Bob Wachter

Last year, a study published in the Lancet Gastroenterology and Hepatology Journal, one of my favorite journals for light reading, looked at this question of potential de-skilling because of AI.

Very experienced gastroenterologists who did this procedure called colonoscopy, looking up into people's colons, were given an AI colonoscopy tool, which puts a little box around lesions inside the colon that it deems suspicious and finds some things that the doctors will miss.

They had access to the tool for three months.

The doctors liked it and they benefit from it.

Then the tool was turned off.

Their performance on doing their colonoscopies fell significantly after the tool was turned off.

These were doctors who had an average of 10 years of experience doing this procedure.

So in just three months of exposure to this AI crutch, they got less good at this thing that they had been doing for 10 years.

These questions of how the AI interacts with human actors in really complex systems where the stakes are high and the AI is getting better every minute and the humans are not, I think are really fascinating.

Let's say that AI in healthcare delivery continues to improve and augment the lives of patients and physicians the way that you're describing in this book, the way that you hope it does.

I'm curious what you see that looking like, and especially how the role of the physician changes.

We did an episode…

a few years ago about what are called cobots, robots that are collaborative.

This was in nursing homes in Japan.

They were these big physical robots that could help lift a patient clean and so on.

And the finding from research around them was that the healthcare workers actually loved it, A, and B, were able to lean into what they as humans are good at.

which is dealing with patients on a human level rather than just moving them around and getting them to the bathroom and stuff like that.

So if we use that as the sort of model here, let's say for a physician like yourself or maybe someone a generation or two younger, if AI unfolds the way that you're hoping it does in 10 years, let's say, what does the physician get to do that maybe they're really great at now that some of the burden has been lifted by AI?

I think the fundamental question of AI in healthcare is not creating my note or reviewing my chart.

It is computerized decision support.