January 4, 2020 • 35 mins
With savvy and health-conscious people taking control of their wellbeing through apps and sites, technology is meeting the desire for individuals' responsibility for their health. But is the day coming soon when doctors will be obsolete, replaced by computers that read our health-related data to treat us? We explore these questions and more in this classic episode.
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Episode Transcript
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Speaker 1 (00:01):
Hey, everybody, it's me Josh and for this week's s
Y s K Selex, I've chosen will computers replaced doctors.
It's an episode so dated I still wore a fitbit
when we recorded it. No, but seriously, it is a
really interesting episode. And even though we recorded it years ago,
the stuff that we're talking about still quite hasn't come
(00:22):
to fruition. So sit back and enjoy this peek into
the future. Welcome to Stuff you should know, a production
of My Heart Radios How Stuff Works. Hey, and welcome
to the podcast. I'm Josh Clark. There's Charles W. Chuck Bryant,
(00:44):
our guest producer Noel is here. Yeah, Jerry needs a
buffer day from her Christmas break. I can't say that again. No,
she's at home on her buffer day. And the freezing
cold because we record these somewhat in advance, we are
in the midst of the polar vortex and um, yeah,
everyone's just talking about how cold it is. We're back.
(01:06):
It is our first recording after the holidays. It's literally
freezing cold up. So welcome back, buddy. Thanks, Welcome back
to you too. Even though this will be what like
late January, it will be a balmy sixteen. I think
the end of the end of January. When is when
this one comes out? All right, Well, happy New Year
and happy New Year to YouTube, and happy holidays to you.
Thanks um Chuck, Yes, sir, you're feeling good. You're loose,
(01:28):
You're ready. I'm loose. So you see this, you've seen
this before. Yeah, your Fitbit, My fit bit is that
buzz marketing. Not really, It's just a really good example. Um.
I feel like fit Bit. I'm not like necessarily loyal
to it or anything like that. They don't pay me
money to mention the podcast. Sometimes I'll just be like,
stop staring at me. Fit Bit. Yeah, um, but no,
(01:50):
I like it. I'm happy with it. Um I I
pointed out though, because it's part of this to me,
and I don't think it's over confirmation bias. It seems
like there really is a growing desire among just average
ordinary people to be able to track there their health,
(02:11):
their well being, their activity. Um, and to do it easily. Yeah,
we have tools now that make it like that thing
super convenient. Yeah, it's in fit It's not the only one.
There's like Nike fuel Band. There's Jawbone is another really
good one. There's others like um that track uh, your
galvanic response, so they're able to put that together with
(02:32):
respiration and heartbeat and come up with a pretty good
assessment of how many calories you're burning at any given time,
which is like kind of a holy grail with this
kind of thing right now. Um, there's others that track
your sleep. There's apps out there that let you, um
track your mood. Um. There's sites like quantified self, which
are basically like people trying to push wearable technology like
(02:55):
this further into the future. There's entire websites like share
care dot com that are dedicated to health information and
health um uh support yeah, self advocacy, yeah. And and
there's this It seems to me, this desire to kind
of say, hey, this is my health, this is my body.
I want to know more about it, you know, totally
(03:17):
Like I don't want to necessarily cut out doctors, but
I I want to decide if I should go to
the doctor, if it's time or not, and I want
to use data to do that. Yeah. I imagine I
frustrate a lot of doctors because I'm one of those
obnoxious people that goes in and it's like, well, here's
what I think I have based on my research. There's
(03:39):
nothing wrong with that. Yeah, that is what you're an
informed patient. That's true, exactly what you're supposed to do.
And if you're getting on your doctor's nerves, then go
see another doctor. Uh yeah, I agree. Actually in search
of a new GP right now for those because and
others you got on his nerves. Other reasons too, really
cold cold hands now like poor bedside manner, never seen
(04:01):
the doctor Like here's my intern from Emory. Yeah, which great.
You know. I love them getting experienced, but I would
like them both to be in there, not just like
smell you later and the doctor leaves. Well that's another
thing too. It's kind of like, um, doctor, okay, let's
let's just lay it on on the table here. What
what you've just mentioned and what I was talking about,
(04:22):
if you put it all together. The medical field, physicians
in particular, are currently in a what's the beginning of
what's possibly a really pickle of a state for them.
I think a transition period, yes, but they may be
transitioned right out of existence in large parts. Yes, I
may for sure, depending on who you talk to. There's
(04:44):
like this whole question now, like, what is the future
of medicine, and more specifically, in the case of this
episode that we're talking about, do human physicians factor largely
into that future? And the answer is no, yeah, depending
on who you ask, Like I said, um, we there's
(05:04):
this one guy, Dr Kent Bottles, who um, he feels
that GPS might go the way of the Dodo and
be replaced by diagnostic computers, maybe with avatars. Then there's
other people like farhad Manjou is a technical writer, his
wife as a pathologist. He thinks, no, no, no, the
(05:25):
GPS are the ones that are going to be in business.
The specialists are gonna be out of business because computers
are really good at specializing on one single thing, not
maybe so good at a general practitioner thing. So there's
lots of opinions out there on how much they'll be
replaced and who might be replaced. Right then, as a
reclient wrote a column who basically he basically said like now, like,
(05:48):
we we will still need humans, but we mainly need
humans to communicate to the other humans and facilitate the
the interaction between the robots and the humans, and we
already have this. They're called nurses or a nurse practitioners.
He kind of as reclined, is the one that thought
that a computer avatar might have a better bedside manner
than a doctor. Well, let's give that one example. There's this,
(06:10):
there was there's an example I kept finding while we
were doing research for this, and it's actually in the
article on how stuff works. Um, it's uh. There was
a kiosk, a medical kiosk, during a panel called man
Made Minds colon Living with Thinking Machines. When there's a
colon in there, you know it's serious stuff. Um. And
it was at the World Science Festival in two thousand
(06:31):
and eleven. And basically, this, this computerized avatar um interacted
with a woman whose baby had diarrhea, and the woman said, hey, Avatar,
my baby has diarrhea. What are you going to do
about it? And the avatar said, well, tell me all
the symptoms and all this stuff, and avatar decided that
the baby's diarrhea, while present, wasn't severe enough to warrant
(06:55):
immediate medical attention, so it went ahead and made an
appointment with a hue and doctor for later on that week,
and the mother said that she preferred the treatment by
the avatar to the real life nurses at the hospitals
where she lived in New York. Yeah. Uh so it
is possible to create computers with better bedside manner than say,
(07:18):
your g P. Well, it's at the very least it
will be consistent. And that's one of the things that
I'm not poopooing. Doctors or nurses are many, many, many,
many great ones, but I've also had some pretty bad
experiences in emergency rooms and with doctors and nurses. With
a computer, at least it's a consistent you know, their
program to display empathy no matter what. You know, they're
(07:40):
not too busy and they're not, you know, having a
bad day, so they don't you know, they don't have
any prejudices against you personally or anything like that. Their computer.
They don't hate diarrhea. But humans, humans respond to even
programmed empathy, even synthetic empathy from a a computer. I
(08:01):
could see that a little bit. Like I've dove into
the gaming world enough to know that, you know, the
realism of a of a avatar can be convincing, and
it's not like you think, oh, it's a real person,
but it helps to put a human face on it,
you know, exactly. Literally, Um, they I saw a reference
(08:22):
to a study that found um, people who are being
treated for anxiety disorders tended to share more about their
experiences and themselves with an avatar them with a human psychiatrists.
