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Despite the revelation on HN that there are high error rates in medicine, this problem has been well known for a long time.

So here is the easy problem: using information technology to help doctors deliver high quality healthcare.

Here is the hard problem: replacing the entire health system with technofantasy buzzword medicine.

If no one can solve the easy problem, why should we listen to anyone who thinks they can solve the hard problem? That's the voodoo magic.

If you want to get rid of 80% of doctors, then you would need to think of how to replace the role of the doctor in the following situations, which crop up every day in the hospital:

Making the decision to stop chemotherapy balancing the risks and benefits in a patient with advanced cancer that has failed multiple lines of treatment.

Managing a patient with borderline personality disorder who tried to hang herself early that day and needs to be observed medically who is demanding at all costs to walk outside and smoke.

Managing a patient with chronic severe abdominal pain of unknown aetiology, that has had all the tests known to man, multiple surgeries etc with no result.

Managing a patient with severe emphysema who passes out at home from breathing failure, comes to ED, gets resuscitated, then rips off the mask and drives home on her scooter. Repeat this 150 times a year.

A woman has advanced cancer. She is dying, no treatment will benefit her. The family decides to keep her comfortable. Her last son finally comes back from overseas and starts demanding that everything be done to save her.

So this is the thing... Doctors do lots of things, they do tests, they think, they prescribe drugs, they do surgery etc etc... all of those can be replaced by other specialised practitioners and probably robots one day. But what they actually, really do, most of the time, is take responsibility for a patient, in the face of often great uncertainty and very imperfect science.




The OP has got something right and something wrong. Yes replacing all of healthcare with machines is not possible today. But we know that in order to capture the full benefits of a technology, usually a new business needs to be started, because old businesses are resistant to changes. That's true inside and outside of healthcare.

And about the role of doctors: Pilots do also have huge responsibility. Part of them being responsible is being able to defer themselves to checklists, to algorithms and to machines when needed, which is practically always in their profession.

Doctors resist that need. They resist checklists. They resist expert systems. They resist evidence based medicine(why else is evidence based medicine so slow ?).

How would healthcare looks if our the people who treated us stopped resisting to those factors?




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