Now replace some / all of those humans with... A machine whose function also needs insurance approval.
It's gonna end badly.
I still think healthcare needs to be reformed, and I hope that insurance will someday be a thing of a past, but I've hung up my chain saw for now.
Things were ruined slowly. They unfortunately will need to be fixed very slowly too.
> They unfortunately will need to be fixed very slowly too.
We should have stacked the courts ourselves, brandished executive orders etc, had some spine.
Edit: I think I need to make clear my thinking that the right has selectively destroyed institutions and levied them in other areas where it makes sense for their agenda. It's not been wanton. So when I say leverage the playbook it's not a one sided act of destruction.
When the wrong targets get destroyed, everyone suffers. When parasitic forces are destroyed, the system functions better. It's the difference between defense and friendly fire.
What’s going to be different now than in 2010?
There is an intermediary between customers and seller and it's allowed to take percentage of the sale. No such entity will ever work in the interest of the consumer. It has every incentive to inflate prices. Intermediary is needed but it should be financed by buyers with flat fee (possibly for additional incentives that reinforce the desired behavior). The tragedy here is that initially it was. But it was deemed too expensive for the buyers and got privatized which made it vastly more expensive in the long run.
Insurance is also wrong. Insurance is gambling and gambling needs restrictions. You are allowed to take people's money without providing any service most of the time, so you shouldn't be allowed to refuse legal service for that privilege.
https://my.clevelandclinic.org/health/symptoms/10880-fever
https://www.mayoclinic.org/diseases-conditions/fever/symptom...
https://www.osfhealthcare.org/blog/whats-considered-a-fever-...
https://www.brownhealth.org/be-well/fever-and-body-temperatu...
https://www.childrensmercy.org/siteassets/media-documents-fo...
I can keep going if you'd like. Google has a lot of results and every single one says a fever is around that range (sometimes 100, sometimes 100.4).
You didn't say the doctor disputed you had a fever. You said the doctor told you the fever wasn't concern until 100.4. Which I'm guessing is your fault for misinterpreting. If you google around, it's very easy to see the fever thresholds.
Here, I'll even paste a summary for you, and I can keep going if you like:
Key Temperature Thresholds
- 100.4°F : The standard definition of a fever.
- 103°F : Contact a healthcare provider
- 104°F : Seek medical attention, particularly if it does not come down with - treatment.
- 105°F : Emergency; seek immediate care.
In one of your own links (clevelandclinic.org), here's an excerpt for you:
When should a fever be treated by a healthcare provider? In adults, fevers less than 103 degrees F (39.4 degrees C) typically aren’t dangerous and aren’t a cause for concern. If your fever rises above that level, make a call to your healthcare provider for treatment.
I actually did say that the doctor disputed I had a fever
A fever is 38c, great. What the parents said was that you may have misheard because a fever isn't serious until 104. Which is line's up with the language you used.
> and they said it's not a concern until...
Parent is not suggesting that a fever isn't at 100F, they're suggesting that it's not "a concern" until 104F, a number strangely similar to 100.4 that you claim you heard, presumably, while you had a fever.
This even translates to the pediatric space. I took all of my kids to the pediatrician because either they don't make comments to me like they do to my wife, or I don't take shit from them. I'm not sure which. Here's an example:
My wife and daughter were there and the doctor asked what kind of milk my daughter was drinking. She said "whole milk" and the doctor made a comment along the lines of "Wow, mom, you really need to switch to 2%". To understand this, though, you need to understand that my daughter was _small_. Like they had to staple a 2nd sheet of paper to the weight chart because she was below the available graph space. It wasn't from lack of food or anything like that, she's just small and didn't have much of an appetite.
So I became the one to take the kids there. Instead of chastising me, they literally prescribed cheeseburgers and fettuccine alfredo.
My daughter is in her 20s now and is still small -- it's just the way she is. When she goes to see her primary, do you know what their first question is? "When was your last period."
The weight thing was not the key aspect of my original comment. They chastised my wife for continuing to give my daughter whole milk while being underweight, but did not make similar comments to me. That was the point.
For women, their pains and problems are far too often whisked away by hand waving and "it's hormones and periods" and serious issues are often overlooked. Very little has changed in that area over the last twenty years.
However, your argument focuses on the routine intake instead of any listening part. The fact that the doctor measures height, weight, temperature, and blood pressure on intake and then asks about LMP doesn’t surprise me… that’s the part of the script where you just provide the data before you bring up concerns.
Not to say the doctor was not a jerk, just that your argument doesn’t do much for me.
I wonder how many units of their training courses are spent on this and how much is spent on the cultural reinforcement of it.
* https://www.health.harvard.edu/pain/the-dangerous-dismissal-of-womens-pain
* https://pmc.ncbi.nlm.nih.gov/articles/PMC10937548/
Is that supposed to be a problem? How does it connect to the story in your comment?