Oh that's interesting because they're like not embarrassed to tell
a real person. Yeah, that makes sense, I might open
up more to to a computer. Right, So so we've
(08:44):
got that part, like the bedside manner. It is possible
that we can create machines now and are creating machines
now that have at least equal, if not better bedside
manner than some physicians. Yeah, okay, so bedside manner one
of the big things that doctors bring to the table.
Check computers have that. Yeah, it's it's different now than
(09:04):
it was in the old days. I feel like just
the whole quality of personal care is gone down. It's
not necessarily the doctor's falter. There's a lot of reasons
to place the blame. But it's not like when you
were a kid and you feel like you had your
family doctor who knew you, maybe even gave birth birth
you're my son exactly. Um, it just invested like you
(09:27):
gotta stick with the same doctor if you want that
kind of care, I think, right. And there's another benefit
besides bedside banner UM that comes with that that kind
of care, that kind of personal care is an awareness
of your medical history. Yeah, not just that, but oh well,
your dad died of congenital heart disorders like that, so
you may be at higher risk of it. To just
(09:48):
that kind of awareness has been typically lost to even
though we have medical histories and they're in our charts
that they're in our files UM, and intimate knowledge of
a patients UM medical history is pretty much lost in
today's modern practice of medicine. Yeah. UM. That's another thing
that that computers could conceivably top doctors on UM, which
(10:14):
basically falls under the umbrella of diagnosis or diagnostics. Yeah.
I mean there's two two sides to this. There's diagnoses
and treatment and some UH programs. A little bit of
the history this UM goes back to the nineteen seventies.
At the University of Pittsburgh, they develop software to diagnose problems. UM.
(10:36):
MASS General since the eighties has been working on their
d X plan, which provides ranked list of diagnoses. Whereas
the what's the computer the M Watson Watson who who
won at jeopardy. Yeah, that's more based. Um, it looks
like on treatment options than diagnosis at this point. So
(10:56):
they're using these well yeah, but they said it's not
they haven't. I don't think they want to leave it
alone with diagnosis yet. No, and to do its thing.
There's already something out there for diagnosis that's meant to
support physicians. From what I understand with Watson, if there
is a doctor of the future, it's Watson. Um. He
(11:19):
has a lot of advantages over not just um human doctors,
but other artificial intelligence healthcare machines. I guess you could
clumsily call it. He has a knack for natural language.
So let's say there's like a structured formula or formulaic
(11:39):
type of language that the medical field is supposed to use, right, yes, okay, Um,
health records don't always necessarily contain that language. They might
contain natural language, which is really confusing for computers to
take in an absorb. Yeah, you know, the humans can
(12:00):
pick up on meanings of things that robots and and
software cannot, like inferences, and we might be using sarcasm,
although there's probably not going to be any sarcasm in
your medical records. Yeah, but like figurative language and stuff
like that, but computers a language is a big part
of the problem. Or more to the point, with the diagnosis,
patient says he feels like he has a hive of
(12:22):
bees in his stomach, Like that might mean something that
you or me, but to a computer it's like followed
a bunch of bees or something. Right, Watson has the
advantage of saying, Okay, well, there's a sensation of bees
in the stomach, there's not actually bees in the stomach,
So let's figure this out then, Watson, or anything that
(12:42):
that he eventually becomes UM, well, we'll be able to
go through medical records, current medical research, UM, the patient's
medical history, UH, diagnostic tests that were done, blood work, UM,
instrument tests, and put it all together there and then
spit out a list of diagnoses with different confidence levels.
(13:06):
So the one at the top is the one that
Watson says is he is ninety eight point seven percent
sure is what's wrong with this patient? And UM as
a diagnostician, that's pretty impressive, and that's using all the
available data that's that's available also to human physicians, but
(13:26):
they simply don't have the time to take it all
in Yeah. I think some research said that eighty per
of doctors spend less than five hours a week reading
medical journals a month a month. Yeah, so that's these
things can read thousands in seconds. So it's it's sort
of a matter of of efficiency really, and like if
(13:50):
doctors don't have time to read all this stuff, I know,
we we looked into this one sort of a savant
diagnoser is that a word? I don't gnostician? Diagnostician? Uh
doctor uh Dolly Wall in San Francisco. He's sort of
legendary for diagnosing things, to the point where he does
(14:10):
it on stage as almost like a parlor trick. I
would love to see it. I would too. They give
him forty five minutes and and a bunch of symptoms
basically like really confusing because they're trying to stump him,
and generally he comes out on top. But he even
uses a program, a diagnostic program called isabel Right, that's
the one I said earlier, that's already here. Yeah, so
(14:32):
doctors are using these to help themselves out. But he
says that he's never had Isabelle offered diagnosis that he
has missed, but he's like the dude, Yeah, and He
also admits that he's like, like, I'm a freak of nature, right,
go ahead, quiz me exactly. Yeah. He also reads like
case histories, like for fun, that kind of stuff. He's not,
(14:53):
he's not a normal physician. He's a complete and total outlier. Um,
if he were, if every physician we're like this guy,
then they're there. Probably wouldn't be this conversation going on
right now. But most physicians aren't. And it's not just
with current medical research that they're just not aware of
because they haven't had time to pick up the lance
(15:13):
at the last few months, but it's also their training
to Like if a doctors in practice for twenty years,
the brain and the human brain tends to create habits
because it likes to expend as little energy as possible.
It's it's trying to be as ficient as possible. And
I think the same thing happens with medical practice. You're trained,
you understand, you come out of medical school with a
(15:35):
lot of book learning, and then you put it to
practice and you kind of find your niche and along
the way you forget a lot of the stuff that
you haven't done in twenty years or haven't learned about
in twenty years, so it's not just current stuff, it's
old stuff too. And if you feed the physician's desk
reference into Watson or one of his his compatriots, like,
all of that knowledge can be quickly index in research
(15:56):
to try to spit out a more accurate diagnosed. Yeah.
I think that's a great idea. It's like a partnering
up with computers. It is sarily replacing, but what they're
doing with Watson is is very much moving towards replacing
doctors in that sense. Well, here's a scary stat um.
One in five diagnoses in the United States are incorrect
(16:16):
or incomplete one in five and a lot of times
it's not that the doctor is a jerk or not
any good, but like you said, they just maybe haven't
seen these cases that were written about in some obscure
medical journal that the computer has scanned an index, you know.
