Deep empathy: How AI can strengthen doctor-patient connections
Some experts may worry that AI will depersonalize health care, but others see its potential to deepen relationships.
- Today's rate of innovation and change has made it difficult for patients and physicians to effectively integrate technology into medical best practices.
- Experts agree that physicians need more time in their day to build bonds with patients.
- Dr. Eric Topol believes that artificial intelligence may help restore that time, creating what he calls "deep medicine."
Today's rate of technological change is as unprecedented as it is unpredictable. This speed of innovation has created medical marvels that improve and save lives. Other technologies, however, have proven more difficult for physicians and patients alike to integrate successfully into health care practices.
"Exhibit A is the electronic health record (EHR), which has made the blood of countless physicians boil with frustration," writes Michael Dowling, president and CEO of Northwell Health, in his book Health Care Reboot. Created to store, track and share patient records, "[t]he EHR can be a cruel taskmaster, demanding a doctor's attention during a patient visit and requiring numerous clicks to enter even basic data."
Physicians spend an average of six hours per workday logging clinical data into the EHR—and face-time with patients suffers. The average doctor-patient consultation clocks in at 18 minutes, and a fair amount of that time goes to logging information.
Like it or not, technology is part of the patient experience. One study found that barriers to widespread adoption of electronic personal health records will likely include computer anxiety and concerns for security and privacy.
For better or worse, technology is affecting the doctor-patient relationship. According to Eric Topol, executive vice president of Scripps Research, the most beneficial change can come if we properly navigate artificial intelligence.
Will AI replace doctors?
With AI taking on the routine work, doctors will have more time to be actively involved with patients and referring physicians.
Photo: Tom Werner/Getty Images
That may sound counterintuitive. Technology like EHRs have affected doctor-patient interactions, and when we speak of AI entering a job market, it's with premonitions of the robopocalypse. Consider America's roughly 2 million truckers, who may lose their jobs to self-driving vehicles.
Yet blue-collar jobs are not the only ones subject to AI takeover. Some jobs that require the most advanced education are more likely to become obsolete, according to entrepreneur Andrew Yang. "Doctors, lawyers, accountants, wealth advisers, traders, journalists, and even artists and psychologists who perform routine activities will be threatened by automation technologies," he writes in The War on Normal People.
Day-to-day workplace routines will determine whether AI can perform a job, because the technology can perform routine tasks faster and more accurately than people, without needing a break.
To pick one example from medical practice, radiologists spend much of their time analyzing patient films. It takes years of education to develop that skill. Even then, certain diagnoses can be tricky and human deficiencies, such as confirmation bias and inattentional blindness, can lead to mistakes.
Deep learning could streamline the process of analyzing medical images. One day, AI may be able to read more medical images more quickly and compare them to a catalog exponentially larger than anyone could memorize. It may also detect anomalies too fine for detection by the human eye. And you only have to develop an AI once, as opposed to the extensive costs of training and maintaining human radiologists.
AI is unlikely to eliminate the need for radiologists, but rather it may enable radiologists to be more actively involved with patients and referring physicians as part of the care team. We're years away from AI becoming commonplace in radiology departments. However, the principles are sound and the technology is already under development. Some day, when AI can manage standalone diagnosis for routine cases, radiologists will be free to focus on the most challenging cases.
AI will free up radiologists' time to work on the most challenging cases. Here, neuroradiologists in Paris operate on a patient affected with an arteriovenous deformation.
Photo GERARD JULIEN/AFP/Getty Images
Deep learning, deeper empathy
In Deep Medicine, Topol suggests that well-implemented AI can free physicians from repetitive tasks, providing more face time to meet, inform, reassure and follow up with patients. It can also minimize burnout and improve health care quality. Topol cites one study from the National Bureau of Economic Research that found for every extra minute a home visit lasts, risk of readmission was reduced by 8 percent.
The same gains may be possible with EHRs. Integrated AI can make it easier to log entries, consolidate records, and draw data from external sources such as a patient's smartwatch or mobile device.
"Human performance is unlikely to change materially over time. But machines will progressively outperform humans for various narrow tasks," Topol writes. "To take humans to the next level, we need to up our humanist qualities, that which will always differentiate us from machines." He calls deep learning's potential to support medical empathy and outcomes "deep empathy."
A humane pairing
Busywork and routine labor so severely cut into physician schedules that Danielle Ofri, an associate professor of medicine at New York University School of Medicine, has suggested imposing fines on hospitals that detract too much from patient face-time.
As the National Bureau of Economic Research survey suggests, health care is a field where literally every minute counts.
"Most importantly ... when people are sick, they need empathy," Topol told Big Think in an interview. "They need the person who is their doctor to be with them, to understand what they're going through, because being in pain and being sick is the loneliest thing in the world. And if you don't have a doctor that is empathic, that is the worst-case scenario. We've got to get that back."
