NEW ORLEANS — People have concerns over artificial intelligence taking their jobs. Others say it will simplify and enhance their jobs.
So, what does AI mean to you when you go to the doctor?
When Mike Riemer was diagnosed with prostate cancer 16 years ago, doctors did not think the prognosis was good.
They gave me 18 to 21 months. Oh, it was devastating. I remember sitting in my recliner, my chair, and just I had to tell my wife. And uh, I said, ‘I think, I think I probably have cancer,” said Mike Riemer.
There was chemo, radiation, and medications. And when faced with a decision about taking the pills he is on today, that extensive, complicated package insert, written in legalese, was even too confusing for Mike, who is a former educator with a Master’s Degree and is working towards his Ph.D.
So, he turned to his friend, retired urologist Dr. Neil Baum for some extra advice.
Dr. Baum then turned to ChatGPT. He asked the program for 300 words, on a tenth-grade reading level, all the details, pros and cons, of the medication, when taken by a man of Mike's age, with his exact medical history. It popped up on his computer screen in seconds.
He said it really helped him.
“Oh yes. It gave me the confidence that this was the right thing to do,” said Riemer.
“This amazing technology, that has revolutionized medicine, I mean this is going to be better than penicillin,” said Dr. Neil Baum, a retired urologist, who is on the faculty at Tulane School of Medicine.
Dr. Baum believes this could help parents with a sick child in the middle of the night. Should they go to urgent care immediately, or the doctor's office in the morning?
And it can help doctors spend more time treating patients and less on red tape.
“Prior authorization is the bane of most healthcare workers. When a doctor has to write and request permission for a study, a lab test, a medication, with ChatGPT, within seconds, a letter's generated. Within hours, or a day, you get a response,” explained Dr. Baum.
He says this could save doctors six to eight hours weekly that they spend on these types of non-medical tasks that contribute to burnout.
“Doctor burnout is impacting nearly 50 percent of, of physicians today. This is going to be truly a game changer,” said Dr. Baum.
But can't a doctor disagree with what ChatGPT says based on his or her training?
“Absolutely, it must be edited by the doctor,” he added.
Chairman of Urology at Tulane, Dr. Raju Thomas, says not only is ChatGPT enhancing medical care, but so are other types of artificial intelligence.
“Thirty years ago, do you think you'll ever perform surgery without touching a patient? I'd say, ‘That ain't going to be so.’ But now, most of my patients, I don't even touch, because I see a 3D image like I'm at the IMAX movie every day. Very precision driven. So, as I age, I'm actually getting better,” said Dr. Thomas.
Dr. Thomas has been doing robotic surgery since the 90s, but now with AI, there are more precise dimensions and images of each patient’s anatomy pre-op. So, robotic surgery to remove a large kidney tumor is safer. That could mean less cutting, and blood loss, a shorter hospital stay, less pain, fewer narcotics, less time under anesthesia, a quicker recovery, and an overall better outcome. AI will mean the doctor’s movements will be recorded, and the exact operative report will be printed out by computer reviewing the video, instead of him writing up each case post-op.
“That kind of blows my mind, saying, you know, can I really be sure the anatomy is being adequately portrayed? That is being done now,” said Dr. Thomas.
But he says AI comes with serious concerns, is big brother watching over a doctor's decisions? Every patient is a different shape and size, every tumor is too, and growing in different positions. Our anatomy is like our fingerprints. No two are the same. So, some surgeries will take longer.
“I don't think I will like to be judged by a computer, which is feeding into the insurance company, and them holding that against me, even though the patient's outcome was perfect,” said Dr. Thomas.
These computer advances are being used to scan mammograms, pap smears, prostate cancer cells and skin lesions. Dr. Baum says there are advantages.
“Who would you rather go to, a doctor who has seen a few, or a doctor who has seen hundreds of thousands, and even millions of examples, and help make the diagnosis?” asked Dr. Baum.
Dr. Thomas sees some disadvantages.
When asked if it scares him, Dr. Thomas replied, “Yeah, because what if they miss something, you know, behind a shadow?”
Dr. Thomas is also concerned that medical students are not choosing pathology, or radiology as a specialty, over concerns AI will be reading scans and biopsies, not trained doctors. And he's concerned that with cancer, AI will only be taught to recommend standard, not customized treatments.
“So, these algorithms can be set up by the AI category, and then ultimately forced upon us in managing our patients, because it might be a short cut and less expensive, Remember, this is not AI used to make a car. This is a human life and everybody on the inside is different,” said Dr. Thomas.
The doctors say the new technology can warn doctors if a prescription would have a dangerous interaction with another. And it can help save costs to the $4 trillion-a-year health care budget, but that could also have a downside.
“Will it be used just for cost cutting which can compromise patient care? I know the insurance companies want to make a profit and increase their share prices and stuff, but at the end of the day, it's the patient that matters,” said Dr. Thomas.
There is potential for abuse. So, Dr. Baum says it's going to have to be regulated, but he believes the benefits are going to be tremendous.
“ChatGPT will never replace a physician. It can not and it will not be able to hold the patient's hand,” said Dr. Baum.
Nor a surgeon's scalpel, at least for now.
And Dr. Thomas says after every operation, the doctor has to write a report about what happened in the case.
He now has concerns that a robot will take over that task, just by analyzing the moves it made.
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