Artificial Intelligence vs Natural Stupdity

Artificial Intelligence: A Rescue for Natural Stupidity in Modern Medicine, But Won't Substitute A Magic Bullet Medicine

Artificial intelligence (AI) is intelligence exhibited by machines, particularly computer systems that is able to perceive their environment and use learning and intelligence to take actions that maximize their chances of achieving defined goals (Rocell SJ et al, 2021).

The opposite of "artificial intelligence" is "natural stupidity" or "human stupidity".

Natural Stupidity in Medicine

"In contrast to AI, let us examine natural stupidity. Unfortunately, there is an abundance of that in our world, perhaps a preponderance. In medicine, we hope that every physician is intelligent, or at least competent. But that may not be the case." Says Dr Buchwald, a professor emeritus of surgery and biomedical engineering at the University of Minnesota, in Minneapolis. He wrote in General Surgery News about the AI versus natural stupidity in medicine (Buchwald H, 2024).

The topic is closely related to the future of a profession – medical doctors. I believe what Dr Buchwald stated in his article is a food for thought for those deep thinker healthcare professionals not only limited to MDs.

I cite some of his key ideas as below, with section title added:

AI: A Rescue for Natural Stupidity

"When I was still in active academic practice, conducting patient rounds, I asked a medical student for his thoughts on a patient's differential diagnosis and how he would proceed to narrow the potential options. He whipped out his iPhone to consult an algorithm. I told him to put the instrument away and to speak from the knowledge base of his nearly four years of medical training to make his own analysis of variables. He proved that he had little knowledge of established facts and, even when prompted, could not produce a reasonable thought sequence.

"After graduation, this student became someone's doctor, treating afflictions, counseling fellow human beings. Fortunately, after a patient consultation, this doctor will be able to postpone diagnosis and therapy by waiting for laboratory and imaging results, allowing him time to go to his iPhone, consult the algorithms and then come to a conclusion for the patient.

"In essence, AI may be the patient's ghost doctor. In some instances, medical AI might prevent the physician from crashing into an unappreciated mountain."

Service Line of Medicine Will Rely on AI

"It has become common practice to place medical specialists into a service line dedicated to a disease entity—for example, a colon cancer service line consisting of a gastroenterologist, an oncologist, a surgeon, a radiotherapist, one or more nurse practitioners, and a stomatist. The surgeon would, for the most part, be kept in the OR to make money for the group. The group head, to whom the surgeon is responsible, is therefore usually not a surgeon; in turn, the group head is responsible to a CEO or to a dean, who probably also comes from another discipline.

"Thus, service line physicians have lost most of the clinical unity, shared knowledge, experience and directional leadership traditionally concentrated in a clinical department unit.

"In surgery, the days of the charismatic departments of Halsted, Cushing, Wangensteen, Lillehei, Varco, etc. are gone. To compensate for that loss, the service line often relies on AI systems."

"..."

AI Could Lead to Fewer General Physicians

"Finally, the detractors of AI offer the specter of unemployment. In fact, reemployment may be the more accurate term. When the covered wagon gave way to the railroad, the railroad to the car, the car to the plane, there were massive shifts in employment; however, there was also a massive increase in employment.

"In medicine, AI may well lead to fewer general physicians. There are internet companies today that offer a paying caller medical advice from an AI robot doctor. The patient of the future may actually establish a relationship with his or her robodoc.

"Today there are fewer physicians per 100,000 (2.6) population in the United States than in corresponding nations (3.8). I have always thought that this trend was negative, but possibly, AI may lower the cost of U.S. healthcare and perhaps even improve the medical advice being offered.

"The fewer practicing physicians may also benefit by being guided by AI to solve difficult diagnostic and therapeutic problems. Such a global change in physician availability could mitigate the American doctor shortage, caused, at least in part, by our expensive medical schools' inability to graduate a sufficient supply to meet the postulated national demand."

Here I end citation of Dr Buchwald's article.

The following is my deep thinking. Dr Buchwald covered many aspects of the impact AI are bring about to medicine. My deep thinking here will focus on the future destination of a profession – medical doctor under the overwelming influence of AI.

Modern Medicine: From Glory to Ugliness

Modern medicine started to emerge after the Industrial Revolution in the 18th century. At this time, there was rapid growth in economic activity in Western Europe and the Americas. During the 19th century, economic and industrial growth continued to develop, and people made many scientific discoveries and inventions. Scientists made rapid progress in identifying and preventing illnesses and in understanding how bacteria and viruses work (MNT Editorial, 2018).