And Dolly Wall Dr Dolly Wall himself at Freak Diagnostician Dollywood, Yeah,
(16:39):
pretty close, which is a wonderful place, by the way,
I know you love Dollywood. Um. Dr Dolly wall Uh
himself says a lot even with me, A lot of
it is intuition, and intuition can be wrong. That's a
criticism though, of computers as doctors. They lack intuition. Like,
there's kind of even larger, even larger than this computer's
(17:03):
replacing doctor's conversation going on. It's kind of a conversation
or a debate over whether intuition or data. Yeah, trump's
one or the other. Which one is the right way
to go? Yeah? This one stat too, it says according
to an expert, I'm not sure what that means. It
sounds sinky, but they said, only of the knowledge of
(17:24):
physicians use to diagnose is evidence based, So that means
is intuition, which which also jibs and dovetails with that
one in five being wrong, I mean, or one in
five being right. I'd like the idea of intuition to
a certain degree for sure, but there's also got to
be like data backing it up. Sure, you know, so
(17:47):
in your perfect world. And it sounds like we still
have physicians, but they go back and double check themselves
using a program. Yeah, but I could also be down
with um simple what is it? What do they call
it here? Um? Something based diseases, rules based chronic diseases. Yeah,
(18:08):
like minor things that are pretty easy to diagnose. They're
not even necessarily minor. We just understand them so fully
that we say type two diabetes is going to behave
and present itself like this. Yeah, but I wouldn't mind
going like it seems like once a year I get
like an upper respiratory infection. It's been three or four
years in a row, and I know what the treatment is,
I know how it feels. It would be great to
(18:29):
go into a machine and have them take some stats
and blow into it and hear my wheezing and give
me a a steroid shot and a Z pack and
a breathing treatment and send me on my way. So
it's always what clears it up. Would you care if
it was a robot that gave you that shot? Not
at all, um, but I definitely would want more personal
(18:53):
care if it was something what if it was a
robot with a nice avatar, sexy avatar maybe or just
a friendly one. Yeah, that was a little, a little,
a little it would touch your forearm here there. Yeah,
well that might be a little creepy. Yeah, if like
it was an old timey doctor who like gave you
some epocac if you had diarrhea, just send you on
your way drink a coke, but it wouldn't send you
(19:14):
on your way to give you ipocac and then it
wouldn't let go of your forearm. Yeah, so strong well
surgical robots. That's a that's a thing. I mean, we're
kidding around, but they've been performing. They've been performing robotic
surgery since the early eighties, um doctor assisted until two
thousand ten, where they were in Montreal. They performed the
(19:35):
first fully robotic surgeries when they removed a prostate with
a fully robotic UH surgeon and fully robotic anesthesiologist Dr
mc sleepy. Dr mc sleepy. Yeah, and the the that's
the real name the robot surgeon was da Vinci, which
is like the basically gold standard for robotic surgical or
(19:57):
surgical robots. Yeah, they had to that thirty thousand robotic
surgeries performed in the US, So it's it's big, it
is and um but the da Vinci is a doctor
basically sitting in a little uh it looks like an
arcade game and using UM robotic arms to mimic his
(20:19):
or her movements on more microscopic levels. Right, So the
robot has more precise movements and can make smaller movements,
um than the doctor. It's tell it's and what's the
opposite of telescoping, like going downward in scale? Whatever that is.
It's taking the movements of the doctor and reducing them
in scale. Let's call it reverse telescoping, reverse telescoping those movements, um,
(20:43):
which is a pretty awesome achievement in and of itself.
That doctors being fed three d um graphics of what
the robot is seeing, uh, and just kind of working
from there. Uh. What we're moving towards apparently is fully
robotic size surgeries. I was talking to Joe McCormick from
(21:04):
Forward Thinking and he was saying that, um, there was
there's something called the Raven four, I believe. Uh. And
basically you just say, this is going to be a
gall bladder surgery on a six ft six male age
you know whatever. And here's his here's the cat scan
of his abdomen um. So go removes gall bladder and
(21:28):
you press enter and the thing goes in there and
like removes the guy's gall bladder and sews him up. Yeah,
that's fully robotic, like fully autonomous robotic surgery. Button then
it does it. You're not actually controlling a machine that
does it exactly the machines doing it at your behest,
but you're not controlling it. Yeah. Um, and we're right
(21:49):
on the cusp of that, and apparently it's already happening.
Uh yeah, but there are some issues. UM. I looked
into it and found that a lot of injury reporting
and robotics agery is um not being reported. It's it's substandard.
And uh, this woman, Sheina Wilson, had robotic surgery for
hysterectomy in two thousand thirteen and apparently this uh intuitive
(22:13):
surgical system had there had been a bunch of injuries
that she didn't know about, and she had her rectum
burned badly and said, if I would have known that
this system had these issues, would not have elected to
take part in it. So there's a lot of under reporting. Um.
The f d A, UM, they have no authority to
(22:35):
force a doctor to do this, and apparently there's every
reason in every link in the chain not to report
these things, you know, and the f d A not
enforcing this kind of thing, not enforcing reporting is ridiculous. Yeah.
You know. The thing is that things like that happen,
and there's under reporting. UM. With human surgic surgeons as well. Yeah, sure,
(23:00):
not just robotic. It's like overall, apparently surgical injury and
accident reporting is not compulsory. Yeah, and here's here's a
few points though. Counterpoints I guess is one, it's not
always the robotic component of the surgery that was the
cause to a lot of times they say they don't
know about this until like a lawsuit is filed, So
(23:22):
it could be weeks or months later with the physician
doesn't know about it, or the FDA might not get
report on it, and like six months later you follow
a lawsuit and that's how it comes to light. Um.
But the FDA is definitely concerned and are supposedly working
to improve this. That's very concerned. They're very concerned. Uh.
And another problem too, and that same article, a lot
(23:43):
of these robotic surgical systems, you still have to have
the correct amount of training. And Uh. The feeling of
some experts is that UM or at least this one guy,
Enrico Benedetti, he's a head of surgery at the University
of Illinois Chicago, UH, says a lot of it just
comes back to training. These some of these doctors aren't
getting adequately trained in these machines enough to perform this regery. Yeah,
(24:07):
like what happens when I do this? Oh? That happens.
That's not good. I've got another alarming stat for you
to hold on. Hold on, hold on. Before that, let's
do a message break real quick. Okay, tell me your
(24:37):
alarming stat al right. JOHNS. Hopkinsider a study that found
as many as forty thou patients die in intensive care
each year in the US due to misdiagnosis man and UM.
Another study found that system related factors like UH, lack
of teamworking, communication, or just poor processes were involved in
(24:57):
six of diagnostic error and cognitive factors, and with premature
closure is the most common, which is basically just sticking
to that initial diagnosis and not being open minded to
other like second opinions. Yeah. So there's this thing called
anchoring bias that UM was in that New York Times article.
(25:18):
Dr Dolly Wall the guy who created this program that's
now around to support diagnostics where a physician will say,
I think it's this, but let me put in the
symptoms and ask Isabelle Um which is the name of
the program, and it's named after the guy who created
the program's daughter. Yeah, when she was three, took her
to the hospital and the doctors said, well, she has
(25:40):
chicken pox. And she did indeed have chicken pox, but
that's all they looked at. They completely missed a pretty
nasty case of necrotizing fasciitis, which we've talked about before,
flesh eating bacteria, and um, she almost died from it.
It was. It was disfigured from it as a result,
so that her father, who was a money manager, said,
(26:00):
I'm going to take whatever computer programming skills I haven't
put it towards this program Isabelle, which is meant to say, yes,
you're right with this diagnosis, I agree with you, or
have you considered these other diagnoses? And he said, like,
had hasabel been around and his daughter's doctors consulted it,
they would not have missed the necrotizing fasciitus. Well, it
(26:21):
makes sense, um as an assist. You know. Um, there's
this company called Life Calm that said in clinical trials
that if you use a medical diagnostic program as an assist, Uh,
those engines were accurate without using exams or imaging or
labs even really just symptoms. Yeah, that's crazy, that's really
(26:44):
really really good. Yeah, like that's a that's an A,
that's a low A. It's still in a. But as
an assistant, I think it's you know, it's kind of
a no brainer, don't you think. Oh yeah, I think so.
