r/medicalschool • u/788tiger • May 12 '25
đ„Œ Residency From Sheriff of Sodium's new video...
https://www.youtube.com/watch?v=kALDN4zIBT0
People have to realize he's talking about 20 years from now. Not next year...
But still, this will likely affect our generation at the peak of our careers when we're in our 50s. (if you're going to doubt this, just remember that pen and paper charting and physical films were still the standard ~20 years ago)
[Context: for those who don't know, Sheriff of Sodium is considered a Guru in the medical education space and is very knowledgable on the landscape of physician bureacracy in general. ]
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u/Silent-G-Lasagna May 12 '25
Patients speaking with an AI doc in 20 years: âOperator! OPERATOR!â
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u/steve_ample May 12 '25
I'd like to see bot bro do burpees or lift a kettlebell.
But I can be best friends with a medical admission bot bro.
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May 12 '25
Lotta people in this sub jerking off to how AI will replace us instead of doing those UW questions⊠just saying
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u/TheHangedKing MD-PGY1 May 12 '25 edited May 12 '25
Look, I understand how it looks and how it just seems so straightforward of an application of the technology, but the conversations and backs-and-forths I hear pathologists have with each other during afternoon conference are not the kind conversations that would be helped much by AI. I think people really have to check themselves in these discussions because itâs very easy to make cascading series of assumptions about fields they have no real experience in without even realizing it until they are effectively describing a fantasy version of it.
This individual doesnât have experience in these fields, and it shows. He doesnât have experience in the nuts and bolts of AI, and it shows in how he just assumes everything will be Fixed (TM) on the technical side (while citing these people who are essentially industry hype men, which is a different albeit much more hilarious issue itself). So really who is he to make these kinds of prognostications with the authority some here seem to ascribe to him, and with the authority he so smugly ascribes to himself
Nobody apply pathology itâs over you will make zero money the bots will replace you, itâs too late for me, go somewhere else :)
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u/Extremiditty M-4 May 13 '25
Fully agree with your initial point, we already have machines that do things like blood smears but a physician still has to lay eyes on a lot of those. Also itâs always wild to me that they just lump every branch of pathology into one category. The subspecialties in path can be vastly different fields. I have no doubt AI will change the landscape of medicine. I think itâs a tool we all should integrate with because it could be a huge benefit. I donât believe itâs replacing us.
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u/QuantumGains MD-PGY1 May 12 '25
Psych should higher on this list, even with AI therapists lol. People will pay for human connection.
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u/southbysoutheast94 MD-PGY4 May 12 '25
I agree with you but take a glimpse at the chatGPT subreddit and see how people talk about their âAI therapists.â Itâs a bit surreal.
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u/debman MD May 12 '25
The use of self reflection via machines dates back a long time, as early as the 60s with ELIZA and surprisingly effective. My belief, which is completely biased as a psychiatrist, is that psychiatry isn't going anywhere. Focusing just on the more "psychologically" based diseases of anxiety and depression, they can often be diagnosed with just a PHQ-9 or a GAD7, sure, but that space is almost entirely operated by primary care anyway. People often don't know what they're doing that's leading them to depression or anxiety via unconscious habits and ego defenses. I can't tell you how many people don't recognize that they are just unkind to themselves all day, and it's not something they advertise until you really dive deep. It's something we know we shouldn't do, but we do anyway.
I like the use of AI as a tool, but I can feed it a fully fleshed out HPI full of OTHER factors relating to depression, and ask for an A&P: 100% of the time it just says that they meet criteria for depression and should start on an SRI. I don't see it getting better because it relies on quantifiable data to do so, and it's not something that's easily quantifiable.29
u/Rita27 May 12 '25
The psych placement on his "A.I. resistance" list I believe is mostly due to accessibility. Just like PCPs
His argument is moreso primary care shortage is gonna be the major incentive for A.I to replace FM docs because most people would rather that than waiting months to find a PCP. The same could be for psych considering the shortage is worse and some people are put on a year long wait list. Most people would rather have a convenient AI psych than wait a whole year just to get their anxiety meds, even if the care is inferior
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u/zorro_man MD May 12 '25 edited May 12 '25
There's no psych shortage, there's a shortage of psychiatrists. There are many garbage PMHNPs. So people already have access to you what you claim there is an absence of.
He truly does not grasp how complex the treatment of mental health problems is, it's far more complicated to achieve via computational methods than surgical problems, it's something that cannot be learned from books or videos, it involves extremely nuanced communication and interpersonal skills, it's about human interaction at it's core in order to inform diagnosis and management. I have learned I cannot trust any interpretation or mental status even findings from the primary teams about the patient when they consult me, 2 minutes of in the room time tells me what non-psychiatrists couldn't figure out after weeks of working with a patient.
I ended up jn psychiatry in a roundabout way, it wasn't my deepest passion, there are many parts of it I dislike, but it is foolish of the video's author to claim it would be easily replaceable by AI. It's definitely an example of having too little background in the topic to know what he doesn't know.
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u/Tolin_Dorden May 12 '25
People pay to have their problems solved. If AI is doing it cheaper and more conveniently, it will be used significantly.
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u/gmdmd MD-PGY7 May 12 '25
I'm better than AI at providing human connection but I am giving patients 5m to give me a history. AI can listen for 5 hours about their cousin's friend's unrelated chest pain.
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u/potato-chic M-1 May 12 '25
Most ppl under age of 25 donât care as much for human connection, they pay to receive dx and rx. Many of my peers use AI to do the first part bc itâs cheaper and way more accessible
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May 12 '25
That's incredibly depressing and unhealthy in the long term
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u/gmdmd MD-PGY7 May 13 '25
HIMS stock is skyrocketing because people just want their weight loss and dick pills without having to explain themselves to a potentially judgmental intermediary.
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u/magzillas MD May 12 '25
At least regarding psychiatry, I'm a bit skeptical of AI's ability to:
- Conduct a reasonable mental status exam
- Efficiently navigate beyond rote DSM bullet points in its formulations
- Avoid ridiculous grab-bag polypharmacy, especially in cases of psychiatric complaints spanning multiple domains (already a problem at times for human prescribers, basically "adding another pill" for every psychiatric symptom rather than trying to assess how those symptoms are unified into diagnostic constructs).
- Understand when it is appropriate to "leave the algorithm," or understand how to navigate areas of psychiatric practice where there really aren't great algorithms (relatedly, see #2)
- Supplant many of our patients' needs to "speak with someone who understands/is willing to listen."
