Artificial Intelligence (AI) is a lifesaver in more ways than one. We’ve all read countless articles on how AI is being used to analyze data with pinpoint accuracy as to whether a brain scan may indicate a patient’s likelihood of developing Alzheimer’s or find the minutest evidence of a cancerous tumor in a blood test. Now, we hear that in China, a robot received its medical license—by passing the qualifying test with high scores!
Researchers from Tsinghua University, Beijing created a robot named Xiaoyi to help boost productivity and assist human doctors in treating patients who live in remote parts of China with limited access to medical help. Over a year was spent inputting data from dozens of medical books into Xiaoyi’s computerized “brain.”
On his exams, Xiaoyi was able to show a “reasoning process” when deciding how to treat symptoms, instead of just accessing information. This robot not only mastered medical and clinical knowledge but also demonstrated an ability to solve some problems using the knowledge gained.
A heady accomplishment to be sure but not necessarily a harbinger of what’s to come. Here’s Dr. Legato’s view:
“There’s no question about the enormous progress we’re making in developing artificial intelligence of various types that will make diagnoses faster and more accurate—and present us with the best ways of treating them. That having been said, there’s no substitute for the skills I like to think every good doctor has developed and continuously perfects in dealing with the people who come into the office.
I resist treating patients by telephone except when it’s really urgent to get them some intervention quickly. Why? Because patients tend to avoid a visit to the doctor if possible—it’s inconvenient and it’s expensive. But usually it’s essential to see, to listen to and to examine the sick person. I immediately assess everything about them, even before they know I’m doing it: how they’ve dressed for the visit, whether or not they seem fit and energetic, the tone and pace of their speech—and that’s even before we go to the examining table! People often are so afraid to admit the kind and extent of their symptoms that it’s only when they are on the point of leaving that they tell me the most important thing about their current health. So even when our helpful (and I think they can be VERY helpful) robot performs with astounding competence, it’s important to know that all of these immediate, important points of any assessment have been added to the input! How to quantify the sadness of an expression, a failing ability to choose the right words, an anxiety that makes the patient’s heart race…I’d rather do it myself than enter or read the data: it’s much quicker! I have even forbidden the use of forms prevalent in so many doctors’ offices: the pages of data about their health and history that patients are asked to fill in before they even meet the physician. I’d much rather ask for those data personally, and assess how the patient answers my questions.
So I hope I’m not replaced by a machine. If I can have one who helps me build an accurate diagnosis and points me to the right things to do to prove and treat it, that would be invaluable! In the meantime, I’ll continue to try to respond to patients with the right words, an appropriate tone of voice, and the carefulness with which I do my examination. I think these are the things that convince them I am aware of their needs, spoken and unspoken.
We already have very smart artificial intelligence aiding us every day; for example, apps can monitor how effective our diets and exercise regimens are while a multitude of programs are ready to address any of our questions. The computer is always on, ready to help me in a whole variety of ways. But I’d like to think that for any patient, talking to a competent and empathetic human being is better than surfing the net—as helpful as it often is to me and to them. Good medical care is still essentially an intimate collaboration between two human beings; one skilled and the other wanting access to those skills. The anxiety and fear that invariably accompany sickness, frailty and dying are best dealt with in person.
I’d be very interested in what all of you think.“
Dr. Marianne Legato, Professor Emerita of Clinical Medicine at Columbia University is an internationally known academic physician, author, lecturer, and specialist in gender-specific medicine. She is founding member of the International Society for Gender Medicine and also the founder and director of The Partnership for Gender-Specific Medicine at Columbia University and its next iteration, The Foundation for Gender-Specific Medicine. These enterprises are the first collaborations between academic medicine and the private sector focused solely on gender-specific medicine: the science of how normal human biology differs between men and women and of how the diagnosis and treatment of disease differs as a function of gender and sex. Her ground breaking textbook on Gender-and Sex Specific Medicine has been published in 2017 in the 3rd edition.
She has published extensively on Gender and Sex Specific Medicine, both scientifically and for the lay public. She is also the founding editor of the journal Gender Medicine, and the Journal Gender and Genome, published for the scientific community. In 1992, Dr. Legato won the American Heart Association’s Blakeslee Award for the best book written for the lay public on cardiovascular disease. She is a practicing internist in New York City and has been listed each year in New York Magazine’s “Best Doctors” since the feature’s inception in 1993.