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I have spent literally years here replying every time explaining that this is not how the doctor shortage works and this is not how the AMA works and that this information is easily discoverable. At this point it's embarrassing.
I guess I will now also have to explain that that is also not how AI in medicine will work and not how medicine works.
Edit: saw the post below. Thanks
A summary or link would help.
The general understanding is that supply for doctors is artificially constrained. The bottleneck maybe residencies, credentialing bodies or just cost of entry.....but they're artificial barrier regardless.
For starters.
At this point, anyone who thinks AI can't disrupt knowledge work has their head in the sand. It may still work out, given the strength of the cartel. But that'd be a case of deliberate sabotage, not inadequacy on part of the AI.
Let me add a little bit -
The constraint is fundamentally ensuring adequate training quality, you'll see people here saying that isn't necessary and maybe they believe it but shit that doesn't seem wise.
People with more knowledge than anyone here (including me) have been working this problem for a long time, the approach is two fold - yes they have been increasing the number of medical schools and residency slots, maybe not as much as required but they are trying. Every year a large tranche of students doesn't advance to the next level of training. We have room to optimize this and interest in doing so.
The other piece has been an explosions in mid-levels, they suck frankly, and have expanded beyond the intended use case while in some ways making the issue worst by overusing specialists. If a US doc wants to retrain to cardiology they need like 2-5 years training. A midlevel needs zero. Guess who makes a better cardiologist?
In most cases the issues are things like allocation problems (which mid levels don't fix, they don't want Gainesville either), a decline in work done by physicians (increasing administration burden, malpractice, and decline in compensation and people work less), a decrease in years worked (turns out women drop out more and faster) and other complicated things like that.
Stealing doctors from other countries is a popular solution and it has some ethical and practical problems (prior to recent political changes everyone wanted to come here, we cant steal from everybody! Additionally if you import enough to depress the wages the reason for coming dies off). However they do seriously need retraining, I don't have access to the private stats but best I can tell the two most common causes of residency termination are intractable substance use and terminal inability to survey the mandatory retraining.
With respect to AI, you can't rubber stamp every case needs actual review to make sure you aren't missing something or you'll be using the doctor as a liability sponge.
AI will come eventually but it isn't ready yet.
AI can't solve procedural work (that's robotics), inpatient work is as much coordination and other soft skills as medical knowledge, and outpatient work has a lot of social components (including the usual things, but also stuff like realizing what the patient means and says are different things).
AI is not ready for that level of ambiguity. It also can't be sued, which the American patient demands.
Sounds like a convenient way to set an arbitrary bar that limits the supply of doctors. Lawyers went through a rapid expansion in supply, and it did not reduce the quality of law. If anything, allowing the competition to take place in the open has increased the bar for getting into elite law-schools. But now, there is also a sufficient supply of mediocre lawyers who fulfill mundane legal duties.
I apologize for sounding harsh, but that is a bad justification. More so on a forum that prides itself in identifying collective incompetence and blind-spots in elite circles. This is the common excuse of Bureaucrats & careerists who love abstractions more than action.
Don't the abusive conditions of residency have a lot to do with why people drop out ?
Aren't mid-levels explicitly 'not cardiologists'. My understanding is that majority of issues are obvious and having a mediocre individual take care of it is a correct allocation of resources. I have a heart problem I have looked at by a cardiologist every 2 years (back in India). The most valuable thing he does is to look at my ultra sound. The ECG is taken by a mid-level and he does the ultrasound because I am long time customer, but a mid-level could do that too. The highest value thing he does is review the ultra sound, and then tell me that my heart is still okay and I am good to go.
His resources are best used for the last part of my checkup (the review) and to spend majority of his time on real emergencies. What's wrong with that ?
eh, I disagree on both points. The ethical problems have never been an issue in the US. Brain-gain is a fundamental national value. Practically, the USMLE + residency matching is hellish for international candidates. I'll let @self_made_human chime in, but it USMLE qualified doctors being incompetent is setting off a bullshit alarm for me.
If I had to speculate, the bottleneck for international candidates is the residency. And it is easiest to get residency slots in the least-desirable towns and cities. It's possible that top international candidates would never agree to waste 3 extra years in the middle of bumfuck nowhere, and therefore only mediocre candidates apply. Top candidates are in competitive fields like cardiology, which needs them to waste about 6-7 extra years in bumfuck nowhere, making it more unlikely that they'll apply."
You'd be surprised. The cutting edge of AI (complex agent swarms) is years ahead of what people think is the cutting edge. (chatgpt subscription).
For example, a chatgpt subscription is 20$/month. I routinely burn 100s of dollars/day in LLM costs. The strongest models are capable of insane things, but it feels like only people in some small circles have realized it so far.
It's still not ready yet, but objects in the mirror are closer than they appear.
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