Blease, C., Kaptchuk, T. J., Bernstein, M. H., Mandl, K. D., Halamka, J. D., & DesRoches, C. M. (2019). Artificial Intelligence and the Future of Primary Care: Exploratory Qualitative Study of UK General Practitioners’ Views. Journal of Medical Internet Research, 21(3), e12802. https://doi.org/10.2196/12802
The potential for machine learning to disrupt the medical profession is the subject of ongoing debate within biomedical informatics and related fields. This study aimed to explore general practitioners’ (GPs’) opinions about the potential impact of future technology on key tasks in primary care. Perceived limitations [of AI] included the beliefs that communication and empathy are exclusively human competencies; many GPs also considered clinical reasoning and the ability to provide value-based care as necessitating physicians’ judgments… However, some GPs believed that the failure to adopt technological innovations could incur harms to both patients and physicians… Overwhelmingly, GPs considered the potential of AI to be limited.
Why it matters: This paper was published in 2019 which, by most standards would be considered ‘recent’. Here are a few quotes from the study participants, just to show how quickly things change (I’ve singled out examples related to diagnosis and communication, although most of the participant responses read something like what I’ve included below).
- “Multiple participants expressed skepticism about the capacity of technology to undertake processes related to clinical reasoning and diagnostic judgments.”
- “Technology will never be satisfactory as patients are looking for that interaction and dopamine squirt (doctor is the drug) which can only be achieved through empathic continuity of care”
- This is the first time I’ve seen the phrase, “doctor is the drug”, which is wrong on so many levels.
- “Please hurry up with the technological advances to take away some of the crap that I still have to sort out – then I will be able to get back to proper diagnosing and doctoring.”
In contrast, here are some findings from a recent Google DeepMind paper:
- “The differential diagnoses provided by AMIE were more accurate and complete than those provided by board-certified primary care physicians, when both were evaluated by specialist physicians.”
- “Patient actors and specialist raters both evaluated AMIE’s performance to be higher than primary care physicians on metrics related to empathy and communication skills.”
My key takeaway: 5 years ago, when these findings were published, most of the quotes in this paper were accurate in how they described the technology, and the views expressed by participants were not unreasonable. Looking back, they haven’t aged well. It’s a stark reminder that things are changing very quickly.
Possible implication: The findings from these participants were almost certainly the consensus view across the field of primary care medicine. And this was quite recent in research timeframes. My question is, where will AI be in 5 years time? Professional culture isn’t prepared to adapt quickly, and we’ve got a lot of work to do.
Note: I realise that I’ve cherry picked a few 5-year-old quotes from relatively uninformed GPs, and contrasted them with the takeaways of incredibly well-funded researchers working at the cutting edge of AI in medicine. It’s not a fair comparison.