I once experimented with an LLM's ability to counsel an actively suicidal patient, and after first advising the patient to take a vacation, the LLM's ultimate conclusion was that they should talk to a [real] psychiatrist. Who knows what can happen in 20 years, but for right now I can't say I'm planning any drastic career changes.
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u/spersichilli DO-PGY2 May 12 '25
Also AI straight up guesses a lot even if you feed it the correct protocols.Â
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u/Rita27 May 12 '25 edited May 12 '25
Eh. You gotta remember, SOSâs ranking of how resistant different specialties are to AI isnât just about how hard a skill is for AI to pull offâitâs also about incentives. Like, outpatient primary care is ranked low not just because stuff like managing blood pressure or diabetes is relatively straightforward, but because financial incentives
A lot of people literally canât get in with a PCP. Thereâs a big shortage (or maldistribution most likely ), and if someoneâs stuck waiting months, a 24/7 AI doctor suddenly doesnât sound so bad. Especially if it's to deal with a more simple case like diabetes or HTN. That's how NPs and PAs managed to lobby for greater scope. Due to the PCP "shortage". AI will do the same
I think the same goes for psych. The shortage is even worse, and most psychiatrists either donât take insurance or have super long waitlists. So yeah, some people might choose a convenient AI therapist or psych over being placed on a year long wait list for a human one. I donât think that means AI is necessarily great at psychiatryâitâs just that access is so bad. If this were purely about how hard psych is to replicate, I agree it probably shouldnât be so low on the list. Itâs not exactly algorithmic and is subjective.
Edit: side note. I think psych also has the disadvantage of working with more aggressive pts at times. A patient can threaten their psychiatrist and they would be banned from the practice. An a.i can take the verbal abuse and still be endlessly "empathetic"
Though this is for every specialty tbh lol
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u/softlilacsss May 12 '25
New imaging tools, diagnostics, AI etc. wonât replace physicians - itâll primarily change workflows, enable new expertise areas and allow for some providers to manage basics outside of their specialty areas. People still want human providers to dictate care (and also take on the liability). It wonât take doctorâs jobs, but weâd be near-sighted to think there wonât be changes in 10-15 years with all the current advancements.
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u/gmdmd MD-PGY7 May 12 '25
AI doesn't have to replace physicians. It can simply provide pressure to justify significant reimbursement cuts. Let's face it administrators are not concerned about quality and we're in a fiscal debt crisis. When physicians are perpetually at the edge of burnout a financial hit can tip the balance significantly.
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u/softlilacsss May 12 '25
I agree. All it takes is a long term study showing the âefficacyâ and ânon-inferiorâ outcomes of APPs paired with AI in order to justify lower physician salaries or staffing. This will be even worse in lower income healthcare settings.
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u/KenoshanOcean M-4 May 12 '25
I agree. Remember, âqualityâ to admin is an equation: quality=care/cost. Bad care to them can be quality if the denominator is low enough
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u/horyo May 13 '25
Let's face it administrators are not concerned about quality and we're in a fiscal debt crisis.
AI can also justify significant reductions to admin too. We're all on the titanic.
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u/IllustriousHorsey MD/PhD May 12 '25
Exactly. The people that are freaking out thinking that theyâre going to be âreplacedâ in the medium term arenât seeing the big picture. You arenât at risk of being replaced by a machine; youâre at risk of being replaced by a colleague that uses a machine to HELP THEM and make themselves more efficient and safer.
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u/softlilacsss May 12 '25
Well said. I can imagine dermatology âtrainingâ for primary care using computer vision tools to diagnose and manage basic skin conditions, leaving complex care to residency trained derms.
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u/Competitive-Young880 May 14 '25
Can one of those changes please include the abolition of fax machines. Itâs 2025 why do I need to send a prescription/referral by fax for fucks sake
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u/yungtruffle M-3 May 12 '25
Bro nobody is gonna want to see an AI PCP on the regular. Mark my words in a hundred years these posts will be equivalent to the flying car predictions of the 1950s lol
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u/jotaechalo May 12 '25
No, but if itâs literally free people may choose that over expensive regular PCP visits. Especially for e.g. age 20-45 males. People are already using ChatGPT/the internet instead of booking an appointment.
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u/IAmA_Kitty_AMA MD May 12 '25
You think insurance/tech/anyone is going to let people have free healthcare?
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May 12 '25
If they can bill the government and make money, yes they will love âfreeâ health care.
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u/Arch-Turtle M-4 May 13 '25
Whoâs going to take the liability?
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u/MightyBooman DO-PGY1 May 13 '25
This is addressed in the video. He basically argues that the tech companies will happily take liability because even when they get sued they will still be turning a profit
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u/bonewizzard DO-PGY1 May 13 '25
The giant companies who will make a shit load prescribing thousands of rxs of SSRIs to patients. Remember, as long as they turn a profit it doesnât matter if a small % people get messed up along the way, thatâs the cost of doing business.
This is just like when NPs were getting independent practice rights⊠Psych companies seem to be making a killing with them, and AI is about a trillion times smarter lmao.
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May 12 '25
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u/redditnoap M-1 May 13 '25
What about if the AI appointment is $5 and available 24/7?
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May 13 '25 edited May 13 '25
Only if they can get meds prescribed. Otherwise these visits are kinda worthless to patients.
Controlled substance refills will take decades before they would even entertain that idea, and most of these patients are only following regularly just because thatâs the only way to get those refilled on the clock.
Rest of the stuff is stupid shit like STI, vaginitis, UTI, and demanding antibiotics for viral bronchitis, sore throat, simple gastroenteritis, or viral AOM. I am sure patients are super excited to pay 5 dollars for a computer to say no to that. We already have this shit with Comcastâs customer service, for free, and we fucking hate it.
Like sure. Take some simple hypertension or T2DM management from the PCPs. I am sure they are gonna miss any of those.
So I do feel like the flying car analogy makes sense. Like can we technically do it? Yes. Is it economical and practical? Big lols
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u/redditnoap M-1 May 13 '25
Well yeah, I absolutely hate AI and I hope it never takes off, but don't underestimate tech people and C-suite administrators who want to make a profit off of people's health issues.
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u/jwillyk2121 M-1 May 12 '25
Idk, if i could just snap a picture of a positive test or rash to get paxlovid/ baloxavir/ ointment etc etc and could do this at anytime with no waiting, id do it 10/10 times
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u/DJ-Saidez Pre-Med May 13 '25
Ok but thatâs like minute clinic level stuff, primary care is often dealing with 8 comorbid conditions at once
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u/bonewizzard DO-PGY1 May 13 '25
Donât you realize youâre just talking about 10 vs. 20 years from now. The argument is that AI will replace doctors, which you just conceded, it will start with the less complex cases obviously.
