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Seattle_gldr_rdr t1_j94ljhi wrote

In America, unfortunately there is every reason to believe that treating gunshot wounds will remain a high-demand specialty.

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cmcewen t1_j955luf wrote

I’m a surgeon.

Surgical specialities aren’t going anywhere anytime soon. It’s too complex and nuanced. There are certain subspecialties that could Have issues in the future, like bariatrics. I expect medication to eventually take that over. Or maybe specialities that are only cancer, medications may ultimately be able to treat all cancer but we are really far from that. Cardiac surgery is moving more and more to minimally invasive cardiology interventions.

Of course it’s difficult to predict the future of medicine.

I say surgical over medical because if AI is gonna take over something first, it’ll be medical decision making. Taking over physical actions of a surgeon is much more difficult. Before y’all come at me, I’m not saying it’s more difficult to be a surgeon, I’m saying the computer has to take on the ability to visualize (we often do stuff blindly just by feel) and make precise movements that are required in surgery which are not in the more decision making medical specialities.

There is no concern of mine at all of mid-levels creeping into taking over surgical specialities. It’s far too difficult. Our current problem is that surgeons aren’t being adequately trained even after 5 years of residency

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scipio0421 t1_j95e3vs wrote

I was going to suggest neurosurgery. It seems like one of those fields you'll always want a human in the mix.

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cmcewen t1_j95g12z wrote

I guess I don’t see any inherent difference between neuro or any other surgical specialty. In fact if machines were gonna take over something, it would be procedures on very fixed structures like the spine or brain. In comparison to bowel, let’s say. Could a robot which knows exactly the coordinates in your brain to remove a tumor because it can read the CT scan do a better job than a human can? Maybe I don’t know,

Could a computer read an MRI and more accurately place screws into the spine? I don’t know.

What’ll happen probably is a surgeon will virtually always be there, and a computer will assist on certain components, I would guess.

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Laylasita t1_j95utf1 wrote

Thank you for showing me how AI is up and coming for the medical industry.

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jazzageguy t1_j9d0god wrote

Aren't surgeons lately using robotic tools in the course of their work? Not to replace them, obviously, but as tools esp in, e.g., laparoscopic procedures? Is there a logical progression whereby robots do more functions, and is there some stopping point that prevents them from becoming autonomous?

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cmcewen t1_j9dacjg wrote

I do robotic surgery.

As it stands, the robot does not make any decisions or do anything at all. It purely does the movement we do with our hands. Sort of like a controller to a video game. That’s all it is.

So for it to make decisions is a massive step. But who knows! Maybe some day!

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jazzageguy t1_j9dbqop wrote

Well yeah, that's why I said "tools" currently. But is there no slippery slope apparent, whereby it assumes more and more functions, e.g., opening, closing, handing you instruments, etc?

Everything you do is predicated on a base of knowledge and experience, right? Is it inconceivable that some and eventually all of that knowledge and experience could reside in an AI database, with the obvious advantages of being continuously updated, and available to practitioners outside the developed-world mainstream of medical information?

With both lower- and higher-level functions increasingly automated.... well, the logical conclusion suggests itself.

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cmcewen t1_j9dcg74 wrote

If I know one thing it would be to never assume we know what is possible in the future.

But I can safely say that AI and robotics is not anywhere close to autonomous surgery right now. But who knows in 30 years where things will be.

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jazzageguy t1_j9dcwog wrote

I hope it's not rude to say this to a surgeon, but in 30 years I very much hope for surgery to be rare, and for most diseases to be prevented and/or treated by genetic manipulation. Future generations will look at surgery as we look at bloodletting.

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jazzageguy t1_j9dde7m wrote

By "diseases" I include those of aging, and aging itself. I don't see why cell death should be the norm after we figure out how to keep cells healthy. I think the present human lifespan is a historical accident, limited because in the resource-limited past we had to make room for new generations, and the idea of a finite lifespan has, so to say, outlived its usefulness.

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cmcewen t1_j9dft2y wrote

No offense taken. I spend half my day talking people out of surgery

I suspect There will always be surgery. Some problems are simply a mechanical problem that can’t be fixed any other way. How can a hernia be fixed without surgery? It’s a structural issue. How can dead bowel be fixed without removing it?

Surgery will always be a component, but you’re right that it’ll always be changing. And we already do much less surgery on people than we used to and we use minimally invasive techniques.

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jazzageguy t1_j9dgina wrote

I didn't say NO surgery. Do we really do less than before? I hadn't known that.

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ledow t1_j95m539 wrote

America's one of the few places in the world where people would ask this question intending to "prosper" from their medical skills.

I want a doctor who wants to help people, not make a profit.

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pmaurant t1_j95wkmz wrote

Ugh!!! This same attitude is why teachers get paid dirt. “They are doing it for the kids and passion for the job.”

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kevdogger t1_j95zlh6 wrote

Hospital administration and insurance companies love this attitude. Make all those save the world doctors do all the work and we'll reap the profits while cutting their reimbursement at same time. I mean they are only in it to help people

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ledow t1_j961yli wrote

Which is why the solution is to FUCK THOSE ORGANISATIONS OFF out of healthcare.

