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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.
The virus is unlike anything many people have ever experienced.
- The public Facebook group, Survivor Corps, is a place where long haulers and survivors congregate.
- Months after recovering from COVID-19, some are suffering from joint pain, hair loss, and cognitive issues.
- These cautionary tales are important in a county where many remain skeptical over the dangers of this virus.
Coronavirus - The Latest: The Covid-19 'long-haulers'<span style="display:block;position:relative;padding-top:56.25%;" class="rm-shortcode" data-rm-shortcode-id="73d1813a9b48841241c01857476e48b4"><iframe type="lazy-iframe" data-runner-src="https://www.youtube.com/embed/kUyKpu-djdc?rel=0" width="100%" height="auto" frameborder="0" scrolling="no" style="position:absolute;top:0;left:0;width:100%;height:100%;"></iframe></span><p><strong>I've been out of the hospital</strong> from COVID-19 for four weeks now and started having severe pain in my big toe, almost like I stepped on a piece of glass or have a severely ingrown toenail—I don't and there's no cut or intrusion. Now my toe is really swollen and red. It hurts to walk or put any pressure on it. Is this what's called COVID toe, and what's the protocol?</p><p><strong>I am on 18 days in bed</strong> with COVID. Luckily, I've been able to manage this horrible beast from home (so far). I actually thought I was feeling better yesterday, and then today I'm going in another direction. I'm having terrible pain when I breathe (right side), and I'm exhausted. I just finished Augmentin, and a week prior, a Z-Pak. I have an inhaler. Today, my doctor wants me to start a Medrol Dosepak (steroids). Has anyone else tried this and has it helped? I'm desperate to try anything right now as long as I can get better. Please give me your thoughts on the steroids; I'm seeing mixed reviews in here.</p><p> <strong>I've been sick with COVID symptoms</strong> for 22 weeks. I'm not getting better. My original symptoms haven't gone away, and I just develop new ones every few weeks. I read an article on three immune responses to this virus. 1) Overactive immune response 2) Normal immune response 3) little or no immune response.</p><p>I am having little or no immune response to this virus.</p><p>It's taking over my body slowly. My primary doctor can't help me. My family and husband don't believe my symptoms and I have nowhere to turn. </p><p>I am so frightened.</p><p><strong>How many of you are experiencing hair loss</strong>, especially hair loss after 5 months? I'm shedding like a dog. </p><p><strong>I had COVID in June</strong>. At least 15 straight days in bed. No smell, no taste except certain spices. I've been diagnosed with two eye conditions now. Fatigue won't go away. Simple things like unloading the dishwasher or taking a shower exhaust me; I need to sit down. Has anyone recovered from these symptoms? If so, how long did it take?</p><p><strong>Has anyone experienced increased joint pain</strong>, specifically in your hands, after COVID? I've had some joint pain in the past, but never this much. It's been four months since I had the virus and the pain seems to have increased since then. [<em>147 comments on this, nearly every one verifying joint pain, especially in hands, ankles, and elbows</em>.]</p>
Medics wait to transport a woman with possible Covid-19 symptoms to the hospital on August 07, 2020 in Austin, Texas.
Photo by John Moore/Getty Images<p><strong>I had COVID symptoms for 2.5 weeks</strong> in March (could not get tested). I was a lot better for two months and then started the whole ordeal again 70 days ago (and am still sick). I have been to the ER twice and told that they think I have COVID. My clinic nurse said the same thing, as did my friend, who is an Urgent Care doctor.</p><p>I have had weeks where my fever went away and other symptoms decreased. But several times now, it comes back full force with a vengeance. The roller coaster is depressing. </p><p><strong>I was fortunate enough to be accepted </strong>into the Mt. Sinai post-COVID treatment program and was really happy to have some experts keep an eye on my long-term effects. Four months after COVID, my EKG came back normal, my antibodies high, and my bloodwork normal. My next tests were a lung function test and CT scan to see if there's long-term damage from the pneumonia. I just got a letter from my health insurance company, Oxford, rejecting the cost of the CT scan. I'm so disappointed. Is anyone else having their COVID treatments rejected by health insurance?</p><p><strong>I'm new here and it looks I'm one of the youngins</strong> in the group (19 btw). I got COVID about a month ago, and I got out of quarantine about a week-and-a-half ago, and I still have yet to see any of my friends. I wouldn't say I'm super popular but I do have a lot of friends, so I thought most of them would want to see me. I was super wrong. The stigma around COVID, especially with the younger demographic, was a joke before I got it in my friend group. Every single one of my friends didn't take it seriously and thought it would never appear in anyone they knew. When I got the virus it sent them all into shock and a couple of them hated me saying it was all my fault telling me that I shouldn't leave my house for a couple months and to not talk to them until next year. Now that I'm fully recovered I thought some friends would want to see me, but actually nobody does. </p><p><strong>Rapid heart rate when standing</strong> (160s-170s). Advice on how to deal with it? Twenty-three days from a positive test. Fever is pretty much gone but I'm trying to get back on my feet, literally. I'm kind of at a loss—whether this is temporary or I should ask my doctor for certain tests. My heart rate is elevated even when lying down (and is tolerable) but even more elevated when sitting. Seems like this isn't just "fatigue."</p><p><strong>My husband recovered from COVID</strong> last month but has been in a lot of pain. Weak and tired all the time. He gets tingly fingers and hands and feet and his ankles feel weak, like his bones are brittle. Has anyone else had this? He's rolled his ankles two or three times since and this has never happened before. His body just feels worn out and exhausted all the time, like he's a 70-year-old man, and he's only 34.</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 dofollow">Facebook</a> and <a href="https://derekberes.substack.com/" target="_blank" rel="noopener noreferrer dofollow">Substack</a>. His next book is</em> "<em>Hero's Dose: The Case For Psychedelics in Ritual and Therapy."</em></p>
Researchers are using technology to make visual the complex concepts of racism, as well as its political and social consequences.
- Often thought of first as gaming tech, virtual reality has been increasingly used in research as a tool for mimicking real-life scenarios and experiences in a safe and controlled environment.
- Focusing on issues of oppression and the ripple affect it has throughout America's political, educational, and social systems, Dr. Courtney D. Cogburn of Columbia University School of Social Work and her team developed a VR experience that gives users the opportunity to "walk a mile" in the shoes of a black man as he faces racism at three stages in his life: as a child, during adolescence, and as an adult.
- Cogburn says that the goal is to show how these "interwoven oppressions" continue to shape the world beyond our individual experiences. "I think the most important and powerful human superpower is critical consciousness," she says. "And that is the ability to think, be aware and think critically about the world and people around you...it's not so much about the interpersonal 'Do I feel bad, do I like you?'—it's more 'Do I see the world as it is? Am I thinking critically about it and engaging it?'"
President Vladimir Putin announces approval of Russia's coronavirus vaccine but scientists warn it may be unsafe.
A new coronavirus vaccine on display at the Nikolai Gamaleya National Center of Epidemiology and Microbiology in Moscow, Russia.
Credit: Alexander Zemlianichenko Jr/ Russian Direct Investment Fund via AP
Medical workers draw blood from volunteers participating in a trial of a coronavirus vaccine at the Budenko Main Military Hospital outside Moscow, Russia.
Credit: Russian Defense Ministry Press Service via AP
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