More from Vinod Khosla on the future of health care (see previous posts Vinod Khosla: Technology Will Replace 80 Percent of Docs and AI will eventually drive healthcare, but not anytime soon), as well as Software Programs Help Doctors Diagnose, but Can’t Replace Them on how doctors and software can work better together.
I think he underestimates both the institutional barriers to change (his incentives para below) as well as the human side, and getting the balance right between better (and more) data and how to analyse it for treatment recommendations (e.g., may mean over screening and uneeded treatment). Quote:
Some critics of more automated healthcare argue that medicine isn’t just about inputting symptoms and receiving a diagnosis; it’s about building relationships between providers and patients. Providing good bedside manner and answering certain questions can often be handled better by a person than a machine, but you generally don’t need a medical degree to do that. Nurses, nurse practitioners, social workers, and other less expensive, non-MD caregivers could do this just as well as doctors (if not better) and spend more time providing personal, compassionate care. I’m not advocating the removal of the human front-end here. I’m arguing that we should build robust back-end sensor technology and diagnostics through sophisticated machine learning and artificial intelligence operating on data in greater volumes than humans can handle.
A transition to automation has already happened in other areas where we once thought human judgment was required. Most commercial flying is now done by auto-pilot, not by the captain. Algorithmic trading now drives most stock market volume. Google’s (GOOG) self-driving car has had zero accidents driving 300,000 miles on normal streets. The same replacement of human involvement by computers will also happen in healthcare. This will create a more comprehensive understanding of patients and improve health outcomes with more personalized treatment. Physicians will have MORE time to spend talking to their patients, making sure they understand, socializing care, and finding out the harder-to-measure pieces of information because they’ll spend a less time gathering data and referring to old notes. And, they will be able to handle many more patients, reducing costs.
The source of healthcare innovation
Where will all this innovation come from? Some believe we have to work within the constraints of the medical establishment. I disagree.
Innovation seldom happens from the inside because existing incentives are usually set up to discourage disruption. Pharma companies push marginally different drugs instead of potentially better generic solutions because they want you to be a drug subscriber and generate recurring revenue for as long as possible. Medical device manufacturers don’t want to cannibalize sales of their expensive equipment by providing cheaper, more accessible monitoring devices. The traditional players will lobby/goad/pay/intimidate doctors and regulators to reject innovation. Expecting the medical establishment to do anything different is expecting them to reduce their own profits. Granted, these are generalizations and there are many great and ethical doctors and organizations.