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Comment by seesthruya | Hacker News Reader

There is a national shortage of radiologists in the US, with many hospital systems facing a backlog of unread cases measuring in the thousands. And, the baby boomers are starting to retire, it's only going to get worse. We aren't training enough new radiologists, which is a different discussion.

Askl to your question on where my confidence stems from, there are both legal reasons and 'not being able to do the work' reasons.

Legal is easy, the most powerful lobby in most states are trial attorneys. They simply won't allow a situation where liability cannot be attached to medical practice. Somebody is getting sued.

As to what I do day to day, I don't think I'm just matching patterns. I believe what I do takes general intelligence. Therefore, when AI can do my job, it can do everyone else's job as well.

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> We aren't training enough new radiologists, which is a different discussion.

About that, I think the AMA is ultimately going to be a victim of its own success. It achieved its goal of creating a shortage of medical professionals and enriching the existing ones. I don't think any of their careers are in danger.

However, long term, I think magic (in the form of sufficiently advanced technology) is going to become cost effective at the prices that the health care market is operating at. First the medical professionals will become wholly dependent on it, then everyone will ask why we need to pay these people eye-watering sums of money to ask the computers questions when we can do that ourselves, for free.

I agree with you on all points. The only question is how long will it take?

The trial lawyer angle doesn't seem accurate. Did trial lawyers prevent pregnancy tests from rolling out? COVID tests? Or any other automatic diagnostic, as long as it was reasonably accurate?

Not as far as I know. Once an automated diagnostic is reasonably accurate, it replaces humans doing the work manually. The same would be true of anything else that can be automatically detected.

No comment on whether radiology is close to that yet, although I don't think a few-million-param neural network would tell us much one way or another.

Are you aware of any states in the US that have made it harder to sue doctors for malpractice?

My point, which I made poorly, is this: There's a reason doctors that went to medical school in India and trained as Radiologists in India can't read US cases remotely for a fraction of the cost of US trained and licensed radiologists.

It's not because the systems to read remotely don't exist.

It's not because they're poorly trained or bad doctors.

Itsty because they can't be sued.

No, it's because the AMA lobbies to protect American doctors' jobs, and refuses to license them to practice in the US. Of course you can still sue for medical malpractice regardless of citizenship. Trial lawyers have nothing to do with it, American doctors who don't want competition are entirely to blame.

A big wrinkle in AI evangelism is that proponents don’t understand the concept of human judgment as a “learned” skill - it takes practice and AI models / systems do not suffer consequences the way humans do. They have no emotions and therefore can not “understand” the implications of their decisions.

For context, generative AI music is basically unlistenable. I’ve yet to come across a convincing song, let alone 30 seconds worth of viable material. The AI tools can help musicians in their workflow, but they have no concept of human emotion or expression and it shows. Interpreting a radiology problem is more like an art form than a jigsaw puzzle, otherwise it would’ve been automated long ago (like a simple blood test). Like you note, the legal system in the US prides itself on “accountability” (said tongue in cheek) and AI suffers no consequences.

Just look how well AI worked in the United Healthcare deployment involving medical care and money. Hint: stock is still falling.

>For context, generative AI music is basically unlistenable. I’ve yet to come across a convincing song, let alone 30 seconds worth of viable material.

This one pops into my head every couple months:

https://youtube.com/watch?v=4gYStWmO1jQ

It's not really my genre, so my judgment is perhaps clouded. Also, I find the dumb lyrics entertaining and they were probably written by a human (though obviously an AI could be prompted to do just as well). I am a fan of unique character in vocals and I love that it pronounces "A-R-A" as "ah-ahr-ah", but the little bridge at 1:40 does nothing for me.

You may have missed the month or so where this[1] AI-generated track (remixed by a person, but nonetheless) dominated pop culture.

[1] https://www.youtube.com/watch?v=1uW_AUwEv-0

> A big wrinkle in AI evangelism is that proponents don’t understand the concept of human judgment as a “learned” skill

Which is ironic given how much variation in output quality there is based on the judgement of the person using the LLM (work scope, domain, prompt quality, etc.)

You say "Legal is easy, the most powerful lobby in most states are trial attorneys."

The most powerful lobby in this case is the ABR which carefully constricts coveted residency spots in Radiology to create an artificial scarcity and keep up incomes. It is the opposite of, say, technology, where we have no gatekeeper and supply increases.

The ABR will say that Medicare doesnt fund enough residency spots, but all you need to do is look at an EoB and see that a week of residency billings covers the entire cost of the resident.

IMHO the ABR isn't quite as powerful as you're indicating, but in general I agree.

For what it's worth, I started a new residency program to train more radiologist, so I do have some skin in the game.

If a teaching hospital with an existing radiology residency program wanted to add one more spot, does the ABR have any power to stop them? If Medicare offered more funding to a teaching hospital to add more spots would the hospital turn it down?

Basically, the ABR needs to approve a residency program for the residents that graduate from the program to be eligible to sit for the boards.

I don't think they would ever do it, but technically the ABR could stop them.

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