But Topol indicates a caveat: Implementing AI in health care just as an efficiency tool would counteract potential gains in doctor-patient relationships.
Michael Dowling agrees. As he told Big Think in an interview: "A lot of publicity has been given to a lot of these [big tech] players. But the core of the care being delivered to people who are very sick is still being done at hospitals and doctors' and ambulatory sites."
And that core must be building a humane — and, indeed, human — doctor-patient relationship.
How Nobel Prize winner physicist Lev Landau ranked the best physics minds of his generation.
Rank 0.5 – Albert Einstein<img type="lazy-image" data-runner-src="https://assets.rebelmouse.io/eyJhbGciOiJIUzI1NiIsInR5cCI6IkpXVCJ9.eyJpbWFnZSI6Imh0dHBzOi8vYXNzZXRzLnJibC5tcy8yNDQ0NDY3NS9vcmlnaW4uanBnIiwiZXhwaXJlc19hdCI6MTYzNjI2NTU4OH0.FtBYC7oJz-ZOiiGC9y0Z50_JvQChmp-ONa3jhR3SuLA/img.jpg?width=980" id="d6f66" class="rm-shortcode" data-rm-shortcode-id="61288810a4f035ec2af8957fad4e9015" data-rm-shortcode-name="rebelmouse-image" />
Albert Einstein With Displaced Children From Concentration Camps. 1949.
Photo by Keystone-France/Gamma-Keystone via Getty Images
Rank 1<p>The group in this class of the smartest physicists included the top minds that developed the theories of quantum mechanics.</p><p><a href="http://en.wikipedia.org/wiki/Werner_Heisenberg" target="_blank">Werner Heisenberg</a> (1901 - 1976) - a German theoretical physicist, who's achieved pop-culture fame by being the name of Walter White's alter ego in <em>Breaking Bad</em>. He is known for the Heiseinberg Uncertainty Principle and his 1932 Nobel Prize award flatly states it was for nothing less than "the creation of quantum mechanics".</p><p><a href="http://en.wikipedia.org/wiki/Erwin_Schr%C3%B6dinger" target="_blank">Erwin Schrödinger</a> (1887 - 1961) - an Austrian-Irish physicist who gave us the infamous "Schroedinger's Cat" thought experiment and other mind-benders from quantum mechanics. The Nobel-prize-winner's <a href="https://en.wikipedia.org/wiki/Schr%C3%B6dinger_equation" target="_blank" rel="noopener noreferrer">Schrödinger equation</a> calculates the <a href="https://en.wikipedia.org/wiki/Wave_function" target="_blank">wave function</a> of a system and how it changes over time. </p>
Erwin Schrödinger. 1933.
Satyendra Nath Bose. 1930s.
Enrico Fermi. 1950s.
Rank 2.5<img type="lazy-image" data-runner-src="https://assets.rebelmouse.io/eyJhbGciOiJIUzI1NiIsInR5cCI6IkpXVCJ9.eyJpbWFnZSI6Imh0dHBzOi8vYXNzZXRzLnJibC5tcy8yNDQ0NDcwNy9vcmlnaW4uanBnIiwiZXhwaXJlc19hdCI6MTY0NDE1MDIxM30.Eg6tca61EredHxjqNH29HY3UeJbgBVa1nA13EhXTooU/img.jpg?width=980" id="90f86" class="rm-shortcode" data-rm-shortcode-id="0f1e6c5e13263a77b2061e1191fd8baf" data-rm-shortcode-name="rebelmouse-image" />
Lev Landau. 1962.<p><strong>Rank 2.5</strong> is where Landau initially ranked himself, rather modestly, thinking he didn't produce any foundational accomplishments. He later moved his prominence, as his achievement mounted, to the higher <strong>1.5.</strong></p>
- Anxiety levels are increasing due to the pandemic and political uncertainty right now.
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- These six books covers anxiety's physiology, environmental factors, and potential treatments.