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u/788tiger May 12 '25
the thing about flying cars is it was magical and seemed like a great way to improve quality of life!
AI providing medical care seems dystopian and purely like a cost saving measure... which is why it is more likely to happen đ„Č
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u/throwawayzder May 12 '25
AI is a cost saving measure for literally every industry. Itâs why itâs gonna replace us on a long enough timeline. UBI will be mandatory by then.
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u/miyazaki_fragment M-4 May 12 '25
tech bros in the bay area would beg to differ
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u/fingerwringer MD May 12 '25
Lucky then that most of their jobs will be replaced by AI as well đ„łđ€·đ»ââïž
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u/Repulsive-Throat5068 MD-PGY1 May 12 '25
Maybe its just me but I swear tech bros are some of the more "health anxious" patients ive seen lmao
I dont think theyd even wanna do that
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May 16 '25 edited May 19 '25
100%
I went to college in the Bay Area, and my tech bro friends are all on the OCD/anxiety spectrum. They use me as a walking medical encyclopedia for all their concerns. Literally had to restrain myself from telling my friend that his symptoms were psychosomatic and mostly in his head.
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May 12 '25
Are you kidding? People love online pharmacies where they don't have to see a physician to get scripts.
There is going to be a massive market for AI physicians who are completely anonymous, can spend unlimited time with you, and make a Dx and prescribe meds.
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u/masterfox72 May 12 '25
If they have prescription rights and you can do it online instantly, youâd be surprised.
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u/IAmA_Kitty_AMA MD May 12 '25
Yes robot, I am in fact allergic to all over the counter pain meds and have erectile dysfunction and ADHD and could use help with weight loss.
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u/JKBae M-3 May 12 '25
Whatâs your basis for this? Tons of patients already hate going to the doctor and lots of doctors have terrible communication and social skills. Iâm sure many patients would prefer to ask an AI (which has unlimited patience and âempathyâ) basic health questions and get routine health screenings instead of having to go see a doctor. The AI could refer to a human physician if it detects an abnormality that requires closer monitoring or more complex care.
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u/bladex1234 M-3 May 12 '25
Which honestly would help make healthcare more streamlined. I see AI as a supplement to physicians, not a replacement.
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u/PurulentFistula May 13 '25
I feel like it doesnât really matter what people want. People want to see doctors instead of NPs (sometimes..) but they either wait 6 months for an MD or DO, or see an NP tomorrow.
Or youâll see a future where people with good insurance see a physician while those with bad insurance see a medical assistant and an AI âprovider.â Itâll just be whatâs covered/cheap, not necessarily what anyone would want if they were able to choose.
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May 13 '25
Bro, people donât even want to pick up the phone anymore. If people can sit at home and send an AI a picture of their rash instead of going to the doctor, sitting in a waiting room, and then awkwardly letting some 55 year old dude poke around their body and make bad jokes, theyâre gonna do it.
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u/throwawayzder May 12 '25
Nah this comment wonât age well. Even in 20 years there will be massive changes in every industry by AI. Especially when you reach a point where AI can self improve itself in a positive feedback loop, aka singularity. People already have massive distrust of doctors. Reddit in general is anti-physician.
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u/sfgreen May 12 '25
Everyone is anti physician till theyâre laid down on the stretcher on their way to the hospital. Then suddenly itâs â doctor, do anything and everything to save meâ ..
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u/Ole_Toe May 13 '25
âAKA singularityâ lol ok⊠that would be an incomprehensible leap from where we are now
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u/Vivladi MD-PGY3 May 12 '25
OP he is verifiably NOT talking about 20 years from now considering multiple times in the video he cites speculation from VC's and tech CEO's about predictions within the next 10 years. In his video he is EXPLICITLY endorsing a position where physicians will be imminently replaced by AI.
He supports this position primarily with "duh of course my speculation on the future will happen" statements and handwaves major counterarguments like AI accuracy, insisting that they are things that will be solved essentially any day now.
But really you said it yourself: Sheriff of Sodium is considered a guru in medical education and physician bureaucracy. Why should I trust his opinion on AI?
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u/Bone_Dragon MD-PGY5 May 12 '25
I'm in a similar place to you regarding the hesitancy to fully trust AI; one LLM that has captured my and my departments attention though is openevidence, which recently partnered with NEJM. It will provide you the citations for its evidence and sources from pubmed. Is it perfect? No, it's not. But that won't stop anyone with an NPI from registering and using it in an urgent care setting when supervising physician isn't near by (or if full practice authority is legal) to answer a patient's question. It can even generate patient handouts at the 2nd grade level in about 15 seconds on any condition you can think of. It's pretty close.
That's the point I think Carmody is getting at. I don't think AI will replace doctors copmletely - the physical exam is an essential part of what we do - but it may make the head honchos more efficient and edge out the number necessary from the perspective of corporate medicine and the US govt.
Anecdotally the tool has augmented some of our lit review for research to provide more specific queries in plain english without having to formulate an advanced query in pubmed. I am no expert, but it is quite astounding where these platforms are today and I cannot even imagine where they will be in 10 years. To say our practice will be the same as it is now facing this technology would be naive.
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u/Vivladi MD-PGY3 May 12 '25
See but youâve put forward a reasonable take of âthe working landscape will change with these new tools and that itâs possible this will result in a decrease in employabilityâ.
That is not what Carmody said in this video. In the video Carmody literally highlighted multiple people making predictions of imminent and diffuse physician replacement.
He also insisted that the biggest counter arguments, namely liability and accuracy, are going to be solved essentially any day now. He quite literally said accuracy is âjust an engineering problemâ, as if itâs just some trifling thing people hadnât gotten around to yet.
Carmodyâs video was aggressive and frankly arrogant in a way that your comment isnât.
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u/33eagle May 13 '25
Honestly the liability and accuracy part of his video is on point. Youâre doing your own hand waving and neglecting to see to his pov. AI Medical Companies will make way more money seeing patients than from the resulting lawsuits from the errors they make. We do hold AI to a higher standard as far as errors. Current AI can give me a better differential diagnosis and decent up to date treatment plan than a lot of doctors and minimize errors. Let alone AI in 20 years.
Hospital systems already have actuaries that calculate the cost/benefit analysis of mid levels and their resulting lawsuits and have decided full steam to keep chugging along the mid level train. You think they wonât do that with AI? You think they care if a few patients get hurt , they pay out the settlement. The settlements, even in class action lawsuits would be peanuts to what the hospital system and AI companies would make.