There should NOT be profit in healthcare. In fact there should be "loss" on a spreadsheet. Huge losses. Because the gain is not spreadsheetable, but from a generation of healthy people who can all "afford" to go to a doctor.

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kevdogger t1_j9633jy wrote

Huge losses in Healthcare?? So yeah Im sure that particular area will be ripe with innovation in the future.

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ledow t1_j963iln wrote

Are you confusing healthcare provision and R&D?

I think you need to look outside the US, where insulin isn't thousands of dollars, generics are widespread, and most medical innovation occurs while also GIVING IT AWAY to the populous.

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kevdogger t1_j96424e wrote

You can't run Healthcare at a huge loss..HUGE..and expect a viable future. Sure point to insulin that's been around a long time and generics that represent old drugs...however where are new meds and treatments that haven't even made it to market yet? Even modern day equipment..pacemakers, joint replacements, stents, robots..they all cost money.

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ledow t1_j96rp2g wrote

Sure you can.

You run it as a service, not as a for-profit industry.

Like the majority of the developed world.

You should not be PROFITING from sickness. Break-even at best. And that's far too fine a balancing act. You SPEND MONEY on healthcare to get more productivity out of your populous... it's literally a loss-leader. Like education, the other example.

Education is a 100% loss industry. You shouldn't be charging kids to go to school, and you spend all the money you do have on their education, and combat wastefulness.

Welcome to "What life is like outside of shitty 'everything's about money' America".

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kevdogger t1_j983rk2 wrote

Healthcare can't be a lost liter. Are you aware what percent of gdp in America Healthcare takes? It needs to break even at a minimum. Education payed for by either federal government..or mostly property taxes for grades k-12. What taxes would you like to raise to offset Healthcare losses? Nothing unfortunately is free

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ledow t1_j9b2f94 wrote

Yes.

https://data.worldbank.org/indicator/SH.XPD.CHEX.GD.ZS

More than just about every other developed country on the planet, including all of those with nationalised healthcare, even when adjusted for GDP, population, etc.

That's PRECISELY my point. You're spending shit on insurers because you want the insurers to profit, and if you just spent LESS but on nationalised healthcare, you'd do better and nobody would be profiting from sick people.

Your healthcare is among the most expensive in the world not because it's the best (far from it), but because you're the only first-world nation not to have nationalised healthcare and the only one to let health insurance dictate how it works, to their profit.

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jazzageguy t1_j9dcg2e wrote

Here's something that's free: Single payer health care and a rational system like the whole rest of the world has would save America approximately half of the money it now spends on its stupid, wasteful, ineffective health care system. Free money in the trillions!

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kevdogger t1_j9dd0qq wrote

Jeez I hate assumptions like this without studies or some specific economic analysis even if referenced. Obama care was supposed to save a lot of money and if you were alive around the time the bill was being debated the cbo had an extremely hard time calculating cost of the bill since they couldn't model a lot of assumptions. Estimates varied wildly and as expected when looking at the costs retrospectively the original estimates were not close to the actual costs of implementation. When the word trillions is thrown around my eyes start to glass over and say..here we go again.

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jazzageguy t1_j9deqv0 wrote

What do you mean "even if referenced?"

"Without studies or economic analysis?" My God, what rock can you be living under, to be unfamiliar with all the published studies and analysis of this? There are literally hundreds. ALL saying the same thing. Consult Dr Google and take a look.

Or, just look at the health care systems of EVERY OTHER DEVELOPED COUNTRY IN THE WORLD. They have all done what I said. They all spend less than half the money per capita of America. Many if not most have better outcomes by every measure, including longer lifespans and less chronic disease.

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kevdogger t1_j9dg1x5 wrote

Thanks bud..you just proved my point.

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jazzageguy t1_j9dga25 wrote

No, I just disproved your points.

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kevdogger t1_j9dn4xc wrote

Telling someone to Google it..you sir are a true warrior..and clearly the irony was lost on you..yet again proving my original point

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jazzageguy t1_j9slqw2 wrote

Inasmuch as your original point was that you're utterly ignorant and clueless, and determined to remain that way, I'm happy to have helped you prove your point. But really the credit belongs to you.

Seriously, what are you saying? That I should have put LINKS in my reply to spoon feed you? Would you have read the material I linked? Of course not.

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jazzageguy t1_j9di8sq wrote

If your point was that you're completely ignorant of the issue, you already made it.

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jazzageguy t1_j9dj94h wrote

The ACA was never intended to "save a lot of money" but to get health care to a lot of people. It worked and continues to work. Unfortunately, Republicans demanded that it "pay for itself," unlike any other govt undertaking, and thus it had to include a tax on higher income people, which inspired hysterical and deafening opposition, and probably required some "cooking of the books" because stupid Republican demands like "balancing the budget" and "paying for itself" (that they only require of Democratic projects) are impossible to achieve. (Did the Iraq and Afghanistan wars pay for themselves? Hardly!)

Trillion is just a number. It exists whether you like it or not.

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