I don't know why. I all I can think of
is possibly worrying about feeding the beasts that will take
(27:05):
your job, or just having too much of a case
load to take the time to double check your work
on a computer would be the only reasons why doctors
aren't using that. Well, the smartphone is becoming a potential
uh self diagnos ur There's all these cool things on
the horizon that you can use your your phone for.
(27:27):
There's one called a live Core which you can take
your own ECG testy and potentially, for the cost of
getting one e c G in a hospital, you could
send a year's worth of daily ECGs you took yourself
to your doctor, and then you carry all that info
and all of your other medical info from all of
your apps that will eventually be integrated into one or
(27:48):
two apps that will probably become preloaded on your iPhone
in the next couple of years. And you've got your
medical history right there. Yeah, and I you know, most
of these require like a little clip on like um,
something called cell scope that's like you clip it onto
your little camera lens essentially, and it's like, what are
the little magnifiers with the lights that doctors used to
(28:08):
look in your ears and eyes? Uh, yeah, it looks
like one of those clipped onto your your iPhone and
it produces, uh, you can do imaging for skin moles
and rashes and ear infections. They have one called NTRA
that you could potentially give your own eyes uh, get
your own like glasses prescription done and then you ordering
(28:31):
the information to some website and they say and then
this one called Adamant that smells your breath, that smells
gases in your breath and it could detect like lung
cancer even yeah, apparently you have real metabolic changes to
the smell of your breath yea when you have different
(28:52):
types of cancer, not just long um. Like bees can
detect breast cancer. Um. If you breathe into like this
special glass fear with bees around it, they can be
trained to detect lung cancer and they come back with
the correct results a lot of the time. So a
lot of these are on the horizon they're not like
in heavy rotation yet, No, but but it's pretty neat
(29:13):
All of them reveal this idea that no one cares
about your particular health and well being more than you.
Unless you're one of those dudes who doesn't really care.
Then your your wife does or your mom you know,
and we probably cares more about me than me, right,
But there's there. The point is the doctor, the insurance company,
(29:36):
the the hospital. While they're all in the field because
they do care about your health, of course, they can't
possibly care about it more than you or your loved
one does. So the idea of giving you the ability
to keep all of that information yourself and easily handed
over to them or potentially down the road, a computer
version of them. I can't think of any any better
(29:58):
revolution in medicine right now than that read. I think
it's pretty exciting. Yeah. I think we're going to live
into the triple digits, buddy. Yeah. And I think there
will always be a need for doctors and nurses. I
don't think anyone will be wholly replaced but a little
robot assist. Yeah. Yeah. Let me make one more point,
all right, there's so you've heard of genomics, Yes, There's
(30:20):
also this thing called proteonomics, which is basically your protein
version of your your genome, your genome, and it's all
of the proteins in your body that you have that
your manufacturing, that you're losing, and all the changes and
fluctuations in them. And the idea is that you can
get a full work up of your proteonome and your genome,
(30:41):
and eventually you can add that to your medical history
as well, what your E k G reading has been
over the past year, um, any way you may have
gained or lost or anything like that, what your breath
smells like metabolically speaking, and not only have your current
state of health, but personalized your version of that personalized
(31:03):
down to your genes and proteins in your body, so
a treatment could be specifically tailored to you. Wow, that's
gonna be really tough for a human physician to do
that on their own. To top that, Yeah, the the
amount of data available already is overwhelming human doctors. When
you add this other kind of stuff on it, it's
(31:23):
just pulling away from them more and more. Yeah, and
medical record keeping is uh, I know, there's been issues
with that and digitizing that and keeping up with medical records,
and if you could be yourself advocate and keep up
with your own medical records, it might be kind of nice.
So I I feel like we answered the question, which
is yes, no more doctors. I don't know. I think
(31:46):
in in the future, I will always have humans to
interact between us. I think because we're always gonna want
somebody to yell at or be like what is this
robot doing? Or can you help me this robots give
me some ipocacu and won't let go on my arm
or burn my rectum. Yes, we're always going to need humans.
It's just I don't know, well we need physicians, and
(32:06):
if we do, will they be super specialized like just
the Supreme Court of Physicians. Who knows. It's pretty exciting.
But we will see this change one way or another
in the next fifteen years under my prediction to it's happening. Okay,
goog and Chuck if the year yeah. Really, If you
wanna learn more about computers possibly replacing doctors, you can
(32:31):
type those words into the search bar how stuff works
dot com. And since I said search bar, that means
it's time for a message break. Okay, So, so what
(32:55):
do we have listener mail time. Yeah, I have one
called I'm gonna call it fight Club. Okay, hey guys,
just finished the podcast on deep refrigerating. I think I'll
keep my Energy Star certified fridge. Thanks very much. But
Josh did mention something about eating weeds and asked a
(33:16):
somewhat rhetorical question, what are weeds anyway? Just plants we
say are bad? It reminded me of some today's common
uh some that some of today's common noxious weeds. How
they got their reputation not so long ago, lawns were
perfect blends of Bermuda rye and Kentucky blue grass. They
also included many types of clover, dandelion, and other quote weeds.
In fact, many seed mixtures specifically included white clover because
(33:38):
it makes an excellent cover in soils where more common
grasses won't grow. In steps the Scott Fertilizer Company, post
World War Two America housing tracks were popping up all
over the US and new suburbia, and Scott was encouraging
returning gis to take pride in their new lawns and
to buy their products to do so. And we're extremely
high waisted pants, that's right. They produced fertilizers, weed killers,
(33:59):
and other long your products, some of which had a
curious side effect killing many leafy greens that came up
to the point that we're not considered weeds at the time,
including white clover. Instead of reformulating, what they did was
what any red blooded American corporation would do. They redefined
what was a weed. White clover made that list as
the dandelions, when in fact both are still in use
(34:20):
today in cooking and medicines. Would you call that a
noxious weed? No? So thanks for that, guys, and thanks
for all the knowledge I've learned and have a great
and that is from Robert Paulson. Oh yeah, Robert Paulson.
He's a he's a sharp dude. That's why I called
it fight club, remember that. Oh yeah, I think I
made a joke to him about that once on Twitter
(34:41):
and he never responded. Yeah, he's he writes in a
lot now he's every time I see his name, I
think and his name is Robert Paulson. Yeah, thanks a lot,
Robert Paulson. We appreciate you. If you ever shot in
the head and the commission of a robbery, we will
dispose of your body. Um. If you want to get
in touch with me and Chuck, and you have a
name that you would like us to poke fun at
(35:02):
Bring it On. You can tweet to us at s
y s K podcast. You can post your name on
Facebook dot com slash Stuff you Should Know. You can
send us an email to stuff Podcasts at how stuff
Works dot com. And then, of course, go visit our website.
Make it your homepage. It's the coolest place on the web.
