I was asked to put this comment in my blog for wider distribution as a public service announcement for the historical record.
I totally disagree with Bill Gates who says AI will eliminate the need for Physicians. Years ago testifying at trial in a malpractice case I was cross examined by the opposing attorney who confronted me aggressively asking me how I could testify as an expert on something that was in no medical textbook and there was no supporting evidence in the literature to back up my testimony. My answer was 30 years of training and experience and not everything in medicine is in the literature and textbooks and I just "knew" it was the right answer and in the end my opinion was upheld and supported. Maybe AI might be able to deal with some super easy questions but Medicine will always have an "Art" to it which involves physicians with the training and experience to make the tough calls and diagnosis. For the same reason physician extenders like PA's and ARNP's can never replace fully trained and experienced MD/DO's. I spent a year as the supervising MD's in an ER and 20% of the diagnosis made by PA's and ARNP's were flat wrong and could have harmed the patient. It was not that they were not dedicated, compassionate, and ethical because they were. It was because they lacked adequate training and experience for the task at hand. Ask yourself when you are critical at risk of death who do you want taking care of you and your family? If you don't speak up and take a stand you will get what you paid for and advocated for, with silence being no advocacy and receiving unnecessary and dangerous care.
Here is another example. One night in the ER an ARNP ran up to me saying the patient in room 30 is having a stroke and we need to give him TPA. TPA is an anticoagulant meant to dissolve a clot and stop the stroke but it carries a high risk of brain hemorrhage so you need to be close to 100% accurate before you give TPA. I went and examined the patient, came out, and told the ARNP the patient has Wernicke's Korsakoff Syndrome to which she replied "What the hell is Wernicke's Korsakoff Syndrome" and can you provide me a reference to read about it. I ordered Thiamine(B1) 200 mgs IV STAT to which she replied "we don't give that a high dose IV in this ER" to which I replied "for Wernicke's Korsakoff Syndrome" you do. We gave the medication and the patient left the hospital the next morning with no symptoms and no stroke. The ARNP simply did not have enough training and enough experience to recognize the correct diagnosis and had TPA been given the patient would have received unnecessary and risky treatment and would not have gotten better until someone gave him that STAT dose of B1!
