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Comment by robobenjie | Hacker News Reader

When contemplating what jobs were going to be replaced by robots, I never thought of doctors, but it now seems quite plausible, even probable.

(Not that doctors are going to be gone completely, just that their jobs will be forever changed the way that CNC has completely changed the job of a machinist)

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I wonder if doctors would become more of a service industry -- doing "patient care" (as customer service) instead of "disease care" now. Could be an improvement for the experience of receiving healthcare; definitely interesting to think about!

The doctors I know tend to think that it's at least 90% that way already (and has been for a while), at least if you're a primary-care doctor seeing patients in an office, rather than a surgeon or some kind of specialist. The typical patient isn't presenting with a rare disease worthy of a medical TV drama, and instead the main problems are patient-interaction ones: getting the right information out of them, picking treatments that the patients will be satisfied with and follow, figuring out what complicating lifestyle factors they might have, building trust with the patient and family members, etc. With the increasing influence of evidence-based medicine, where doctors are supposed to follow experimentally validated rubrics, the diagnosis itself is often semi-mechanical anyway even when done by a human.

I meant more that the metric consumers (patients) use to differentiate between doctors could in the future shift to being customer-service-based. You're right that in a lot of ways diagnosis right now is semi-mechanical, but I think there is still the perception that you have to make sure you're going to the "best doctor" in terms of treatment (they are a good doctor means they diagnosis correctly and treat appropriately) not in terms of customer service (which would be they treat me the best).

With increasing automation and crowd-sourcing of customer service, and automated interviewing becoming available to employers , and better computer vision(detecting emotions in live video , and it might be possible to detect lying automatically and maybe more precisely than humans), and the fact that larger part of medical support is done by peer groups (and probably better) i think the building blocks to provide the services you mentioned in highly automated fashion will become available.

Off-topic, but the phrase "evidence-based medicine" sounds very loaded. If not evidence, what was it based on before?? Serious question.

Theory. "We think that X comes from Y and the reasoning is ..." and then somebody else says the exact opposite, with an equally likely-sounding reasoning, and then you don't know what to do. "Evidence-based" means "shown to work - we may not know why, but at least it does".

On this topic, I recently realized the dangers in trying to propagate "evidence-based" throughout all sectors of healthcare. A nurse was complaining about a doctor questioning if a certain drug was safe for breast-feeding women (well for the child, actually). Indignantly, the nurse said "but this manual right here says it's safe! How much more evidence-based can it get!". To her, "the book says so" was "evidence". 'Evidence-based medicine' is no panacea - the principles maybe, but the hard part is in the implementation.

What's the alternative? Nurses don't trust manuals? Obviously as a society we should always strive for better science. But just like lady justice wears a blindfold, nurses should follow the manual.

Of course, that wasn't my point; my point is that when 'evidence based' becomes a mantra that is malunderstood by many, its use in inappropriate contexts devaluates the word and with that, the concept itself.

"Evidence-based" means that you tie statistical outcomes to procedures as apposed to doing what you think might be right based on your limited life experience (which is biased).

For example, let's say there is a test that checks for a birth defect that must be treated or it will result in infant mortality. Let's also say that the test causes infant mortality one time in 10,000. Whether you perform the test has to do with the statistical likelihood that the fetus will have the birth defect - if the likelihood is less than the probability of the test killing the baby then you shouldn't do it.

'evidence based' is also used to refer to mainstream medicine as opposed to quack medicine like homoepathy and crystals.

Computers are commonly used to assist in diagnosis. You might want to look up computer-assisted diagnosis[1]. If I am to believe my machine learning lecturers, their use is actually a bit more widespread than what the wikipedia page describes.

Anyway, I think it is likely to see a transition to computers diagnosing and doctors just checking the results; at least for some areas. If you have a diagnosis and patient information I guess it isn't that difficult to come up with a treatment. I think that doctors themselves basically memorize decision trees.

[1] http://en.wikipedia.org/wiki/Computer-aided_diagnosis

I'm sure most people wouldn't expect doctors to be replaceable. But look at the process to become an MD and think about the amount of pure memorization involved. Then it all makes sense.

Once a robot doctor is ready, imagine how easy would it be to create another one. Replicate the hardware, software and copy all the data. Compare this with the amount of time it would take to make a human doctor.

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