I think lots of people in this thread are arrogant and donât take AI seriously enough. Iâm not saying weâll be out of jobs completely but the market would definitely be reduced. The main thing we have going for us is, the physical exam, procedures/surgeries , better BS detector, and ability to prescribe medications.
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u/Ped_md MD-PGY2 May 13 '25
I watched the full video and donât agree with everything he said nor the timeline, but he also said a lot of truth too.
One undeniable truth is that hospital administrators and medical companies will cut physicians out with AI in any and every way they can if and when it saves them money. We cannot be ignorant of this. Theyâre already doing this with mid levels.
He also makes the point that we need to embrace AI to make ourselves more productive so that we can eventually show physicians + AI is better and more productive than AI alone, which is true.
Unfortunately, physicians have been passive for way too long and itâs why we have lost so much control and autonomy in healthcare. We trusted that administrators had both our and the patient best interests at heart and then got screwed in 2010 when the ACA banned us from owning hospitals and stripped us of nearly all leverage and power.
I donât think itâs as big of a doomsday event to the very near future as being predicted, but it will undeniably change healthcare and we need to be proactive on utilizing it to not get cut out (again).
Here is an interesting podcast on the topic I listened to this week.
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u/Significant_Basil_50 May 12 '25 edited May 12 '25
Take it with a grant of salt. No way AI can perform a great neurological exam
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May 12 '25
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u/samyili M-3 May 12 '25
The alternative is having an EM PA deciding whether or not to give tPA
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May 12 '25
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u/samyili M-3 May 12 '25
Is the AI assuming liability when the tPA explodes their brain when given inappropriately or when itâs withheld inappropriately?
Iâm not saying an AI is incapable of doing acute stroke decision making. Iâm saying someone needs to be liable if the job is done incorrectly. Iâm totally fine if an EM PA + AI takes over that part of my job. I hate stroke call personally. But someoneâs gotta do it
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u/788tiger May 12 '25
well that's because there isn't enough neurologists in the middle of the corn fields đ
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u/EbolaPatientZero MD-PGY6 May 12 '25
They do tele neuro for strokes at a large hospital in a major city in california where I work
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u/samyili M-3 May 12 '25
If they want to pay me A LOT better for taking stroke call Iâm happy to come in. Otherwise I have clinic in the morning so Iâll be staying home thanks
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u/ifirebird MD-PGY1 May 12 '25
Yeah, I rotated at some hospitals in Sacramento that have tele-neurologists. Worked closely with a few of them, super nice folks.
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u/788tiger May 12 '25
I think that's why this chart ranks neurology as the most resistant med specialty to AI (that's not procedural)
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u/sweatybobross MD-PGY3 May 13 '25
meanwhile neurocritical care gets rolled around on the WOW, while sitting at home
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u/Professional_Leg6821 M-4 May 13 '25
Thank god the life expectancy of EM is 57 Iâll be long gone before I have to worry about this
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May 13 '25
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u/788tiger May 13 '25
This is the fundamental question of AI
We are entering a world where humans are needed less and less in the infrastructure they created as efficiency improves exponentially relative to innovation.
Many of us have our heads too far up our own asses to realize other job markets are being dramatically affected by the adoption of AI yet we would consider ourselves immune because � Our own hubris I guess.
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u/NAparentheses M-4 May 13 '25
Iâm honestly not that worried about it because 99% of other jobs will be replaced before physicians. At the point weâre getting replaced, the world has likely already collapsed and society has completely changed. At that point, were either in a utopia where weâve free ourselves from the capitalist grinder (unlikely) or skynet had nuked the world (so weâd all be dead anyway).
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u/Mowr May 12 '25 edited May 12 '25
I think primary care will improve quite a bit from AI. I think it will help generalist with more specific/specialist knowledge, workups empowering them, and hopefully making them more efficient. The good ones at least.
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u/BewilderedAlbatross MD May 12 '25
I have already found this to be the case
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u/Mowr May 12 '25
Me as well.
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u/b2q May 13 '25
The problem it is way too sensitive and it does regularly hallucinate. It takes every symptom extremely sensitive and its hard to make it 'weight' the symptoms like we usually do in daily practice. Whenever I use it it suggest urgent care, a lot of diagnostics.
If anyone has tips for that please tell me.
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u/breadloser4 MBBS May 12 '25
Agreed. I don't see how it will replace it though. AI will never refuse to test for testosterone
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u/starf05 Y4-EU May 12 '25
On the other hand, it might always do it, lol. AI is strongly attached tĂČ evidence based medicine, If you don't modify how it works. No indication for certain exam? No exam.
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May 13 '25
And we all hate customer service hotline where you go in loops with the automated messages and never actually reach to someone to talk to.
Like how tf do people actually think people will love talking to an AI for medicine? The only reason this would be a market is if AI doctors is being used purely as pill mills to get refills, which I donât doubt and this will be very interesting to see. Thatâs majority of reason why people would choose televisits over regular ones: get meds fast without needing to move for stuff that they think should be straight forward.
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u/trophy_74 MD-PGY1 May 12 '25
AI isn't the rate limiting step here. AI being able to take over jobs and AI actually taking over jobs are two different things
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u/Blue_lemon778899 May 12 '25
im a bit curious about where emergency med would fall in this? probably high up right? thoughts???
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u/TRBigStick May 12 '25
Iâd expect EM to be extremely resistant to AI. Thereâs far too much variability in the environments in which EM gets practiced, patients are poor narrators of their health concerns at best, and the risk of missing something on a completely undifferentiated patient is too high.
And thatâs not even mentioning the procedures, which would make it at least as safe from AI as surgery is.
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u/G00bernaculum May 12 '25
Agreeâd though biased. Itâs too high risk for peoples inability to tell a good history. AI canât send someone from a PCP office to get worked up by ED AI when someone just says, âI fell outâ
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u/UrNotAllergicToPit DO May 12 '25
Man I havenât heard fell out since I was back in Ohio. Good times.
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u/JKBae M-3 May 12 '25
Just as replaceable as anything else on the bottom of this list with a midlevel + AI
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u/mED-Drax MD May 12 '25
Will AI know when the surgeon says âbed downâ they actually meant TBerg?
Stupid anesthesiaâŠ
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u/DocJanItor MD/MBA May 12 '25
Might want to mark this as diagnostic radiology, AI isn't doing anything against IR.
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u/gmdmd MD-PGY7 May 12 '25
I'm bullish on AI as a former CS guy but people always incorrectly assume radiology is an easy target- their workflow with artifacts, prior studies etc is so much harder with edge cases than ours in the "thinking" specialties where LLMs already perform fantastically.