The question seems to be warranted to me, since being underweight can stop you from menstruating. So if you find someone thin and her last period was off in the distant past, you can conclude that there's a problem and something should be done about it; if it was a couple of weeks ago, you can conclude that she's fine.
(It could also just be something that is automatically assessed as a potential indicator of all kinds of different things. Notably pregnancy. For me, it bothered me that whenever you have an appointment at Kaiser for any reason, part of their checkin procedure is asking you how tall you are. I'd answer, but eventually I started pointing out to them that I wasn't ever measuring my height and they were just getting the same answer from my memory over and over again. [By contrast, they also take your weight every time, but they do that by putting you on a scale and reading it off.] The fact that my height wasn't being remeasured didn't bother them; I'm not sure what that question is for.)
Particularly given the alarming stories of people being prosecuted for having miscarriages, it feels ridiculous.
If anything I hope more automated diagnostics and triage could help women and POC get better care, but only if there’s safeguards against prejudice. There’s studies showing different rates of pain management across races and sexes, for example. A broken bone is a broken bone, regardless of sex or race.
You need to delete your social media accounts and change where you're getting your news from. Nobody is "being prosecuted for having miscarriages". A few people have been investigated for drug abuse during pregnancy which led to the baby's death, which sensationalist news stories twisted into attention-grabbing headlines.
A doctor asking about cycle is just a core piece of diagnostic data like taking blood pressure and temperature, not some conspiracy to harm you.
Doesn't this suggest that they don't care what the answer is?
You are asking how it connects, and it absolutely doesn't. But they keep asking and won't accept "it's regular" as an answer.
She's in her 20s and is seeing her primary for routine things, not because of her weight -- that part of the story was about how they chastised my wife for giving her whole milk but said absolutely nothing to me about it later on.
It doesn't have opinions, research, direction of its own. Is this a path of codifying the worst elements of human society as we've known it, permanently?
One was against it, the other one saw it as a good idea.
I would love to have real data, real statistics etc.
Also, the very idea that LLMs would prescribe you ritalin at all is laughable... Having no human doctors in the loop is a guaranteed way to cut prescription drug abuse, as ya can't really bribe an LLM or appeal to its humanity...
I have it so strong, that after I was preparing myself, my work desc, my books everything, i was starring into the books i wanted to learn for 15-30 minutes unable to just start or do anything.
With ritalin, i might have this mental block to, but its overcome in a few seconds.
I went from a 'nearly/borderline failing grade' to the nearly the best grade in just one year.
This changed significantly were I am today.
So your solution is to outsource thinking and work? That'll work out great in the long run.
How are you defining technology? How are you defining human problems? Inventions are created to solve human problems, not theoretical problems of fictional universe. Do X-rays, refrigerators, phones and even looms solve problems for nonhumans?
Claiming something that sounds deep doesn’t make it an axiom.
Ok fellas put your money where your mouth is. It’s easy to talk until you put your money behind it (or lack of by getting rid of spending on it) if you are so confident in doctor as a service by llm.
Really? Which ones?
> insurance won't pay for them
Non sequitur, replacing doctors with AI will not help you pay for the preposterous US healthcare system. Vote!
If I were picking a specialty now, I'd go with pediatrics or psychiatry over something like oncology.
But most of us live in America in 2026. There are a lot of interests that don't give a shit about you who would love if you to got your medical care from a machine that "cannot tell how many r's are in strawberry". And there a lot of useful idiots with no real medical issues who will loudly claim the machine is great.
patients -> AI -> diagnosis (you know, with a camera, or perhaps a telephone I guess)
What REALLY happened
patients -> nurse/MD -> text description of symptoms -> MD -> question (as in MD asked a relevant diagnostic question, such as "is this the result of a lung infection?", or "what lab test should I do to check if this is a heart condition or an infection?") -> AI -> answer -> 2 MDs (to verify/score)
vs
patients -> nurse/MD -> text description of symptoms -> MD -> question -> (same or other) MD -> answer -> 2 MDs verify/score the answer
Even with that enormous caveat, there's major issues:
1) The AI was NOT attempting to "diagnose" in the doctor House sense. The AI was attempting to follow published diagnostic guidelines as perfectly as possible. A right answer by the AI was the AI following MDs advice, a published process, NOT the AI reasoning it's way to what was wrong with the patient.
2) The MD with AI support was NOT more accurate (better score but NOT statistically significant, hence not) than just the MD by himself. However it was very much a nurse or MD taking the symptoms and an MD pre-digesting the data for to the AI.
3) Diagnoses were correct in the sense that it followed diagnostic standards, as judged afterwards by other MDs. NOT in the sense that it was tested on a patient and actually helped a live patient (in fact there were no patients directly involved in the study at all)
If you think about it in most patients even treating MDs don't know the correct conclusion. They saw the patient come in, they took a course of action (probably wrote at best half of it down), and the situation of the patient changed. And we repeat this cycle until patient goes back out, either vertically or horizontally. Hopefully vertically.
