Bob Wachter

I will admit to you, I have de-skilled on map reading.

can no longer read a map.

The question about de-skilling in medicine is complicated.

There are parts of de-skilling, for example, the physical exam we're definitely not as good at as we used to be.

There are elders who lament that partly because the physical exam was about its clinical value and partly about the laying on of hands and sort of the connection between the doctor and the patient.

But I think it gets romanticized.

I would rather have a CAT scan than my lung exam to try to figure out what's going on in your lungs or your abdomen.

So there are certain parts of de-skilling that just happen because the new technology is better than what we used to do, and you no longer need the technology.

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…