Here is why AI is not ready to replace me!

Hey everyone,

In 2016, Vinod Khosla predicted that AI will do 80% of my (physician's) job. Here is the paper, the predictions start on page 79. As of today I use AI for 0% of my clinical decision making and 80% of my charting. 

While AI has seem some adoption in healthcare, its mostly been assigned to non clinical decisions. Interestingly, the successes in AI diagnostics (such as pneumonia detection via cough, here) have failed to see any tangible market adoption.

Here are the inaccurate assumptions I often see technologists makes:

1. More data = better outcomes
The reality is we simply do not have the medical knowledge to do anything with the plethora of data being collected. Furthermore, it's impossible for me to track daily patient data for my 2000 patients. 

Without significant advances in science, at this point more data = more patient anxiety = likely equal or worse outcomes. 

2. Medicine is certain
The uncomfortable truth is medical decisions are based on rough probabilities of risk and reward. This is true for strep throat, sepsis, cancer and trauma. There are almost no certainties in medicine and even gold standards have inaccuracies. 

Again this isn't a problem of too little data, its a problem of medical knowledge and poor diagnostics. We need new tests to detect cancer, not more MRIs. We do not use MRI's to diagnose cancers and we likely never will. This is somewhat perplexing to me as the its an obvious point of failure to innovate. 

3. Who will be liable?
Most AI solutions in healthcare do not go through FDA approval, as they are classified as SaMD. While this is excellent from a business perspective, as it reduces costs and legal risk. It's a hinderance for market adoption as all liability now rests on the clinician. 

Furthermore, our licensing authorities now require a level of explainability in all tools we use. In this instance I side with the technologists and believe requiring explainability for AI will vastly minimize its potential. 

Thank you for reading,

Rishad