You’re Wired for Anxiety. And You’re Wired to Handle It | Anne Marie Albano | Big Think<span style="display:block;position:relative;padding-top:56.25%;" class="rm-shortcode" data-rm-shortcode-id="006926deaed2698d42ef27cba83f173a"><iframe type="lazy-iframe" data-runner-src="https://www.youtube.com/embed/mUv37ttgQVE?rel=0" width="100%" height="auto" frameborder="0" scrolling="no" style="position:absolute;top:0;left:0;width:100%;height:100%;"></iframe></span><h2>Anxious: Using the Brain to Understand and Treat Fear and Anxiety - Joseph Ledoux</h2><p>Neuroscientist Joseph Ledoux has written <em>the</em> go-to book for understanding everything about anxiety: how it arises in consciousness, its physiological manifestation, reshaping psychotherapy, environmental stressors—you name it. Ledoux argues that you must treat the outward symptoms <em>and</em> inner causes if you want to holistically address anxiety. He points out that uncertainty about the future (and how to prepare for it) is a common trigger for anxiety disorders, which puts 2020 into perspective. </p><p style="margin-left: 20px;">"Patients with panic disorder…have a hypersensitive suffocation alarm system, which falsely detects a dangerous level of CO2 and lead to hyperventilation, which in turn produces an actual rise in CO2 (due to short, fast inspiration). The resulting dizziness and light-headedness lead the person to misinterpret the physiological changes and worry and dread follow in the panic-stick person."</p><h2>The Upside of Stress: Why Stress is Good For You, and How to Get Good At It - Kelly McGonigal</h2><p>Health psychologist Kelly McGonigal flips the anxiety script on its head in this inspiring and motivational work on the advantages of stress. Anxiety is part of life—we've known that since Freud, and intuitively, long before (Kierkegaard had a few things to say as well). What if you can reframe that physiological energy and use it as a catalyst for action? McGonigal offers plenty of ways you can do just that. </p><p style="margin-left: 20px;">"One of the effects of the biological stress response is to make you more open to your experience. You feel things more, and your ability to notice expands. You are more sensitive to other people and to your environment."</p><h2>My Age of Anxiety: Fear, Hope, Dread, and the Search for Peace of Mind - Scott Stossel</h2><p>Scott Stossel, a longtime editor of <em>The Atlantic</em>, has suffered from crippling anxiety for years. This half-memoir, half-exposé offers a compassionate gaze into the personal and societal complications of anxiety. Stossel investigates the many attempts at therapy, from the common to the outlandish. Most importantly, he offers real-world advice for controlling and managing symptoms. </p><p style="margin-left: 20px;"> "Conscientious people who were highly neurotic tended to be more reflective, more goal oriented, more organized, and better at planning than average; they tended to be effective, 'high-functioning' workers—and to be better at taking care of their physical health than other workers."</p>
Photo: Lightspring / Shutterstock<h2>The Trauma of Everyday Life - Mark Epstein</h2><p>In this beautiful handbook for life, psychiatrist Mark Epstein puts Buddhism into action. He claims humans are all traumatized in some capacity, which creates lasting and often subconscious anxiety. Epstein uses the vast toolkit of Buddhist philosophy to reengineer trauma as a catalyst for transformation. The first step is not only striving for what is good and pleasant. You have to face trauma head-on. If you do, Epstein assures us, the world is yours. </p><p style="margin-left: 20px;">"The key, taught the Buddha, lies in not taking trauma personally. When it is seen as a natural reflection of the chaotic universe of which we are a part, it loses its edge and can become a deeper object of mindfulness."</p><h2>How Emotions Are Made: The Secret Life of the Brain - Lisa Feldman Barrett</h2><p>We don't react to situations, writes psychology professor Lisa Feldman Barrett. Rather, we constantly create our reality. It only feels like reacting because of how deeply our patterns are imprinted. Fortunately, patterns are malleable. In this spellbinding book about the nature of emotions and human consciousness, Barrett leads the reader through the historical construction of emotions, assuring you that you don't need to be the victim of your mind. You are the author of your experiences. </p><p style="margin-left: 20px;">"[Emotions] are not triggered; you create them. They emerge as a combination of the physical properties of your body, a flexible brain that wires itself to whatever environment it develops in, and your culture and upbringing, which provide that environment." </p><h2>Wayfinding: The Science and Mystery of How Humans Navigate the World - M.R. O'Connor</h2><p>There's something beautiful about getting lost. Not only does it make you notice your surroundings, it activates parts of your brain that remain silent when you default to using Waze for navigation. Science writer Maura O'Connor's exquisite book reminds us of what we've lost in an automated world and the anxiety this "ease" adds to our lives. Of course, she also offers solutions that keep you mentally engaged and emotionally healthy. </p><p style="margin-left: 20px;">"Mapping is an act of committing to memory the experience of bodily movement and reenacting it. It's a kind of performance, like telling a story."</p><p>--</p><p><em>Stay in touch with Derek on <a href="http://www.twitter.com/derekberes" target="_blank">Twitter</a>, <a href="https://www.facebook.com/DerekBeresdotcom" target="_blank" rel="noopener noreferrer">Facebook</a> and <a href="https://derekberes.substack.com/" target="_blank" rel="noopener noreferrer">Substack</a>. His next book is</em> "<em>Hero's Dose: The Case For Psychedelics in Ritual and Therapy."</em></p>
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