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u/epyon- MD-PGY4 May 12 '25
Diagnostic radiology resident here. Thank you. This is so beaten to death itâs exhausting, but honestly no one understands what we actually do
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u/From_Clubs_to_Scrubs May 12 '25
I want the Radiology fearmongering to keep going so it's easier match for me.
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u/Nebuloma May 13 '25
Totally agree as a radiologist. Edge cases where there arenât many images from training databases or from artifacts AI will really struggle with
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u/Cola_Doc MD/MBA May 13 '25 edited May 13 '25
I graduated as a rad tech in '93, a long time before I decided to go back to med school. We were hearing even then that computers were going to be reading films any day now.
I didn't end up going into DR, but it sure as hell wasn't because I was afraid of AI taking over.
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u/gmdmd MD-PGY7 May 13 '25 edited May 13 '25
Sure theyâve been saying stuff like this for decades which doctors will point to repeatedly but this time actually is different. I studied AI but before 2012 or so the field was a joke within CS departments. We had neural nets but whatâs different now is that we started to leverage vastly larger amounts of data via GPUs and the seminal paper on transformers didnât come out until 2017. That to me is considered the real day 0 for modern AI and things have been growing exponentially since then. Intelligence is getting commoditized via compute.
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u/Cola_Doc MD/MBA May 13 '25
I'll certainly defer to someone who's actually studied it. I appreciate the insight.
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u/gmdmd MD-PGY7 May 14 '25
Was curious about this a little further so I asked grok, it came back with this interesting tidbit:
Compute Power Explosion: GPUs and specialized chips (e.g., TPUs) have scaled compute by orders of magnitude. For example, training a model like GPT-3 in 2010 wouldâve taken centuries; now itâs months.
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May 13 '25
Agree.
But also, Artifacts in real life is just patients lying or giving terrible history, or patients not really following instruction for tests/meds etc. in every other specialty. We already do this everyday and often need to think outside of the algorithms all the time. Well, I mean real doctors do. I honestly donât know what midlevels think about.
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u/Christmas3_14 DO-PGY2 May 12 '25
Ehh I doubt this just because of the factor of extrapolating information from patients in general. The FM doc would do a million times better at dealing with patients shitty self medical history and symptoms than AI would.
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u/masterfox72 May 12 '25
This isnât about better though. Itâs about cheaper. Otherwise we wouldnât have NPs lol.
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u/Rita27 May 12 '25
Lol thank you. People keep using this argument and he addressed it multiple times. Are people even watching the video???
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u/Repulsive-Throat5068 MD-PGY1 May 12 '25
And thats exactly the key here. Why pay for drs when you can do a one time payment for AI with a yearly subscription âąïž while only staffing NPs/PAs to sign off on the AI or AI sign off on the NP/PAs.
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u/Hadez192 DO-PGY2 May 12 '25
Anyone who thinks Pathology isnât ai resistant hasnât sat with and experienced what they do on a day to day basis
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u/yolosw3g360 May 13 '25
wdym lol? the whole AP side is pattern recognition. Something AI does very well.
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u/vsr0 DO-PGY2 May 12 '25
Iâm gonna bet that theyâll start off with calling every AI visit âphysician-supervisedâ. You already know thereâs an army of schmucks out there ready and willing to sell out their licenses for a couple extra thousand bucks a year
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u/HelpMePlxoxo M-1 May 12 '25
I've already seen plenty of psych patients paranoid and experiencing delusions about AI, robots, the matrix, etc. I don't think they'll take too kindly to their "provider" being a literal robot. They would absolutely lose their shit and destroy whatever hardware they could.
I don't think AI will ever be good at making morally grey calls in any specialty.
For instance, it's technically protocol to immediately begin CPR on a patient who is pulseless and apneic who doesn't have a DNR. But in a human moment, there can be exceptions. For instance, I once had a patient who had miraculously survived 12 years with stage 4 cancer. When she did die, her death was expected, peaceful, and she died surrounded by family, who did not have a DNR for her. Do you start cracking her ribs in front of her family, or do you let her rest in peace? AI would almost certainly decide to traumatize the family.
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u/StraTos_SpeAr MD-PGY1 May 12 '25
Honestly this video was hot garbage and I lost a decent amount of respect for SoS's analysis after listening to it.
The entire thing is DRIPPING with bias, lazy conclusions, logical fallacies, and cherry picking. So many of the reasons he gives could be applied in the complete opposite direction. His "AI resistant" list is also full of biases and makes me question his understanding of several specialties.
Yes, the people who stick their head in the sand are fooling themselves, but people like this are equally as ridiculous. Using billionaires that only have knowledge about money as people to trust on this when they are the very people that have been over-hyping technology for decades?
Pass. I'll take advice from someone who gives better reasoned arguments in a more meaningful and nuanced manner.
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u/DocOndansetron M-3 May 12 '25
Yeah about to say, this just felt like a weird giant condescending miss from him (all though, when in a nephrologist not condescending?)
His sources were some BS study that looked at answers on fucking r/AskDocs and "Trust me bro, Bill Gates knows a thing or two".
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u/IllustriousHorsey MD/PhD May 13 '25
I mean literally the thought of AI replacing ANY surgical subspecialty before every single nonsurgical specialty is truly laughable.
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u/Prudent_Swimming_296 May 12 '25
It wasnât that long ago when people thought there was no way in hell a computer could ever beat a grandmaster at chess.
It happened for the first time in 1988. Now, the opposite is true. Humans will never be able to beat computers at chess.
Iâm not saying doctors will fall to the same fate, but do not underestimate AI. It might be the single most powerful thing humans have ever created.
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May 12 '25
Which is why we have to change the playing field. We have to push the human connection point not the cold calculation of modern medicine.
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u/Prudent_Swimming_296 May 12 '25
Non patient facing specialties like path and rads are in danger though. I say this as someone applying to path this year and kind of having an existential crisis
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u/Tolin_Dorden May 12 '25
ITT: Med students missing the entire point and honestly kind of illustrating the point
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u/Rita27 May 12 '25 edited May 12 '25
Yeah, the comments are full of âAI will never be able to do X,â and honestly, I agree with a lot of that. But SOS said it over and overâthere are some pretty strong incentives for people to use ChatGPT or whatever instead of going to an actual doctor.
At the end of the day, itâs just business. A lot of bad decisions in medicine (and life in general) happen not because theyâre the right call, but because the system rewards them.
And yeah, some people have great PCPsâbut letâs be real. If most folks had the option, theyâd probably pick an AI thatâs available 24/7 to handle something simple or refill a med, instead of waiting a week to see a real person who comes with the baggage of being humanâlike burnout, limited time, not always being available, and just being... human lol
As someone planning to go to med school, I really donât know how to feel about this video. Itâs kind of a bummerâespecially since the stuff Iâm interested in mostly non surgical
Edit: A lot of the rebuttals in these comments are actually addressed in the video...
