/03/30/top-5-technologies-disrupting-healthcare-by-2020/#183882f26826" target="_blank" rel="noreferrer noopener"><em>pervade 90% of hospitals</em></a><em> and replace as much as </em><a href="https://fortune.com/2012/12/04/technology-will-replace-80-of-what-doctors-do/" target="_blank" rel="noreferrer noopener"><em>80% of what doctors currently do</em></a><em>.</em></p>



<p>Radiology is another good example where AI is driving significant <a href="https://www.insideprecisionmedicine.com/artificial-intelligence/how-artificial-intelligence-is-driving-changes-in-radiology/" target="_blank" rel="noreferrer noopener">changes</a>. From workflow to post-scan image reconstruction, radiology is at the leading edge of how AI-based medicine is shifting from an option to an imperative. And today, there are over 500 FDA <a href="https://healthexec.com/topics/artificial-intelligence/fda-has-now-cleared-more-500-healthcare-ai-algorithms" target="_blank" rel="noreferrer noopener">approved</a> AI algorithms with the vast majority in radiology.</p>



<p>A fundamental question that emerges: what is the expectation of care are given a growing body of evidence for the utility of AI? Should every differential diagnosis have a “computer assist” as part of the process? Or should the distant lub dub of a heart sound live only in the ear of the clinical or be cognitively amplified by technology? And most importantly, what are the consequences for failing to leverage lifesaving technology that has clinical validation and availability?</p>



<p>Today, new questions will be asked regarding the best care, the available care, and the standard of care that medicine will be held up to. New standards and expectations for excellence will challenge the core capabilities in the practice of medicine. The cognitive domain of the clinician—once held as sacrosanct—will come under scrutiny as AI offers the accuracy and speed that is fundamental to care.&nbsp; The path is defined by ambiguity.&nbsp; But what maybe be most important about that early path are the guardrails that are put in place for all stakeholders.</p>
<p>The post <a href="https://medika.life/physicians-arent-becoming-obsolete-the-standards-of-care-are/">Physicians Aren’t Becoming Obsolete, The Standards Of Care Are</a> appeared first on <a href="https://medika.life">Medika Life</a>.</p>
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		<post-id xmlns="com-wordpress:feed-additions:1">17789</post-id>	</item>
		<item>
		<title>Perhaps, A Braver New World</title>
		<link>https://medika.life/perhaps-a-braver-new-world/</link>
		
		<dc:creator><![CDATA[John Nosta]]></dc:creator>
		<pubDate>Mon, 27 Dec 2021 23:15:29 +0000</pubDate>
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		<guid isPermaLink="false">https://medika.life/?p=13534</guid>

					<description><![CDATA[<p>The drip, drip, drip of innovation might just be a myth. Change commonly occurs as a punctuated reality that’s a function of converging events or a single disruption to a system or construct.&#160; I wonder if the famous term “singularity” coined by Ray Kurtzweil may be better suited for the discussion of these innovation inflection [&#8230;]</p>
<p>The post <a href="https://medika.life/perhaps-a-braver-new-world/">Perhaps, A Braver New World</a> appeared first on <a href="https://medika.life">Medika Life</a>.</p>
]]></description>
										<content:encoded><![CDATA[
<p>The drip, drip, drip of innovation might just be a myth. Change commonly occurs as a punctuated reality that’s a function of converging events or a single disruption to a system or construct.&nbsp; I wonder if the famous term “singularity” coined by Ray Kurtzweil may be better suited for the discussion of these innovation inflection points (think Big Bang) than its current expression of technology’s cognitive assent over mankind.</p>



<p><strong>From evolution to the industrial revolution</strong>, this is a recurrent theme for humanity and all life on earth. We receive a kick in the ass and move (sometimes crying and screaming) into the future. Sometimes, it’s a singular event that drives a profound transformation—remember those dinosaurs and that asteroid?&nbsp; And if you use your imagination, you might even see that horrific sphere in the sky and conger some images of the COVID-19 virus. Sometimes it’s a cluster catastrophic events or a confluence of magical things.&nbsp;</p>



<p><strong>Change is disruptive.</strong>&nbsp; But adoption is gradual.&nbsp; And that where people get confused.</p>



<p>The year 2021 was certainly disruptive.&nbsp; And it was defined by COVID-19 and void of innovation that perfectly reflected the difference between disruption and adoption. Certainly, there were important breakthroughs including therapeutics and vaccinations.&nbsp; But failure was also a defining aspect of a tumultuous year. Adoption can drag its feet…</p>



<p><strong>Clinical uncertainty was met with the demands of rapid action and resulted in the complexities of innovation, confusion, and adoption. </strong>COVID-19 compressed years of science, pharmaceutical development, technological advances and clinical practice into just months—sometimes even days. And then, layered moral imperative of action into this equation. The lessons learned from 2021 are vast. But, in many instances, these lessons were driven by events, or, if I may, singularities that helped shape and drive action. </p>



<p>It seemed that almost every day in the past year provided new data, insights, and guidelines that helped informed&nbsp;clinical practice. Yet, this pushed clinicians away from the “clinical comfort zone” into more a “risk/reward” posture where conformation was either antidotal, pre-published, or driven by societal and political pressures. Consensus—from patient to clinician—was sometimes difficult to find. But bravery, from thought to deed, was frequently at hand.</p>



<p><strong>Today, we are around the corner from another asteroid or spike protei</strong>n.&nbsp; But we are also at the center of another confluence that offers the potential to transform and protect humanity from those fireballs in the sky.</p>



<p>Social need, technology, genomics, artificial intelligence and a host of factors are aligned for more than a change, but a tectonic shift of unimaginable proportions. These are coming at us with the jolt of disruptive transformative that can make us cling to a safer and more predictable past. But that’s the nature of transformation.&nbsp; It’s sudden and shocking.&nbsp; But the human side of that journey may not always align.&nbsp; </p>



<p>The traditional vision of our future and of transformation is our desire for&nbsp; “the same but better.”&nbsp; From the emergence of the electric car (a transition) to the introduction of a new beta-lactam antibiotic with better tolerability and spectrum of coverage (another transition), we adopt in baby steps.&nbsp; But technology can often loom larger and step more broadly.&nbsp;</p>



<p>That’s where we are today.&nbsp; Look up and you’ll see it.&nbsp; We are just heartbeats from our next inflection point. The question isn’t only about the wonder of technology to help solve these conflicts, but the bravery of humanity to move forward.</p>
<p>The post <a href="https://medika.life/perhaps-a-braver-new-world/">Perhaps, A Braver New World</a> appeared first on <a href="https://medika.life">Medika Life</a>.</p>
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