It's Stuff you Should Know dot com. Stuff you Should
(35:26):
Know is a production of iHeart Radio's How Stuff Works.
For more podcasts for my heart Radio, visit the iHeart
Radio app, Apple Podcasts, or wherever you listen to your
favorite shows.
Hey, everybody, it's me Josh and for this week's s
Y s K Selex, I've chosen will computers replaced doctors.
It's an episode so dated I still wore a fitbit
when we recorded it. No, but seriously, it is a
really interesting episode. And even though we recorded it years ago,
the stuff that we're talking about still quite hasn't come
(00:22):
to fruition. So sit back and enjoy this peek into
the future. Welcome to Stuff you should know, a production
of My Heart Radios How Stuff Works. Hey, and welcome
to the podcast. I'm Josh Clark. There's Charles W. Chuck Bryant,
(00:44):
our guest producer Noel is here. Yeah, Jerry needs a
buffer day from her Christmas break. I can't say that again. No,
she's at home on her buffer day. And the freezing
cold because we record these somewhat in advance, we are
in the midst of the polar vortex and um, yeah,
everyone's just talking about how cold it is. We're back.
(01:06):
It is our first recording after the holidays. It's literally
freezing cold up. So welcome back, buddy. Thanks, Welcome back
to you too. Even though this will be what like
late January, it will be a balmy sixteen. I think
the end of the end of January. When is when
this one comes out? All right, Well, happy New Year
and happy New Year to YouTube, and happy holidays to you.
Thanks um Chuck, Yes, sir, you're feeling good. You're loose,
(01:28):
You're ready. I'm loose. So you see this, you've seen
this before. Yeah, your Fitbit, My fit bit is that
buzz marketing. Not really, It's just a really good example. Um.
I feel like fit Bit. I'm not like necessarily loyal
to it or anything like that. They don't pay me
money to mention the podcast. Sometimes I'll just be like,
stop staring at me. Fit Bit. Yeah, um, but no,
(01:50):
I like it. I'm happy with it. Um I I
pointed out though, because it's part of this to me,
and I don't think it's over confirmation bias. It seems
like there really is a growing desire among just average
ordinary people to be able to track there their health,
(02:11):
their well being, their activity. Um, and to do it easily. Yeah,
we have tools now that make it like that thing
super convenient. Yeah, it's in fit It's not the only one.
There's like Nike fuel Band. There's Jawbone is another really
good one. There's others like um that track uh, your
galvanic response, so they're able to put that together with
(02:32):
respiration and heartbeat and come up with a pretty good
assessment of how many calories you're burning at any given time,
which is like kind of a holy grail with this
kind of thing right now. Um, there's others that track
your sleep. There's apps out there that let you, um
track your mood. Um. There's sites like quantified self, which
are basically like people trying to push wearable technology like
(02:55):
this further into the future. There's entire websites like share
care dot com that are dedicated to health information and
health um uh support yeah, self advocacy, yeah. And and
there's this It seems to me, this desire to kind
of say, hey, this is my health, this is my body.
I want to know more about it, you know, totally
(03:17):
Like I don't want to necessarily cut out doctors, but
I I want to decide if I should go to
the doctor, if it's time or not, and I want
to use data to do that. Yeah. I imagine I
frustrate a lot of doctors because I'm one of those
obnoxious people that goes in and it's like, well, here's
what I think I have based on my research. There's
(03:39):
nothing wrong with that. Yeah, that is what you're an
informed patient. That's true, exactly what you're supposed to do.
And if you're getting on your doctor's nerves, then go
see another doctor. Uh yeah, I agree. Actually in search
of a new GP right now for those because and
others you got on his nerves. Other reasons too, really
cold cold hands now like poor bedside manner, never seen
(04:01):
the doctor Like here's my intern from Emory. Yeah, which great.
You know. I love them getting experienced, but I would
like them both to be in there, not just like
smell you later and the doctor leaves. Well that's another
thing too. It's kind of like, um, doctor, okay, let's
let's just lay it on on the table here. What
what you've just mentioned and what I was talking about,
(04:22):
if you put it all together. The medical field, physicians
in particular, are currently in a what's the beginning of
what's possibly a really pickle of a state for them.
I think a transition period, yes, but they may be
transitioned right out of existence in large parts. Yes, I
may for sure, depending on who you talk to. There's
(04:44):
like this whole question now, like, what is the future
of medicine, and more specifically, in the case of this
episode that we're talking about, do human physicians factor largely
into that future? And the answer is no, yeah, depending
on who you ask, Like I said, um, we there's
(05:04):
this one guy, Dr Kent Bottles, who um, he feels
that GPS might go the way of the Dodo and
be replaced by diagnostic computers, maybe with avatars. Then there's
other people like farhad Manjou is a technical writer, his
wife as a pathologist. He thinks, no, no, no, the
(05:25):
GPS are the ones that are going to be in business.
The specialists are gonna be out of business because computers
are really good at specializing on one single thing, not
maybe so good at a general practitioner thing. So there's
lots of opinions out there on how much they'll be
replaced and who might be replaced. Right then, as a
reclient wrote a column who basically he basically said like now, like,
(05:48):
we we will still need humans, but we mainly need
humans to communicate to the other humans and facilitate the
the interaction between the robots and the humans, and we
already have this. They're called nurses or a nurse practitioners.
He kind of as reclined, is the one that thought
that a computer avatar might have a better bedside manner
than a doctor. Well, let's give that one example. There's this,
(06:10):
there was there's an example I kept finding while we
were doing research for this, and it's actually in the
article on how stuff works. Um, it's uh. There was
a kiosk, a medical kiosk, during a panel called man
Made Minds colon Living with Thinking Machines. When there's a
colon in there, you know it's serious stuff. Um. And
it was at the World Science Festival in two thousand
(06:31):
and eleven. And basically, this, this computerized avatar um interacted
with a woman whose baby had diarrhea, and the woman said, hey, Avatar,
my baby has diarrhea. What are you going to do
about it? And the avatar said, well, tell me all
the symptoms and all this stuff, and avatar decided that
the baby's diarrhea, while present, wasn't severe enough to warrant
(06:55):
immediate medical attention, so it went ahead and made an
appointment with a hue and doctor for later on that week,
and the mother said that she preferred the treatment by
the avatar to the real life nurses at the hospitals
where she lived in New York. Yeah. Uh so it
is possible to create computers with better bedside manner than say,
(07:18):
your g P. Well, it's at the very least it
will be consistent. And that's one of the things that
I'm not poopooing. Doctors or nurses are many, many, many,
many great ones, but I've also had some pretty bad
experiences in emergency rooms and with doctors and nurses. With
a computer, at least it's a consistent you know, their
program to display empathy no matter what. You know, they're
(07:40):
not too busy and they're not, you know, having a
bad day, so they don't you know, they don't have
any prejudices against you personally or anything like that. Their computer.
They don't hate diarrhea. But humans, humans respond to even
programmed empathy, even synthetic empathy from a a computer. I
(08:01):
could see that a little bit. Like I've dove into
the gaming world enough to know that, you know, the
realism of a of a avatar can be convincing, and
it's not like you think, oh, it's a real person,
but it helps to put a human face on it,
you know, exactly. Literally, Um, they I saw a reference
(08:22):
to a study that found um, people who are being
treated for anxiety disorders tended to share more about their
experiences and themselves with an avatar them with a human psychiatrists.