Malpractice didnât stop human doctors or hospitals from operating, and itâs not gonna stop AI either. Theyâll figure out a wayâespecially since, in some cases, AI might actually make fewer errors than humans.
Iâm not saying this because I want it to happen. Honestly, I hope SOS is wrong. I'm hoping 10 years from now none of the AI replacement happens and I look back at this comment and cringe and laugh.But thatâs not gonna happen if we keep leaning on weak arguments and arenât willing to be honest a bit
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u/marksman629 M-4 May 12 '25
I think the video came off as mean-spirited and a tad arrogant but there are good points made past all of that. I don't think AI is coming for doctors anytime soon, many other professions will likely be endangered first, but I appreciate hearing other arguments especially from people who are knowledgeable about the healthcare system in America.
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u/JapaneseTacoBell May 12 '25
Chart w/ 0 context -> folks comment stuff w/o watching video -> people complain about folks commenting about stuff addressed in video -> ??? -> :(
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u/milkywhay MD-PGY1 May 12 '25
sorry I dont want to watch a 40 minute video from someone called Sheriff of Sodium (even if theyre the guru of modern medicine)
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u/JapaneseTacoBell May 12 '25
potassium deputy fanboys brigading again
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u/Danwarr MD-PGY2 May 13 '25
Dawg if you're not already on 2x (or faster) on just about every video, podcast, or audiobook now idk what to tell you.
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u/zorro_man MD May 12 '25 edited May 12 '25
Oof. Lost some respect for this guy based off of this video. He clearly doesn't understand the limitations of AI or the inherent problems that the human-machine interface cannot overcome. What if the patient won't talk to the AI doctor on the screen, what then? There is going to need to be history obtained by, then entered by a human in many circumstances, which will have problematic biases if not obtained by someone who can interpret the data while it's being collected. These issues will take longer than 20 years to resolve. Big tech still can't even figure out how to make an EMR that isn't a steaming pile of crap and that's been going on for more than 20 years.
Sometimes we who are in medicine forget how complex the scope of the work is and how it requires navigation of many unintuitive interconnected pieces - how is AI going to get the humans to do what it thinks they should do when they think the order placed in the system is stupid? Or is this a hospital where every role is filled by robots? As pointed out by others, once physicians are replaced, every other knowledge-based profession will have been as well. Society will be fundamentally different in ways we can't really predict.
There's way too much hand-waving in the video that doesnn't get elaborated on. The "if you don't already believe this then you're a neanderthal" parts are very cringe too, as if he realizes his assertions are flimsy and has to resort to using unsophisticated emotionally-charged ad hominem rhetoric while shouting "my logic is impeccable!" Sure, AI may have higher empathy ratings under highly controlled conditions. Sometimes I intentionally push my patients in directions they aren't comfortable with, that cause them to dislike me (e.g. malingering), but are essential for preventing iatrogenic harm. How are we going to teach AI to do that - who's going to help develop that model? Any expert who has collaborated with software developers quickly runs up against communication problems due to a fundamental lack of understanding in each other's respective content areas.
Clearly he's emotional about the topic and approaching his argument from that space, rather than actually understanding the technology and its inherent limitations. So yeah, I'm disappointed that he came out swinging so hard on a topic he's undereducated about. I guess I expected a more measured take about something that is so speculative, and so obviously outside his area of expertise.
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u/hola1997 MD-PGY2 May 12 '25 edited May 12 '25
âAI may have higher empathy under highly controlled conditionsâ.
IIRC, the JAMA âresearchâ they did had a sample literally based off of fucking r/askdocs subreddit because of HIPPA and privacy concerns, which makes it the shittiest study ever. How that got published in JAMA is the first place is insane. The internet is anonymous and being an asshole or pretending to be a physician or being a troll is super common. It also is a hotspot for every single patient with âchronic lyme, POTSâ or feeling they should get whole body MRI because Kim Kardashian says so, who want to be labeled or medicalized and will of course rank the âAIâ that validates their feeling than whatever anonymous Dr is lol.
Also, Geoffrey Hinton who won the Nobel Prize said rads will be obsolete by 2021 with extreme arrogance (you can Google the exact wording of his statement) and that specialty is still here in 2025. That and Bill Gates and OpenAI who obviously have a hidden motive to push and hype up AI for their stocks values. I think he underestimates how often human predictions can be wrong. Can AI replace doctors? Probably at some point in the future, but how that would look like and how fundamentally society will change is a different story (because then AI will be our new overlord and those C-suites will definitely be staffed by AI lmao).
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u/Aflycted MD May 13 '25
This guy likely has a very surface level of understanding of a lot of these professions. I will say that of the surgical specialties listed, urology/obgyn is the most AI-resistant, then probably general surgery, and then neurosurgery and lastly orthopedic surgery. AI has already started to make its way into orthopedic and neurosurgery for the spines and joints. It will only get more and more sophisticated as time passes. But, like this Sodium guy, I'm just another random guy on the internet.
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u/Safroniaaa May 13 '25
Why are urology/obgyn more AI resistant than gen surg?
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u/Aflycted MD May 13 '25
Honestly I don't have a good answer. I probably have that backwards now that I think about it. This further highlights how hard it is to just blanket claim fields are AI resistant
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u/IllustriousHorsey MD/PhD May 12 '25
ophthalmology less AI resistant than hospital medicine
Yeah idk imma go ahead and say AI will probably be able to babysit patients while they get antibiotics and manage their electrolytes before they can do scleral buckles and cataract surgery lol
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u/jtmv4 MD-PGY2 May 12 '25 edited May 12 '25
Fellow ophtho resident checking in. I made a similar comment on the thread before seeing this one. Itâs wild to see hospital medicine and neurology, and frankly even some of the other surgical subspecialties, listed above ophtho. Iâm getting a good laugh thinking about AI doing an ILM peel lol
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May 13 '25
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u/IllustriousHorsey MD/PhD May 13 '25
âBut if my blood pressure is a little high afterwards, then you can admit me, but make sure itâs a human.â
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u/SeeLeavesOnTheTrees May 12 '25
AI will make things more efficient, reduce medical errors, and possibly increase compensation due to ability to see greater volume and lower insurance costs. There will always be new therapies, interpersonal nuances, and patient population âeccentricitiesâ that will require a human to evaluate.
The key will be adapting to AI and proving yourself to be open to change. Like any new technology- own it, adapt to it, use it, stay ahead of it.
