80% of Doctors Jobless due to AI? No, AI Won't Beat A Clinician Armed with A Magic Bullet Medicine

Artificial Intelligence (AI) machines will replace 80 percent of doctors in a healthcare future. Legendary Silicon Valley investor?Vinod Khosla, the Sun Microsystems co-founder, made this remarks in his keynote speech at the Health Innovation Summit held in San Francisco in 2012.

Intriguing Remarks

The remarks are intriguing for investors and general consumer public, but could be irritating to healthcare professionals. At the summit, the investor challenged a room full of doctors to disagree with his argument -- a challenge that was met with silence, as reported by journalist Liat Clark from www.wired.co.uk (Liat Clark, 2012)

According to Clark's report, with no qualms about offending an auditorium filled with practicing doctors, Khosla went on to refer to common medical practice as being akin to voodoo, saying "healthcare is like witchcraft and just based on tradition" rather than data driven, as he believes it should be. Machine learning, he argues, will be a more efficient, cheaper and more accurate diagnosis tool one day, leading to a replacement of 80 percent of doctors (those in the upper 20th percentile can remain, apparently).

If that wasn't enough to ruffle a few feathers, he continued by explaining that the major healthcare disruption he is envisaging does not need to be led from within the healthcare community, but may even be more successful if driven from outside (by consumers' needs).

We would not need doctors at all eventually, the Silicon Valley tycoon added.

Doctors Do Not Deny The Sweeping Trends

Davis Liu, MD, an American practicing primary care doctor, was among the audience. Shortly after the summit, he wrote at www.thehealthcareblog.com (Davis Liu, 2012), saying he was inspired to hear from all those speakers, particularly listen to Kholsa, and he considered “Kholsa’s criticism of the health care system is completely valid”.

Human Touch Can Not Be Replaced: Doctors' Dissent

But for one thing only, Dr Liu voiced his dissent, arguing:

• Yes. Care must be incredibly simple to access, extremely convenient and intensely personal.
• Health and medical care is an incredible intersection of technology, science, emotions, and human imperfections in both providing care and comfort.
• To solve health care we need everyone to collaborate.
• There are some things that may never be codified or driven into algorthims. Call it a doctor’s experience, intuition, and therapeutic touch and listening.

Here, the argument of doctor's side was not against Khosla's prediction of the trends that AI will dramatically revolutionize the existing structure of health care system, but against Khosla's point that the revolution will only need entrepreneurs' participation with medical professionals completely shut out, as Khosla holds that to disrupt health care, entrepreneurs do not need to be part of the system or status quo, they can do it without involvement of doctors.

The doctor side's point is that AI could not replace “human touch” between doctors and patients. The voice of American medical doctor researcher Krittanawong (2018) echoed Dr Liu's dissent: AI “cannot engage in high-level conversation or interaction with patients to gain their trust, reassure them, or express empathy, all important parts of the doctor–patient relationship.”

In short, human touch, patients' trust, and doctors' empathy are three trump cards which medical doctors believe may protect them against the threats from AI technologies.

Now the question is, are our doctors in modern medicine providing enough “human touch” and "empathy" which have helped them win the patients' trust and which would render them irreplaceable by AI machines?

What Is Modern Medicine

Modern medicine started to emerge after the Industrial Revolution in the 18th century. At this time, there was rapid growth in economic activity in Western Europe and the Americas. During the 19th century, economic and industrial growth continued to develop, and people made many scientific discoveries and inventions. Scientists made rapid progress in identifying and preventing illnesses and in understanding how bacteria and viruses work (MNT Editorial, 2018).

Since the late 1900s, medical science and technology have advanced with a speed incomparably greater than at any previous time. Philosophical speculation has given way to experimentation as medicine has kept pace with the advancement of science in general. It is unjust to deny the great advance of medical knowledge along with the evolution of culture; and medicine can proudly boast of many conquests that deserve to be called marvelous.

However, there have been accompanying problems.

Triage: The Function of A Doctor

Indeed, although Khosla's view is not short of provoking, it reflects very well the facts. A doctor functions essentially a triage officer, using his or her good memory, and distributes the large quantity of various “goods” from medical research scientists to the consumer patients, with supposed minimum mistakes or errors. But AI machine for sure can do the triage job far better than human being doctors.

Less Healing, More Doctor's Livelihoods

The American physician Robert Mendelsohn, a self-described ‘medical heretic’, popularised antimedicine arguments through his books (such as the one titled Confessions of a Medical Heretic) (1979).

Dr Mendelsohn accused medicine of becoming less about healing than about the maintenance of medicine itself, especially doctors’ livelihoods.

“Doctors in general should be treated with about the same degree of trust as used car salesmen. Whatever your doctor says or recommends, you have to first consider how it will benefit him. For example, if a neonatologist tells you that high risk nurseries improve the survival rates of babies, find out if he works for a high risk nursery”, Dr Mendelsohn's condemnation was penetrating.

A Radical Monopoly with Faceless Bureaucracy

On April 28, 1982, the Royal College of General Practitioners hold its Spring Meeting in Dublin. Ivan Illich, a famous medicine critic philosopher and historian, was invited to make the opening address, which was titled ‘Medicalisation and Primary Care’ (Ivan Illich, 1982).