Oh that's interesting because they're like not embarrassed to tell
a real person. Yeah, that makes sense, I might open
up more to to a computer. Right, So so we've
(08:44):
got that part, like the bedside manner. It is possible
that we can create machines now and are creating machines
now that have at least equal, if not better bedside
manner than some physicians. Yeah, okay, so bedside manner one
of the big things that doctors bring to the table.
Check computers have that. Yeah, it's it's different now than
(09:04):
it was in the old days. I feel like just
the whole quality of personal care is gone down. It's
not necessarily the doctor's falter. There's a lot of reasons
to place the blame. But it's not like when you
were a kid and you feel like you had your
family doctor who knew you, maybe even gave birth birth
you're my son exactly. Um, it just invested like you
(09:27):
gotta stick with the same doctor if you want that
kind of care, I think, right. And there's another benefit
besides bedside banner UM that comes with that that kind
of care, that kind of personal care is an awareness
of your medical history. Yeah, not just that, but oh well,
your dad died of congenital heart disorders like that, so
you may be at higher risk of it. To just
(09:48):
that kind of awareness has been typically lost to even
though we have medical histories and they're in our charts
that they're in our files UM, and intimate knowledge of
a patients UM medical history is pretty much lost in
today's modern practice of medicine. Yeah. UM. That's another thing
that that computers could conceivably top doctors on UM, which
(10:14):
basically falls under the umbrella of diagnosis or diagnostics. Yeah.
I mean there's two two sides to this. There's diagnoses
and treatment and some UH programs. A little bit of
the history this UM goes back to the nineteen seventies.
At the University of Pittsburgh, they develop software to diagnose problems. UM.
(10:36):
MASS General since the eighties has been working on their
d X plan, which provides ranked list of diagnoses. Whereas
the what's the computer the M Watson Watson who who
won at jeopardy. Yeah, that's more based. Um, it looks
like on treatment options than diagnosis at this point. So
(10:56):
they're using these well yeah, but they said it's not
they haven't. I don't think they want to leave it
alone with diagnosis yet. No, and to do its thing.
There's already something out there for diagnosis that's meant to
support physicians. From what I understand with Watson, if there
is a doctor of the future, it's Watson. Um. He
(11:19):
has a lot of advantages over not just um human doctors,
but other artificial intelligence healthcare machines. I guess you could
clumsily call it. He has a knack for natural language.
So let's say there's like a structured formula or formulaic
(11:39):
type of language that the medical field is supposed to use, right, yes, okay, Um,
health records don't always necessarily contain that language. They might
contain natural language, which is really confusing for computers to
take in an absorb. Yeah, you know, the humans can
(12:00):
pick up on meanings of things that robots and and
software cannot, like inferences, and we might be using sarcasm,
although there's probably not going to be any sarcasm in
your medical records. Yeah, but like figurative language and stuff
like that, but computers a language is a big part
of the problem. Or more to the point, with the diagnosis,
patient says he feels like he has a hive of
(12:22):
bees in his stomach, Like that might mean something that
you or me, but to a computer it's like followed
a bunch of bees or something. Right, Watson has the
advantage of saying, Okay, well, there's a sensation of bees
in the stomach, there's not actually bees in the stomach,
So let's figure this out then, Watson, or anything that
(12:42):
that he eventually becomes UM, well, we'll be able to
go through medical records, current medical research, UM, the patient's
medical history, UH, diagnostic tests that were done, blood work, UM,
instrument tests, and put it all together there and then
spit out a list of diagnoses with different confidence levels.
(13:06):
So the one at the top is the one that
Watson says is he is ninety eight point seven percent
sure is what's wrong with this patient? And UM as
a diagnostician, that's pretty impressive, and that's using all the
available data that's that's available also to human physicians, but
(13:26):
they simply don't have the time to take it all
in Yeah. I think some research said that eighty per
of doctors spend less than five hours a week reading
medical journals a month a month. Yeah, so that's these
things can read thousands in seconds. So it's it's sort
of a matter of of efficiency really, and like if
(13:50):
doctors don't have time to read all this stuff, I know,
we we looked into this one sort of a savant
diagnoser is that a word? I don't gnostician? Diagnostician? Uh
doctor uh Dolly Wall in San Francisco. He's sort of
legendary for diagnosing things, to the point where he does
(14:10):
it on stage as almost like a parlor trick. I
would love to see it. I would too. They give
him forty five minutes and and a bunch of symptoms
basically like really confusing because they're trying to stump him,
and generally he comes out on top. But he even
uses a program, a diagnostic program called isabel Right, that's
the one I said earlier, that's already here. Yeah, so
(14:32):
doctors are using these to help themselves out. But he
says that he's never had Isabelle offered diagnosis that he
has missed, but he's like the dude, Yeah, and He
also admits that he's like, like, I'm a freak of nature, right,
go ahead, quiz me exactly. Yeah. He also reads like
case histories, like for fun, that kind of stuff. He's not,
(14:53):
he's not a normal physician. He's a complete and total outlier. Um,
if he were, if every physician we're like this guy,
then they're there. Probably wouldn't be this conversation going on
right now. But most physicians aren't. And it's not just
with current medical research that they're just not aware of
because they haven't had time to pick up the lance
(15:13):
at the last few months, but it's also their training
to Like if a doctors in practice for twenty years,
the brain and the human brain tends to create habits
because it likes to expend as little energy as possible.
It's it's trying to be as ficient as possible. And
I think the same thing happens with medical practice. You're trained,
you understand, you come out of medical school with a
(15:35):
lot of book learning, and then you put it to
practice and you kind of find your niche and along
the way you forget a lot of the stuff that
you haven't done in twenty years or haven't learned about
in twenty years, so it's not just current stuff, it's
old stuff too. And if you feed the physician's desk
reference into Watson or one of his his compatriots, like,
all of that knowledge can be quickly index in research
(15:56):
to try to spit out a more accurate diagnosed. Yeah.
I think that's a great idea. It's like a partnering
up with computers. It is sarily replacing, but what they're
doing with Watson is is very much moving towards replacing
doctors in that sense. Well, here's a scary stat um.
One in five diagnoses in the United States are incorrect
(16:16):
or incomplete one in five and a lot of times
it's not that the doctor is a jerk or not
any good, but like you said, they just maybe haven't
seen these cases that were written about in some obscure
medical journal that the computer has scanned an index, you know.
