About a 1000 years ago (in computer/biotech years), no medical tests were automated. Everything was done by hand. Almost everything involved wet chemistry or wet microbiology. Until the early 1970’s, when a big hulking device was developed for and marketed by Corning (then Corning Glass Works)- the LARC- the leukocyte automatic recognition classifier. This amazing device was able to discern the percentage of leukocytes on a blood smear and classify them into six types- at a then unheard of rate of 100 cells a minute.
Now, we have almost everything done that way. The Pap smear, developed 70 years ago, no longer involves smearing cells on a slide- and with 120 million tests annually- is now being infiltrated by robots. And, while it was first automated by a small company (TriPath), it is now offered by the behemoth, Becton Dickinson (BD) as the FocalPoint GS Imaging System. This device recognizes 100 different abnormal cells. Data demonstrate that the machine detects almost 86% of the cancerous cells (compared to humans finding 79%)- and at a rate of 170 slides a day (humans can reliably perform between 80 and 90; the regulatory limit [yes, there is one] is 100 per day.)
But, this is just the tip of the iceberg. I already talked about Watson (IBM), which is being readied to aid emergency room diagnoses- and other medical applications. Computer aided diagnosis is now taking over mammograms (Hologic’s ImageChecker CAD) , colon images, chest x-rays, and biopsies for prostate and breast exams.
But, right now, these machines are NOT working alone- humans must effect the definitive diagnosis. Yet, this is still an improvement. (For example, to detect more cancers, many centers actually have two radiologists examine each mammogram independently [called ‘double reading’]; using the machine, the ImageChecker CAD, only one radiologist is needed for even better accuracy than that afforded by two humans.)
Computers are already running many other areas of our lives. They are being used to make cars- which is why employment in the auto factories is down. They are assisting physicians in surgery- making it easier for them to operate on a micro-scale and also perform more operations in a day. They are sorting mail- which is how the Postal System hoped to stay viable. (Of course, we are sending less mail, so being really efficient handling one piece of mail is not going to save the day.)
The independent drug store has virtually disappeared. Because, nowadays, computers are needed to track the nearly infinite choices of drugs available, as well as perform inventory management, invoicing, and drug reimbursement. Which is why the independent, small drug store is disappearing- the computer systems represent too high a capital cost for most independent pharmacies to maintain. And, now, with the push for computerized prescriptions (decreasing errors, rendering the ability of anyone to decipher a physician’s handwriting moot, as well as speeding up the entire process), an even higher capital cost is required by the pharmacy.
But, that’s nothing compared to what is being done in hospital pharmacies. Here, the need for many prescriptions every day means there are manifold pharmacists on the staff. One big computerized machine, even at the cost of $ 5- $ 10 million a pop, is not too expensive, when it can replace 25 to 50 pharmacists. That’s a 1 or 2 year payback!
You see, the problem is that this profession requires highly skilled individuals doing repetitive actions. And, just like was (is) true for making cars, it doesn’t take a genius to discern that a computer/robot can do this as well or better than humans. (It does take a genius to design the system, thank G0d.)
This is going to happen to physicians, too. All those highly skilled surgeons, all those highly skilled anaesthesiologists- most of them are involved with repetitive actions, albeit at high skill. Machines beat humans- hands down (oh, come on, this is a perfect metaphor) doing repetitive tasks, at almost any skill level, as long as there are no massive intellectual, problem-solving skills required.
Which is why the one type of physician we need, the one that happens to be in shortest supply, is the primary care physician. These folks have to pay attention to their patient- watch their body language, emotional state, discern what the patient can or cannot handle. In other words, there is a demand for a highly skilled professional that is involved in intricate, problem-solving skills.
What can you say about your current profession?
hmmm…not sure if a robot will tell stories the way I do, or direct a play, or write a story…so, I think I’m safe for a little bit. Phew. One less thing to worry about.
Stuart—
I am not saying YOUR performance could be replaced… but, what do you think TV is? Is it not used in similar fashion for children’s entertainment?
Rather than reading stories to our children, we let them see the movie of the book on tv or in the theater. is that much different? And, a robot could detect when a child’s attention wavers and adjust volume or tempo….
Scary new worlds….
Roy
Interesting facts Roy….but computers cannot do the one thing that makes our society as a whole move forward. It cannot create innovative thought. It cannot dream any bigger than the program it is given. At least not yet! 😉
Ah, Bonnie.
You are an optimist. So much of what our society does crushes innovative thought. “That’s never been done before!”. “We can’t do that- it will expose us to ridicule.”…
I, for one, do not look forward to robotic replacements. However, we should insure that we do- and where we advise our children to go- yields the long term capabilities.
Roy
Seeing that my profession is a hands on I don’t think computers will over take all of it. Some aspects yes but not all. I am a caretaker of the elderly,(my mom) and daycare provider for children(my grandkids) so I guess my profession doesn’t count.
You have that correct, Jan.
I am sure many docs felt the same way- but as they get more specialized, they become more at risk. But, caregiving is the one item none of us would accept from a robot (Eureka or Bicentennial Man, notwithstanding).
Thanks for the drop-in and comments.
Roy
Like many geniuses out there who develop products that put people out of business, my job has been to work myself out of business. (Yes, I’m calling myself a genius – somebody has to start the rumor.) That job is being a mom. I started out with a baby, had more babies, raised babies and sent them out. I still get called in for consultations and support. If the day comes when computers or robotics takes the place of mom and dad, that would be a horrible tragedy. Interesting post, Roy.
And, Bonnie, I doubt very much we will have a machine to replace you. Not even if we get permission to clone and grow stem cells!
May your children be raised by the unique genius called you!
Roy
The medical role has definitely been changing but the schools may be training technicians now instead of clinicians. But there is a greater need for primary care and community care – it just is less valued and prized so less people go into it. It takes more skill to work with a whole person but the preventative medicine would solve more problems then the robots and computers will.
Oh and sometimes, the machines get it wrong too.
Absolutely correct, Roberta.
And, it is, indeed, why we need primary care physicians more than ever. The trick is to keep us from getting to the hospital- that’s the way we truly save health care money.
Roy
Do you think computers can take over the art world? Unfortunately, I feel like our primary care doctors are robots in that they have 15 minutes to spend with each patient, which seems impossible to perform all the diagnostics that are needed. Thanks for the interesting post! ~ Suerae
No way, Suerae!
Maybe for commercial art – where paintings are “created” to adorn hotel rooms and the like.
But, art requires individual creativity- and there should be no repetition in the process.
Roy
Well, as much as I am more becoming encouraged by the fact that computers are really taking over the world, they still cannot perform with love. 🙂
Scott:
That is certainly true. But, some of us- who have been unhappily married- may view the care and feeding by robots to be familiar.
Seriously, though- that is one of the arenas that folks like IBM are trying to beef up their offerings. And, compared to some docs, it’s pretty clear that Watson could perform their duties with at least a comparable bedside manner.
But, emotional needs are not among the (immediate) cards for robotic replacement. Only those with repetitive tasks that require great precision (the latter obviates kissing…)
Thanks for dropping in- and giving me a great laugh!
Roy
Yeah…I don’t think computers/robots will beat our creativity. Computers only use the data that is provided to them. They are just tools. It is up to the individual to use the tool creatively and effectively.
I’m with you Chris! But, I certainly like having the computer around to do the repetitive work, so I CAN focus on my creativity.
Roy