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Artificial intelligence versus clinicians

BMJ 2020; 369 doi: https://doi.org/10.1136/bmj.m1326 (Published 03 April 2020) Cite this as: BMJ 2020;369:m1326

Rapid Response:

Machines vs. Humans: A tug of war in the healthcare

Dear Editor,

It is often asked, could machines replace doctors? The introduction of various new technologies in healthcare like Artificial Intelligence (AI) has heated up this debate in the recent times. We believe that there are several pros and cons to the use of these technologies in the management of patients.

The pros of Artificial Intelligence:

In recent years, AI has been increasingly incorporated throughout healthcare delivery systems. We agree with the author that the deep learning AI systems, which learn by themselves from a large set of examples, continually integrate new knowledge and perfect themselves with a speed that humans cannot match (1). Across the globe there is an acute shortage of qualified doctors and other healthcare professionals, especially in remote areas, putting patients at a disadvantage. AI may help in alleviating some of the shortages and the stresses of burnout in doctors by sharing some of their work. Automating some of the routine tasks that take up a doctor’s time, such as documentation, administrative reporting, or even triaging images, can free up doctors to focus on the more important challenges of the management of their patients (2). AI can further offer diagnoses and treatments, issue reminders for medication, create precise analytics for pathology, images, and predict overall health based on electronic health records and personal history, again easing some of the burden placed on doctors (3).

Strong advocates of AI emphasise that most symptoms of illness have physical causes and that the devotion and concern simulated by machines sufficiently replicates human forms of communication. Machines can now provide mental health assistance via chatbot, monitor patient health, and even predict cardiac arrest, seizures, or sepsis (1).

The cons of Artificial Intelligence:

AI-powered predictive analytics can surely identify potential ailments faster than human doctors, but when it comes to decision-making, AI cannot yet fully and safely take over for human physicians. In other industries, machine learning bots are often able to quickly correct themselves after making a mistake, with or without human intervention, with little to no harm done. However, there is no room for trial and error when it comes to patient health, well-being, and safety (3). The opponents or sceptics of AI argue that it is overhyped, profit driven, and not always in patients’ best interests and AI may not outperform doctors (1). Moreover, human doctors can relate to their patient as a fellow mortal, vulnerable being and gain holistic knowledge of the patient’s illness as related to his or her life. Thus doctors and other healthcare workers often establish a genuinely intimate and empathetic connection with their patients. This requires knowledge of social relationships and norms that is not easily accessible to machines (1). In addition, AI presents challenges of data privacy, security and medical errors, which are compounded by the fact that most algorithms need access to massive datasets for training and validation (2).

Balancing Human factors and Machines:

The majority of AI experts believe that a blend of human experience and digital augmentation will be the natural settling point for AI in healthcare. Each type of intelligence will bring something good for healthcare, and both should work together to improve the delivery of care (2). The increased comfort with AI technologies should not represent a decrease in the value patients place on a face-to-face interaction with an empathetic, informed, and attentive human physician. Technological advancements are rapidly changing the face of healthcare, offering a range of benefits but also some serious drawbacks. As we move further into the fourth industrial revolution, patients and practitioners alike will be keeping an eye on the latest innovations and advancements (3).

But, the most important aspect of medical management of patients has taught us over the centuries that "doctor-patient relationships can have a therapeutic effect, regardless of the treatment prescribed” and hence machines can never replace humans in totality and are only tools for assisting them and augmenting their efficiency.

Reference:

1. RamptonV. Artificial intelligence versus clinicians. BMJ 2020; 369 doi: https://doi.org/10.1136/bmj.m1326 (Published 03 April 2020)
2. Bresnick J. Arguing the Pros and Cons of Artificial Intelligence in Healthcare. Health Analytics.com. 17th September 2018. https://healthitanalytics.com/news/arguing-the-pros-and-cons-of-artifici....
3. The Dangers of AI in the Healthcare Industry [Report]. THOMAS. 7th May 2019. https://www.thomasnet.com/insights/the-challenges-and-dangers-of-ai-in-t...

Competing interests: No competing interests

12 April 2020
RAJU VAISHYA
Consultant Orthopaedic Surgeon
Abhishek Vaish
Indraprastha Apollo Hospitals
Sarita Vihar, New Delhi 110076, INDIA