Since the late 1900s, medical science and technology have advanced with a speed incomparably greater than at any previous time. It is unjust to deny the great advance of medical knowledge along with the evolution of culture; and medicine can proudly boast of many conquests that deserve to be called marvelous.

However, there have been accompanying problems.

A Radical Monopoly with Faceless Bureaucracy

On April 28, 1982, the Royal College of General Practitioners hold its Spring Meeting in Dublin. Ivan Illich, a famous medicine critic philosopher and historian, was invited to make the opening address, which was titled 'Medicalisation and Primary Care' (Ivan Illich, 1982).

In his address, Illich described medicine as a 'radical monopoly' , and as such, medicine becomes an end of itself, rather than a tool for healing. Doctors are technicians who work for impersonal institutions. Medicine, which used to promote natural healing by working with the body, is now a practice located in a faceless bureaucracy without commitment to individuals or their personhood, relying on technical expertise rather than rapport and humanism. Medications and treatments lead to more medications and treatments, rather than true health.

Illich did not deny that much about medical advancement was good - sanitation, vector control, inoculation, and general access to dental and primary medical care. His key point is that the problem arose when bureaucratic managers and the entire emerging structure of medicine limited the freedom of individuals to choose their own care or undergo bodily healing on their own.

Decades later, the situation has yet no change. On 13 November 2015, British medical doctor Erika schwartz wrote in The Daily Mail: Don't let your doctor kill you! Modern medicine doesn't train them to see patients as individuals (Erika Schwartz, 2015).

So the modern medicine evolved into a status quo where "human touch" and "empathy" are in the worst deficiency.

Less Healing, More Doctor's Livelihoods

The American physician Robert Mendelsohn, a self-described 'medical heretic', popularised antimedicine arguments through his books (such as the one titled Confessions of a Medical Heretic) (1979).

Dr Mendelsohn accused medicine of becoming less about healing than about the maintenance of medicine itself, especially doctors' livelihoods.

"Doctors in general should be treated with about the same degree of trust as used car salesmen. Whatever your doctor says or recommends, you have to first consider how it will benefit him. For example, if a neonatologist tells you that high risk nurseries improve the survival rates of babies, find out if he works for a high risk nursery", Dr Mendelsohn's condemnation was penetrating.

Adding Insult to Injury: Critical Shortage of Effectiveness

Again, in the American physician Robert Mendelsohn's point of view (1979),

• Modern Medicine's treatments for diseases are seldom effective, and that they are often more dangerous than the diseases they're designed to treat.

• The dangers are compounded by the widespread usage of dangerous procedures for non-diseases.

• More than ninety percent of Modern Medicine could disappear from the face of the earth - doctors, hospitals, drugs and equipment- and the effect on our health would be immediate and beneficial."

Dr. Mendelsohn's startling hypothesis that people would be healthier if 90% of Modern Medicine were scrapped was confirmed (A Book Review. 2002). In Bogota, Columbia, Los Angeles County, California and in Israel, when the doctors went on strike in these three different places, the death rate went down dramatically. During the month-long physicians' strike in lsrael in 1973, the doctors reduced their daily patient contact from 65,000 to 7,000. Guess what happened? "According to the Jerusalem Burial Society, the lsraeli death rate dropped fifty percent during that month.

Again, decades later, the status quo still remains unchanged. On February 22, 2017, health science journalists (David Epstein et al, 2017) wrote in The Atlantic:

• When Evidence Says No, but Doctors Say Yes. Long after research contradicts common medical practices, patients continue to demand them and physicians continue to deliver. The result is an epidemic of unnecessary and unhelpful treatments.

In 2019, professor Jacob Stegenga, a philosopher of science at the University of Cambridge in his book Medical Nihilism presents a stinging critique of medicine, arguing that most treatments do not work well, and many do more harm than good.

Triage: The Function of A Medical Doctor

With a critically shortage of effective treatments, a medical doctor functions as a triage officer, who using his or her good memory, distribute various "goods" (effective or ineffective treatments) known to him or her to the consumer patients, with supposed minimum mistakes or errors. But AI machine for sure can do such a triage job way faster and more accurate than human being doctors.