And Dolly Wall Dr Dolly Wall himself at Freak Diagnostician Dollywood, Yeah,
(16:39):
pretty close, which is a wonderful place, by the way,
I know you love Dollywood. Um. Dr Dolly wall Uh
himself says a lot even with me, A lot of
it is intuition, and intuition can be wrong. That's a
criticism though, of computers as doctors. They lack intuition. Like,
there's kind of even larger, even larger than this computer's
(17:03):
replacing doctor's conversation going on. It's kind of a conversation
or a debate over whether intuition or data. Yeah, trump's
one or the other. Which one is the right way
to go? Yeah? This one stat too, it says according
to an expert, I'm not sure what that means. It
sounds sinky, but they said, only of the knowledge of
(17:24):
physicians use to diagnose is evidence based, So that means
is intuition, which which also jibs and dovetails with that
one in five being wrong, I mean, or one in
five being right. I'd like the idea of intuition to
a certain degree for sure, but there's also got to
be like data backing it up. Sure, you know, so
(17:47):
in your perfect world. And it sounds like we still
have physicians, but they go back and double check themselves
using a program. Yeah, but I could also be down
with um simple what is it? What do they call
it here? Um? Something based diseases, rules based chronic diseases. Yeah,
(18:08):
like minor things that are pretty easy to diagnose. They're
not even necessarily minor. We just understand them so fully
that we say type two diabetes is going to behave
and present itself like this. Yeah, but I wouldn't mind
going like it seems like once a year I get
like an upper respiratory infection. It's been three or four
years in a row, and I know what the treatment is,
I know how it feels. It would be great to
(18:29):
go into a machine and have them take some stats
and blow into it and hear my wheezing and give
me a a steroid shot and a Z pack and
a breathing treatment and send me on my way. So
it's always what clears it up. Would you care if
it was a robot that gave you that shot? Not
at all, um, but I definitely would want more personal
(18:53):
care if it was something what if it was a
robot with a nice avatar, sexy avatar maybe or just
a friendly one. Yeah, that was a little, a little,
a little it would touch your forearm here there. Yeah,
well that might be a little creepy. Yeah, if like
it was an old timey doctor who like gave you
some epocac if you had diarrhea, just send you on
your way drink a coke, but it wouldn't send you
(19:14):
on your way to give you ipocac and then it
wouldn't let go of your forearm. Yeah, so strong well
surgical robots. That's a that's a thing. I mean, we're
kidding around, but they've been performing. They've been performing robotic
surgery since the early eighties, um doctor assisted until two
thousand ten, where they were in Montreal. They performed the
(19:35):
first fully robotic surgeries when they removed a prostate with
a fully robotic UH surgeon and fully robotic anesthesiologist Dr
mc sleepy. Dr mc sleepy. Yeah, and the the that's
the real name the robot surgeon was da Vinci, which
is like the basically gold standard for robotic surgical or
(19:57):
surgical robots. Yeah, they had to that thirty thousand robotic
surgeries performed in the US, So it's it's big, it
is and um but the da Vinci is a doctor
basically sitting in a little uh it looks like an
arcade game and using UM robotic arms to mimic his
(20:19):
or her movements on more microscopic levels. Right, So the
robot has more precise movements and can make smaller movements,
um than the doctor. It's tell it's and what's the
opposite of telescoping, like going downward in scale? Whatever that is.
It's taking the movements of the doctor and reducing them
in scale. Let's call it reverse telescoping, reverse telescoping those movements, um,
(20:43):
which is a pretty awesome achievement in and of itself.
That doctors being fed three d um graphics of what
the robot is seeing, uh, and just kind of working
from there. Uh. What we're moving towards apparently is fully
robotic size surgeries. I was talking to Joe McCormick from
(21:04):
Forward Thinking and he was saying that, um, there was
there's something called the Raven four, I believe. Uh. And
basically you just say, this is going to be a
gall bladder surgery on a six ft six male age
you know whatever. And here's his here's the cat scan
of his abdomen um. So go removes gall bladder and
(21:28):
you press enter and the thing goes in there and
like removes the guy's gall bladder and sews him up. Yeah,
that's fully robotic, like fully autonomous robotic surgery. Button then
it does it. You're not actually controlling a machine that
does it exactly the machines doing it at your behest,
but you're not controlling it. Yeah. Um, and we're right
(21:49):
on the cusp of that, and apparently it's already happening.
Uh yeah, but there are some issues. UM. I looked
into it and found that a lot of injury reporting
and robotics agery is um not being reported. It's it's substandard.
And uh, this woman, Sheina Wilson, had robotic surgery for
hysterectomy in two thousand thirteen and apparently this uh intuitive
(22:13):
surgical system had there had been a bunch of injuries
that she didn't know about, and she had her rectum
burned badly and said, if I would have known that
this system had these issues, would not have elected to
take part in it. So there's a lot of under reporting. Um.
The f d A, UM, they have no authority to
(22:35):
force a doctor to do this, and apparently there's every
reason in every link in the chain not to report
these things, you know, and the f d A not
enforcing this kind of thing, not enforcing reporting is ridiculous. Yeah.
You know. The thing is that things like that happen,
and there's under reporting. UM. With human surgic surgeons as well. Yeah, sure,
(23:00):
not just robotic. It's like overall, apparently surgical injury and
accident reporting is not compulsory. Yeah, and here's here's a
few points though. Counterpoints I guess is one, it's not
always the robotic component of the surgery that was the
cause to a lot of times they say they don't
know about this until like a lawsuit is filed, So
(23:22):
it could be weeks or months later with the physician
doesn't know about it, or the FDA might not get
report on it, and like six months later you follow
a lawsuit and that's how it comes to light. Um.
But the FDA is definitely concerned and are supposedly working
to improve this. That's very concerned. They're very concerned. Uh.
And another problem too, and that same article, a lot
(23:43):
of these robotic surgical systems, you still have to have
the correct amount of training. And Uh. The feeling of
some experts is that UM or at least this one guy,
Enrico Benedetti, he's a head of surgery at the University
of Illinois Chicago, UH, says a lot of it just
comes back to training. These some of these doctors aren't
getting adequately trained in these machines enough to perform this regery. Yeah,
(24:07):
like what happens when I do this? Oh? That happens.
That's not good. I've got another alarming stat for you
to hold on. Hold on, hold on. Before that, let's
do a message break real quick. Okay, tell me your
(24:37):
alarming stat al right. JOHNS. Hopkinsider a study that found
as many as forty thou patients die in intensive care
each year in the US due to misdiagnosis man and UM.
Another study found that system related factors like UH, lack
of teamworking, communication, or just poor processes were involved in
(24:57):
six of diagnostic error and cognitive factors, and with premature
closure is the most common, which is basically just sticking
to that initial diagnosis and not being open minded to
other like second opinions. Yeah. So there's this thing called
anchoring bias that UM was in that New York Times article.
(25:18):
Dr Dolly Wall the guy who created this program that's
now around to support diagnostics where a physician will say,
I think it's this, but let me put in the
symptoms and ask Isabelle Um which is the name of
the program, and it's named after the guy who created
the program's daughter. Yeah, when she was three, took her
to the hospital and the doctors said, well, she has
(25:40):
chicken pox. And she did indeed have chicken pox, but
that's all they looked at. They completely missed a pretty
nasty case of necrotizing fasciitis, which we've talked about before,
flesh eating bacteria, and um, she almost died from it.
It was. It was disfigured from it as a result,
so that her father, who was a money manager, said,
(26:00):
I'm going to take whatever computer programming skills I haven't
put it towards this program Isabelle, which is meant to say, yes,
you're right with this diagnosis, I agree with you, or
have you considered these other diagnoses? And he said, like,
had hasabel been around and his daughter's doctors consulted it,
they would not have missed the necrotizing fasciitus. Well, it
(26:21):
makes sense, um as an assist. You know. Um, there's
this company called Life Calm that said in clinical trials
that if you use a medical diagnostic program as an assist, Uh,
those engines were accurate without using exams or imaging or
labs even really just symptoms. Yeah, that's crazy, that's really
(26:44):
really really good. Yeah, like that's a that's an A,
that's a low A. It's still in a. But as
an assistant, I think it's you know, it's kind of
a no brainer, don't you think. Oh yeah, I think so.