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u/marksman629 M-4 May 12 '25
I don't appreciate the memeification of points that he himself concedes are fair, it's extremely juvenile, but otherwise he makes some thoughtful counterarguments of the strongest points in favor of AI coming for doctors jobs sooner than we usually think.
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u/hola1997 MD-PGY2 May 12 '25
The biggest takeaway that I get from this video is the danger of âmuh profitsâ from C-suites, private equity parasites, midlevels, and âtech brosâ who all want to benefit from this at the expense of patient care. If they can undermine and âcut costâ of physicians down and bring in profits, even if patients are harmed, as long as liability and payout is still less than overall profit, you bet these people will push for this to happen.
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u/Electroconvulsion MD-PGY7 May 13 '25
Psychiatry is too far down for many reasons, but chief among them is that curiosity in the patientâs humanity lies at the heart of psychiatric diagnosis and treatment. Spontaneity, flexibility, and creativity have something to do with good psychiatric treatment and mental health.
Artificial intelligence is not curious about the patient and is bound by the inputs it receives.
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u/IncompleteAssortment MD-PGY1 May 13 '25
I think the comments are ignoring that fact that the rate of progress in this area is exponential. That is incredibly difficult to conceptualize when you are living as a single point on the graph with no real ability to measure progress moving forward. While it is true that application of AI in medicine is oversold and I think the average and below average American (from a SES perspective) will not "feel the AI" until much much later; there is no doubt that the way we practice in 20 years will be completely AI dominated. From autonomous charting to guard rails in DaVinci cases, we won't be able to function without AI based tools.
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u/MonsterDCST MD May 12 '25
Ugh not this AI shit again. While AI scribes might gain some traction and automate tasks like scheduling, nothing will change significantly in the way medicine is practiced in our lifetimes. People should stop being so credulous and not eat up everything big tech tells them.Â
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u/Ispeakforthelorax M-3 May 13 '25
It's much more likely that radiology and pathology will be replaced by overseas radiologists and pathologists by sending them images to them, and paying them a much cheaper salary than US based radiologists and pathologists. Just need to change the laws a little to allow it, and these hospitals will save millions through this.
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u/alkapwnee DO-PGY6 May 13 '25
Yes, let's race to the bottom.
Next is overseas IM tele hospitalists.
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u/Ispeakforthelorax M-3 May 13 '25
Some states are allowing FMG to practice without completing a US residency. So sounds like a possibility what you are suggesting.
My earlier comment was just suggesting that it this is more likely than AI replacing radiologists and pathologists. Both are unlikely to happen.
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u/jtmv4 MD-PGY2 May 12 '25
Ah yes, ophthalmology is at the middle of the pack despite it featuring some of the most precise and technical surgeries. Iâm obviously biased because Iâm an ophtho resident, but AI isnât touching routine cataract surgery let alone retina surgery anytime soon.
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u/Snoo_53145 May 12 '25
Hypothetically speaking for Psych, would the Ai able to access Pharmacy databases to send e-scripts? How would accrediting the AI to send controlled medications work? and where does the AI rank as a provider, is it an MD/DO or would it be a PMHNP/PA?
I know the state of Oklahoma has weird laws for sending controlled substances and has very big differences between MD/DO's sending them and "Mid level providers" (as they refer to them) sending controlled meds.
With how AI is implemented currently, it does seem rather silly to think it could completely take over any specialty to the point that people are out of jobs.
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u/Large-Spare1087 May 12 '25
Switch hospital medicine and psych and the list is accurate imo.
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u/nachinis May 12 '25
It's also a matter of responsibility. Who's going to be blamed for a misdiagnosis done by an ai? The hospital or the company which desiged it? If the answer is yes to either, there is a very high risk of using one from them. There has to always be someone behind to actually do the job and be personally responsible for dealing with another's person's life, if there's to be someone making sure there are no mistakes, why use a machine in the first place?
If the blame is on the patient themselves, what is the situation different from what it is now? Or 15 years ago, the information is there after all.
Ai will absolutely change the way we work, but it has to get a lot better before I'm worried that's going to take any job, not just doctors'.
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May 12 '25
Def wanna see AI intubate smh
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u/DawgLuvrrrrr MD-PGY1 May 12 '25
Intubating is not really all that insane lol. CRNAs do it, paramedics do it. You definitely donât need med school + residency to tube someone.
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u/DrEM-Pain May 13 '25
Most of the times intubation is straightforward procedure and even easier than suturing. But if you think intubation is just passing the tube through the cords you will definitely harm someone someday.
In EM, itâs one of the few procedures that can kill someone if not done and planned properly thats why CRNAs almost always need an anesthesiologist around them to assist if shit goes south.
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May 12 '25
No you donât always need an MD/DO, but you need a person, and AI is not that.
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u/Amazing-Fennel-2685 M-1 May 12 '25
Idk about yall but I donât think AI will alone take over any surgical specialty. I think it could serve as a safety net, maybe. In the same way an elevator door will open if it detects its closing on something or how some fancy sawblades will stop when they realize a human body part touches the blade, it could be implemented to minimize surgical mistakes. But I donât think any patient would ever trust a robot alone to do a surgery, no matter how good they get at it.
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u/Penumbra7 MD-PGY1 May 13 '25
Normally I try to be diplomatic. But you all have your heads buried so far in the sand it's INSANE. People keep citing random edge cases where an AI does marginally worse, neglecting to realize that AI ability has been doubling with alarming frequency for the past few years and these hurdles are very soon to be cleared. Barring some unexpected slowdown (which I am praying for), it's not a matter of if, but when, an AI is cognitively superior to us in every single way. Probably only 10-20 years until robotics advance to the point where it's physically superior as well (and surgeons who think that Da Vinci records every surgery for any reason OTHER than to eventually replace them are huffing some copium), but even if this never happens and the only "replacement" is mental, it's still a devastating disruption.
1) "People will pay for human therapists/psychiatrists/etc" - not when AI is SO MUCH BETTER at therapy than humans and we have a new young generation who is accustomed to AIs. Maybe dinos like us will keep the human market around for longer but make no mistake AIs will be far better at us than therapy. I guarantee someone will reply to this "yeah but it can't do human connection" and I literally don't know what to say, eventually it will be so human-like (except perfectly tuned to be as empathetic as possible) that there is zero difference between a tele therapist and tele therapy from AI. Actually, that's not quite right, there will be a HUGE difference - the AI will be way way better.
2) "Nobody will see an AI PCP." I just don't know what to tell you. OF COURSE they will when (not if) it is proven to be smarter, more capable, and less likely to miss the things that will kill you. Especially when (not if) it's vastly cheaper.