And before you say "let's solve that" keep in mind that a healthy human is only healthy in the sense that their body has the situation under control. Your immune system is fighting 1000 kinds of bacteria, and 10 or so viruses right now, when you're very healthy. There are also problems that developed during your life (scars, ripped and not-perfectly fixed blood vessels, muscle damage, bone cracks, parts of your circulatory system having way too much pressure, wounds, things that you managed to insert through your skin leaking stuff into your body (splinters, insects, parasites, ...), 20 cancers attempting to spread (depends on age, but even a 5 year old will have some of that), food that you really shouldn't have eaten, etc, etc, etc). If you go to the emergency room, the point is not to fix all problems. The point is to get your body out of the worsening cycle.
This immediately calls up the concern that this is from doctor reports. In practice, of course, maybe the AI only performs "better" because a real doctor walked up to the patient and checked something for himself, then didn't write it down.
What you can perhaps claim this study says is that in the right circumstances AIs can perform better at following a MD's instructions under time and other pressure than an actual MD can.
Excellent. We should be striving for a world where humans are meat puppets for machines.
For instance, transportation is a "human problem". It's being successfully solved with such technologies as cars, trains, planes, etc. Growing food at scale is a "human problem" that's being successfully solved by automation. Computing... stuff could be a "human problem" too. It's being successfully solved by computers. If "human problems" are more psychological, then again, you can use the Internet to keep in touch with people, so again technology trying to solve a human problem.
Humans (doctors/nurses) can still be there to make you feel the warmth of humanity in your darkest times, but if a machine is going to perform better at diagnosing (or perhaps someday performing surgery), then I want the machine.
Even now, I'll take a surgeon that's a complete jerk over a nice surgeon any day, because if they've got that job even as a jerk they've got to be good at their jobs. I want results. I'll handle hurt feelings some other time.
The truly compassionate surgeons will want to improve their skills because they care about their patients. They care if they develop complications and may feel terrible if they do, the jerk may not. Being a jerk may mean that the surgeon can rise to the top, but it may not be due to surgical skill at all, they may be better at navigating politics etc.
This seems like an incredibly poor line of reasoning.
Hospitals are often desperate for surgeons. The poorly mannered ones are often deeply unsatisfied, angry at the grueling lives they've opted into, and the hospitals can't replace them. The market is not exactly at work here.
Dude you removed my right thumb I was in for an appendectomy!?
You are so right! I ignored everything you asked for. I am so sorry. I am administering general anesthesia now, then I will prepare you for your next surgery.
But two facts are also true: a) diagnosis itself can be automated. A lot of what goes on between you having an achy belly and you getting diagnosed with x y or z is happening outside of a direct interaction with you - all of that can be augmented with AI. And b), the human interaction part is lacking a great deal in most societies. Homeopathy and a lot of alternative medicine from what I can see has its footing in society simply because they're better at talking to people. AI could also help with that, both in direct communication with humans, but also in simply making a lot of processes a lot cheaper, and maybe e.g. making the required education to become a human facing medicinal professional less of a hurdle. Diagnosis becomes cheaper & easier -> more time to actually talk to patients, and more diagnosises made with higher accuracy.
Unfortunately is this not likely to happen. More like:
Diagnosis becomes cheaper & easier -> more patients a doctor is expected to see in the same period of time as before
Even if your statement is true, it's questionable. People also tend to prefer hearing what they want to hear to hearing what they need to hear, and rank the former interaction higher.
Basically, tech's favorite feedback mechanism, customer reviews, cannot actually be relied upon to tell you how good something is.
I don't need to "talk to a human", I need a problem with my meatbag resolved.
> humans need other humans and human problems can't be solved with technology
WTF are you talking about? Is this bait? You can't possibly mean this. Yes humans are social creatures, but what does that have to do with medicine? Are you talking about a priest, a witch doctor, a therapist? Because if you're not, that sentence is utter BS.
A) nice chatty friendly and cool doctor and can diagnose correctly 50% of the times. B) robotic ai that diagnoses 60% correctly.
What you chose? If you have a disease than can kill your, the ai is 20% more likely to help you and probably prevent. I can’t see too many people choosing human doctor. Anyway I’m sure there will be people that will chose doctor with 10% correctness vs a 100% ai no matter what.
I time is clear there very little human element.
I know. I know. Part of it is that talking to patients on average is useless but still this can’t be really used for an argument against AI.
Still doctors can have a more broad picture of the situation since they can look at the patient as a whole; something the LLM can’t really synthesize in its context.
theyre also going to tell you things other than just what your insurance is agreeing to.
a robo doctor will be corrupt in ways that a regular doctor can be held accountable, but without the individual accountability