Had an interesting conversation at work the other day about doctors. We were discussing the current situation of doctors and their likeliness to prescribe pharmaceuticals for more situations than are probably merited. One of the alternatives is to take matters into your own hands and, given the ready availability of information out there, do the research yourself to diagnose the problem and see what remedies are available.

I mentioned that Doctors should have the ability, let’s call it the wisdom, to recognize situations for what they are, and follow a course of activity even when it’s outside of the prescribed norms. In fact, most of us would presume that’s what we are getting when we go to this human doctor- a personal touch and the wisdom to see beyond the obvious symptoms.  

But this idea was immediately pushed back on, and my guess is, this is absolutely right. There are prescribed procedures for diagnosis and treatment in the medical profession. These are, at best, statistically best practices for obtaining the desired results. In other words, you go in with symptoms a, b, and c, and the prescribed diagnosis is X, with treatment Y.  

I suppose at worst, a diagnosis and treatment course would have been captured by Pharmaceutical companies and health outcomes are subservient to profits.

But at any rate, the days when a doctor could, or would, risk his practice by deviating from the norm are probably gone. Given the bean-counting that happens with insurance companies, what doctor would risk calling his own shots? Using his wisdom, or a hunch, that the prescribed course is not going to work, and the patient should do something other instead?

Maybe this still happens, I don’t know, it probably does. But my guess is that it’s less and less. Let’s face it, basic human calculations will determine that it’s safer to stay within the guidelines. IF it all goes wrong, sure the patient suffers, but at least the doctor can fall back on the security that ‘he just followed “best practices” ’. Insurance companies won’t question it, colleagues won’t question it.  

But it kind of begs the question: what’s the point of doctors?

If health procedures are a matter of plugging variables in to the machine and it spits out the most probably course of remedy, then AI can do the job much better than a human.

I’ve always rested easier on human judgment, fallible though it may be. There is something deeper to wisdom than the computation of probabilities. Even acknowledging the occasional human screwups, I’d rather have wisdom included in the process.  

But I fear wisdom is being excluded in favor of procedure and probabilities. The system itself has been reduced to it through risk assessment tools.

I will admit that I have NO experience or data to back up any of this, it’s just a conversation with some additional personal thoughts about something going on in the world today.

It’s possible doctors ARE making personal calls against the prescribed procedures. It’s possible what I’m referring to as prescribed procedures don’t really exist. I’m just guessing they do, I’m reasoning about the downstream effects.