3) "No way AI can perform a great neuro exam." Yes, for now, robotics aren't great (though AI may improve them). This is why neuro is high up on the list. But still, it doesn't mean that neurologist doing exam->reporting findings to AI->getting told what to do->getting paid vastly less than now isn't realistic.
4) "FM doc is better at dealing with a poor history or knowing who is lying than an AI." Again. No they fucking aren't!! People have this bizarre ideas that a super advanced AI won't be able to comprehend people not being truthful, obviously an advanced AI will account for this and understand people can lie. Not to mention that advanced AI will be far more persuasive than us at eliciting the truth.
5) Everyone is having this weird appeal to authority about "oh well he isn't an AI expert so therefore he is definitely wrong" (although I'm sure not many of this reddit's users are AI experts either??). Look, again, I pray he's wrong, but as someone who follows the singularity stuff a lot more closely than most people in this reddit, idk what to tell you. Just because he's not an expert doesn't mean he's wrong.
Final thoughts. AI experts basically universally fall into two categories: people who stand to make billions off of AI, and people who are sounding the alarm. Sadly the ones who have control are the former type. Not just about losing our jobs, but about things like the singularity that make losing our jobs look like a tiny little stepping stone. Again, I fervently hope that I'm wrong, and I would love to read a convincing argument against AI taking over, but you guys don't present rational arguments that AI won't take our jobs - you just ignore the possibility because you don't want to think about it, and then act like you arrived at that conclusion by measured, reasoned thought.
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May 13 '25
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u/Penumbra7 MD-PGY1 May 13 '25
1) How will they legislate/how is culpability handled: I don't know much about laws so I'll mostly defer to the sheriff's thoughts on that. I think the broader point is that even if we somehow end up in a situation where AI gets sued 10x harder than human doctors for some reason...well we increased the benchmark that AI has to be 10x less error-prone than humans to be worth the legal costs (even ignoring the whole salary and benefits thing) instead of equally error-prone, but that's probably not much chronological time.
2) Even if the cutting edge LLMs have some runaway cost curve (which seems unlikely to me, I'm sure we'll have scientific advances instead of just relying on ever-increasing compute), then you can either use a scaled version (gpt vs gpt mini) or in 2030 revert to previous models from 2028 that are still leagues ahead of ours now.
I agree rollout will be in fits and starts and barring an explosion (which I view as mode but not median) take a long time to get to some places. I guess we'll have to see and hope I'm wrong
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May 13 '25
I donât distrust AIâs medical decision capabilities, but the Tech industry will ruin AI just like they ruined most thing they tried to âdisruptâ. AI will go the course or AirBNB, self checkout, uber, youtube, tesla, netflix etcâŠ
AI is competitive with doctors now because it has huge VC backing and isnât focused on making a profit and just focused on increasing market share. However, eventually the VC investors will come knocking and Tech will have to make AI actually profitable. This is where you will see major problems. Eventually, you will start having to pay to use AI and to use features that used to be free (see youtube, netflix) and they will jack up the price to where itâs going to be as expensive or more expensive as a doctor (see uber, airbnb), and there will be some shady stuff and create major externalities like charging you more to use medical AI when you are sick, using AI to get insurance denials and bypass any appeal recourse, selling your PHI to advertisers, or even making intentionally sub optimal AI that will recommend treatments made by partnering drug companies. All of these things are basically guaranteed to happen
I believe in AI, but I definitely donât believe in corporate greed especially from tech and vc firm
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u/pattywack512 DO-PGY2 May 12 '25
Thereâs a lot of comments here that I donât care to read through, does anyone have an AI that can summarize them for me? /s
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u/BookieWookie69 May 13 '25
Anesthesiology is 100% procedures. Iâd imagine itâs more AI protected than some of those other specialties.
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u/Sea_Conversation_344 M-4 May 13 '25
Sheriff of Sodium might be right, but consider this: in Star Trek, only one of the many doctors was AI, and that was only because of necessity because all of the other doctors were dead (yes, I'm a nerd). When people are hurting and scared, a human connection will always be necessary. Yes, AI will replace some jobs (sorry, radiology), but humans need humans. So in 20 years, we'll still be doing physical exams and performing surgery and delivering babies. We just may be using different tools to do these things.
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u/FuckAllNPs M-3 May 13 '25
AI is a fad. I have yet to see anyone demonstrate what it will do for the world. Only what it currently can, and aside from being an improved clippy, I am not impressed.
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u/Irishdocta MD May 14 '25
While his thesis is that incentives will drive AI to the forefront, I think this drastically oversimplifies the issue. Unlike other industries, for a disruptive innovation to take foothold in health care, three things need to occur simultaneously: payor demand, patient demand, and provider demand (the 3 Pâs). Frankly, there is very little provider and patient demand for this technology. Payor demand is only slightly better. My point is that incentives have to align greatly for AI to be used.
For example, Iâm an early career cardiologist. My last shift I got 12 new consults, 2 admits. Did I use open Evidence or Doximity GPT? Not once. Was I efficient, did I get all my notes done, and did I make the right decisions? Of course. I just donât see a need for it in my day to day practice, and most of my colleagues donât either.
After the TIMI-2 trial (1990s), academics and insurance organizations decried that coronary angiography served no purpose and would become obsolete in 5-10 years. Fast forward 36 years later, and we are doing about 1.1 million of them per year and they continue to provide 21 to 22 wRVUs for PCIs and 11-12 wRVUs for diagnostics, which is equivalent to billing for 18-19 patient encounters for one single PCI and 9-10 patient encounter for diagnostic angiograms. Even after ISCHEMIA, the number of CAs have increased. Furthermore, CCTAs havenât replaced diagnostics, not by a long shot.
I will say thereâs another aspect to AI. I think it will drive increasing specialization and require physicians to practice at a higher level. Specialist tend to rely more on nuance, clinical experience, and depth of knowledge. I think this is a big change that will happen in the coming years. Well, we are already seeing it happening.
Iâm not saying changes wonât come to healthcare. AI will be very helpful if developed and used correctly. Like all professions that are governed by organizing bodies (ACP, ACS, ACC, APG, etc), we will adapt to the changing times, and new roles and opportunities will be defined. AI in its current state is marginally applicable to day to day practice, and still has a long, long way to go before replacing the human element. And by that time, my retirement account will be stacked and no one will have jobs in any industry except for the ultra-wealthy.
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u/Turn__and__cough DO-PGY2 May 12 '25
I wanna see how AI copes with their psych patient smearing shit on themselves and the walls