While writing this post, I am pretty sure that AI will eventually replace many triage jobs a medical doctor do. Therefore, quite a number of doctors may start to worry about loss of their jobs.

On the other hand, I would say to medical doctors: No worry. You won't lost your job if you walk away from the current ineffective triage job and start to use a magic bullet.

A Magic Bullet Medicine Buried in The Dust

While a problematic modern medicine is frustrating both the patients and many healthcare professionals, few people today are aware that there was a healing art called acupuncture 2000 years ago in China which functions as primary care, with magic efficacy and intimate human touch (physically and mentally).

The efficacy of this ancient acupuncture as described in Chinese medicine classic Huangdi Neijing was marvelous: the symptom relief of almost any illness encountered at that time happens the instant the needle is in, and the permanent cure eventually follows with a high-level of certainty. So the efficacy is not only instant (patients will feel improvement in less than 5 seconds) but highly reliable.

Most importantly, this healing art promotes human body's self-healing, at an unimaginable efficiency and speed, with essentially no side effects involved at all. For example, it can help the body completely reverse cancer just in 3 weeks (read this).

It never suppresses or impede self-healing like the conventional medicine (drugs and surgeries) in most cases does.

AI Won't Substitute A Magic Bullet Medicine

This "hidden" ancient wisdom – Neijing acupuncture, a gift from the almighty nature or the god, if its potential is fully recognized, will help you, the medical doctors, survive the unavoidable oncoming "disastrous" event.

As American family doctor Davis Liu voiced (Davis Liu, 2012): Care must be:

1) incredibly simple to access,

2) extremely convenient and

3) intensely personal.

Neijing acupuncture not only meets these criteria, but way more importantly, it is magically effective!

You will note that even a tiny, and distorted portion of Neijing acupuncture – today's meridian acupuncture or dermatome-based acupuncture -- have already changed many conventional medicine practitioners' professional perspectives forever (Read this)! And it even helped in saving a 130 years old non-conventional medical profession which would have otherwise been history (Read this)!

AI can be a rescue for natural stupidity, particularly may easily replace a triage job, but won't substitute the human touch from a dexterous hand which can perform the job of diagnostic palpation and therapeutic manipulation of a magic bullet.

Keep reading my Newsletter – The "hidden" Truth of Acupuncture Science. Knowing this truth which has been deeply buried in the dust of 2000 years will help all healthcare professionals - who started to feel the threats from AI technology - easily find their way out.

References

A Book Review. 2002, Sickening Medicine. https://www.qcc.cuny.edu/socialsciences/ppecorino/medical_ethics_text/Chapter_3_Moral_Climate_of_Health_Care/Reading-Sickening-Medicine.htm (accessed on March 5, 2023)

Buchwald, Henry, MD, PhD. Intelligence Versus Natural Stupidity in Medicine. MAY 17, 2024 MAY 17, 2024 General Surgery News

David Epstein and ProPublica, When Evidence Says No, but Doctors Say Yes. The Atlantic 2018. https://www.theatlantic.com

Davis Liu, MD, Vinod Khosla: Technology Will Replace 80 Percent of Docs, Aug 31, 2012. https://thehealthcareblog.com/blog/2012/08/31/vinod-khosla-technology-will-replace-80-percent-of-docs

Erika schwartz, Don't let your doctor kill you! Modern medicine doesn't train them to see patients as individuals, The Daily Mail 2015 https://www.dailymail.co.uk/health/article-3310928

Ivan Illich, Medicalisation and Primary Care. J. Royal College of Gen Pract., 1982, 32, 463-470.

Ivan Illich, Medical Nemesis, Pantheon Books, N. Y. 1976,

Jiayi Shen et al, Artificial Intelligence Versus Clinicians in Disease Diagnosis: Systematic Review. JMIR Med Inform. 2019

Krittanawong C. The rise of artificial intelligence and the uncertain future for physicians. European Journal of Internal Medicine. 2018;48:e13–e14. doi: 10.1016/j.ejim.2017.06.017.

Liat Clark, Vinod Khosla: Machines will replace 80 percent of doctors. 04.09.2012, https://www.wired.co.uk/article

Robert Mendelsohn. Confessions of a Medical Heretic. 1979

Russell SJ et al, 2021. Artificial Intelligence: A Modern Approach (4th ed.). Hoboken: Pearson