I don't know why. I all I can think of
is possibly worrying about feeding the beasts that will take
(27:05):
your job, or just having too much of a case
load to take the time to double check your work
on a computer would be the only reasons why doctors
aren't using that. Well, the smartphone is becoming a potential
uh self diagnos ur There's all these cool things on
the horizon that you can use your your phone for.
(27:27):
There's one called a live Core which you can take
your own ECG testy and potentially, for the cost of
getting one e c G in a hospital, you could
send a year's worth of daily ECGs you took yourself
to your doctor, and then you carry all that info
and all of your other medical info from all of
your apps that will eventually be integrated into one or
(27:48):
two apps that will probably become preloaded on your iPhone
in the next couple of years. And you've got your
medical history right there. Yeah, and I you know, most
of these require like a little clip on like um,
something called cell scope that's like you clip it onto
your little camera lens essentially, and it's like, what are
the little magnifiers with the lights that doctors used to
(28:08):
look in your ears and eyes? Uh, yeah, it looks
like one of those clipped onto your your iPhone and
it produces, uh, you can do imaging for skin moles
and rashes and ear infections. They have one called NTRA
that you could potentially give your own eyes uh, get
your own like glasses prescription done and then you ordering
(28:31):
the information to some website and they say and then
this one called Adamant that smells your breath, that smells
gases in your breath and it could detect like lung
cancer even yeah, apparently you have real metabolic changes to
the smell of your breath yea when you have different
(28:52):
types of cancer, not just long um. Like bees can
detect breast cancer. Um. If you breathe into like this
special glass fear with bees around it, they can be
trained to detect lung cancer and they come back with
the correct results a lot of the time. So a
lot of these are on the horizon they're not like
in heavy rotation yet, No, but but it's pretty neat
(29:13):
All of them reveal this idea that no one cares
about your particular health and well being more than you.
Unless you're one of those dudes who doesn't really care.
Then your your wife does or your mom you know,
and we probably cares more about me than me, right,
But there's there. The point is the doctor, the insurance company,
(29:36):
the the hospital. While they're all in the field because
they do care about your health, of course, they can't
possibly care about it more than you or your loved
one does. So the idea of giving you the ability
to keep all of that information yourself and easily handed
over to them or potentially down the road, a computer
version of them. I can't think of any any better
(29:58):
revolution in medicine right now than that read. I think
it's pretty exciting. Yeah. I think we're going to live
into the triple digits, buddy. Yeah. And I think there
will always be a need for doctors and nurses. I
don't think anyone will be wholly replaced but a little
robot assist. Yeah. Yeah. Let me make one more point,
all right, there's so you've heard of genomics, Yes, There's
(30:20):
also this thing called proteonomics, which is basically your protein
version of your your genome, your genome, and it's all
of the proteins in your body that you have that
your manufacturing, that you're losing, and all the changes and
fluctuations in them. And the idea is that you can
get a full work up of your proteonome and your genome,
(30:41):
and eventually you can add that to your medical history
as well, what your E k G reading has been
over the past year, um, any way you may have
gained or lost or anything like that, what your breath
smells like metabolically speaking, and not only have your current
state of health, but personalized your version of that personalized
(31:03):
down to your genes and proteins in your body, so
a treatment could be specifically tailored to you. Wow, that's
gonna be really tough for a human physician to do
that on their own. To top that, Yeah, the the
amount of data available already is overwhelming human doctors. When
you add this other kind of stuff on it, it's
(31:23):
just pulling away from them more and more. Yeah, and
medical record keeping is uh, I know, there's been issues
with that and digitizing that and keeping up with medical records,
and if you could be yourself advocate and keep up
with your own medical records, it might be kind of nice.
So I I feel like we answered the question, which
is yes, no more doctors. I don't know. I think
(31:46):
in in the future, I will always have humans to
interact between us. I think because we're always gonna want
somebody to yell at or be like what is this
robot doing? Or can you help me this robots give
me some ipocacu and won't let go on my arm
or burn my rectum. Yes, we're always going to need humans.
It's just I don't know, well we need physicians, and
(32:06):
if we do, will they be super specialized like just
the Supreme Court of Physicians. Who knows. It's pretty exciting.
But we will see this change one way or another
in the next fifteen years under my prediction to it's happening. Okay,
goog and Chuck if the year yeah. Really, If you
wanna learn more about computers possibly replacing doctors, you can
(32:31):
type those words into the search bar how stuff works
dot com. And since I said search bar, that means
it's time for a message break. Okay, So, so what
(32:55):
do we have listener mail time. Yeah, I have one
called I'm gonna call it fight Club. Okay, hey guys,
just finished the podcast on deep refrigerating. I think I'll
keep my Energy Star certified fridge. Thanks very much. But
Josh did mention something about eating weeds and asked a
(33:16):
somewhat rhetorical question, what are weeds anyway? Just plants we
say are bad? It reminded me of some today's common
uh some that some of today's common noxious weeds. How
they got their reputation not so long ago, lawns were
perfect blends of Bermuda rye and Kentucky blue grass. They
also included many types of clover, dandelion, and other quote weeds.
In fact, many seed mixtures specifically included white clover because
(33:38):
it makes an excellent cover in soils where more common
grasses won't grow. In steps the Scott Fertilizer Company, post
World War Two America housing tracks were popping up all
over the US and new suburbia, and Scott was encouraging
returning gis to take pride in their new lawns and
to buy their products to do so. And we're extremely
high waisted pants, that's right. They produced fertilizers, weed killers,
(33:59):
and other long your products, some of which had a
curious side effect killing many leafy greens that came up
to the point that we're not considered weeds at the time,
including white clover. Instead of reformulating, what they did was
what any red blooded American corporation would do. They redefined
what was a weed. White clover made that list as
the dandelions, when in fact both are still in use
(34:20):
today in cooking and medicines. Would you call that a
noxious weed? No? So thanks for that, guys, and thanks
for all the knowledge I've learned and have a great
and that is from Robert Paulson. Oh yeah, Robert Paulson.
He's a he's a sharp dude. That's why I called
it fight club, remember that. Oh yeah, I think I
made a joke to him about that once on Twitter
(34:41):
and he never responded. Yeah, he's he writes in a
lot now he's every time I see his name, I
think and his name is Robert Paulson. Yeah, thanks a lot,
Robert Paulson. We appreciate you. If you ever shot in
the head and the commission of a robbery, we will
dispose of your body. Um. If you want to get
in touch with me and Chuck, and you have a
name that you would like us to poke fun at
(35:02):
Bring it On. You can tweet to us at s
y s K podcast. You can post your name on
Facebook dot com slash Stuff you Should Know. You can
send us an email to stuff Podcasts at how stuff
Works dot com. And then, of course, go visit our website.
Make it your homepage. It's the coolest place on the web.
It's Stuff you Should Know dot com. Stuff you Should
(35:26):
Know is a production of iHeart Radio's How Stuff Works.
For more podcasts for my heart Radio, visit the iHeart
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