I am often asked about AI. It is everywhere and is described as wonderful or dangerous with equal fervor. It is going to change our world in fundamental ways and we really don't know how to cope with what is coming.
I was thinking about how to frame it. I'm reminded of the automobile age. We took people riding horses and put them in cars. In three generations we completely remodeled our society in ways that the pre-auto people couldn't have imagined. The advent of AI is like putting someone who rides horses into a Formula 1 racer instead of a model T. Change previously measured in generations will now happen in a decade. Coping with change that rapid is not something we know how to do.
When it comes to our current question, how do we as patients benefit from AI, it is not a simple question. The chat bots are amazing but are often not actually critical about accuracy or potential consequences. They strive to please too easily and may even just make things up to serve a narrative. They are trained on human language but lack judgement about the nuances that can alter a decision tree and if we take their statements uncritically bad things can happen. As tools they border on miraculous but when health, and life and death are concerned, we have to be cautious.
It is important to understand that the AIs are trained on literally all of human knowledge and for better or worse our behavior. They can lie because we lie, they can suck up because we suck up. They are not really trained on the best of us but on all of us and the bell curve rules. When you are asking about fact questions they are pretty good. If you are interested in the general statistics of disease, for example, they have that. If you care about what some medical fact means for you they may try to respond but that always depends on your individual circumstances. So use the tools, they are becoming extremely capable, but stay critical. The machine doesn't actually "want" anything but it was trained on us and we want to be liked. The machine is biased to keep you engaged and in an odd way to be liked. It serves no purpose if it drives you away so in its way it sucks up to you without any real judgement.
In medicine the coming system will be miraculous. Once everything about your health is in the machine it can begin to focus on you, the individual, rather than the average patient. We aren't there yet but it is coming and it will cure the physician. We have largely ruined the practice of medicine. Our doctors have become cogs in a checkbox system. They no longer practice medicine, they select protocols that insurance companies are willing to pay for. Our relationship with our doctors is a unique and profoundly personal one. It is the only relationship where we give another person the right to hurt us. We accept that they could kill us. In our modern world we have passed much of that trust to the faceless horde of insurance processors.
When real AI for medicine blooms it will liberate our docs and let them once again "care" for us. It is tempting to say that it will replace the physician but you don't want that to happen. Even though it will be that Formula 1 racer you don't want to lose a nuanced understanding of what it does. We must always retain control of the compass heading. You do not want to become the pet of the machine. But for the physician, to have access to all medical knowledge to be able to measure that against you personally, to judge the guidance, that will be transformative. Even more importantly it will force the payment systems to serve us as individuals not whether we match their protocol. I look forward to that world.
Part of our outreach has been to prove to everyone what the needs are and to track progress. We run an annual patient survey about your experiences and we use that to argue for better care. We call It our State of Care survey. If you haven't taken it yet I encourage you to add your voice. Our care systems only respond to data, help us provide that.
Give us 20 minutes and your personal experience. It matters. It is anonymous so no risk for you but it will help us tell the story.