In his address, Illich described medicine as a ‘radical monopoly’ , and as such, medicine becomes an end of itself, rather than a tool for healing. Doctors are technicians who work for impersonal institutions. Medicine, which used to promote natural healing by working with the body, is now a practice located in a faceless bureaucracy without commitment to individuals or their personhood, relying on technical expertise rather than rapport and humanism. Medications and treatments lead to more medications and treatments, rather than true health.

Illich did not deny that much about medical advancement was good - sanitation, vector control, inoculation, and general access to dental and primary medical care. His key point is that the problem arose when bureaucratic managers and the entire emerging structure of medicine limited the freedom of individuals to choose their own care or undergo bodily healing on their own.

Decades later, the situation has yet no change. On 13 November 2015, British medical doctor Erika?schwartz wrote in The Daily Mail: Don't let your doctor kill you! Modern medicine doesn't train them to see patients as individuals (Erika Schwartz, 2015).

So the modern medicine evolved into a status quo where “human touch” and "empathy" are in the worst deficiency.

Adding Insult to Injury: Modern Medicine Is Seldom Effective

Again, in the American physician Robert Mendelsohn's point of view (1979),

• Modern Medicine's treatments for diseases are seldom effective, and that they are often more dangerous than the diseases they're designed to treat.
• The dangers are compounded by the widespread usage of dangerous procedures for non-diseases.
• More than ninety percent of Modern Medicine could disappear from the face of the earth - doctors, hospitals, drugs and equipment- and the effect on our health would be immediate and beneficial."

Dr. Mendelsohn's startling hypothesis that people would be healthier if 90% of Modern Medicine were scrapped was confirmed (A Book Review. 2002). In Bogota, Columbia, Los Angeles County, California and in Israel, when the doctors went on strike in these three different places, the death rate went down dramatically. During the month-long physicians' strike in lsrael in 1973, the doctors reduced their daily patient contact from 65,000 to 7,000. Guess what happened? "According to the Jerusalem Burial Society, the lsraeli death rate dropped fifty percent during that month.

Again, decades later, the status quo still remains unchanged. On February 22, 2017, health science journalists (David Epstein et al, 2017) wrote in The Atlantic:

• When Evidence Says No, but Doctors Say Yes. Long after research contradicts common medical practices, patients continue to demand them and physicians continue to deliver. The result is an epidemic of unnecessary and unhelpful treatments.

In 2019, professor Jacob Stegenga, a philosopher of science at the University of Cambridge in his book Medical Nihilism presents a stinging critique of medicine, arguing that most treatments do not work well, and many do more harm than good.

The Magic Efficacy and Human Touch in Ancient Healing Art

While a problematic modern medicine is frustrating both the patients and many healthcare professionals, few people today are aware that there was a healing art 2000 years ago in China which functions as primary care, with magic efficacy and intimate human touch (physically and mentally).

The efficacy of the acupuncture in ancient China as described in Chinese medicine classic Huangdi Neijing was indeed marvelous: the symptom relief of almost any illness encountered at that time happens the instant the needle is in, and the permanent cure eventually follows with a high-level of certainty. So the efficacy is not only instant (patients will feel improvement in less than 5 seconds) but was also highly reliable and consistent. It works like a magic bullet and very safe, with no side effect more than what a tiny needle pricking on the legs or arms would cause.

By at latest 100 BC, acupuncture in China had already developed into such a point that it was widely practiced as mainstream medicine. It was so popular and successful that the authors of Huandi Neijing strongly proposed that the herbs, most of them are poisonous, should be replaced by needles (LS 1 of Huangdi Neijing). I call this ancient acupuncture in China “Neijing Acupuncture” (NA).

When you read Neijing, you can always feel intensely the strong confidence of the Chinese physicians in that era with the efficacy of their needling: If the remedial effect is not instant, you just have not done the job correctly. The Lingshu 1 says:

“The therapeutic effect should happen like the wind blows away cloud (效之信，若风之吹云); …

"Those who are skilled in using needles will cure a disease easily like plucking out a thorn from the skin, brushing away a dirt, untying a knot, or unclogging a blocked drain (夫善用针者，取其疾也，犹拔刺也，犹雪污也，犹解结也，犹决闭也).

"However chronic an illness may be, there is a way to treat. Those who say 'incurable' simply lacked the skills” (疾虽久，犹可毕也。言不可治者，未得其术也) (Lingshu 1).

AI Won't Substitute A Dexterous Hand Holding A Magic Bullet

While writing this post, I am pretty sure that AI will eventually replace the current construct of modern medicine. But we don't know how soon this will happen. Many doctors working in this troublesome construct may be worrying about lost of their jobs.

But no worry. The "hidden" ancient wisdom – Neijing acupuncture, a gift from the almighty Nature or God, if its potential is fully recognized, will help you, the medical doctors, survive the unavoidable oncoming “disastrous” event.

As American family doctor Davis Liu voiced (Davis Liu, 2012): [Health] Care must be:

1) incredibly simple to access,

2) extremely convenient and

3) intensely personal.

Neijing acupuncture not only meets these criteria, but way more importantly, it is magically effective!

You will note that even a distorted very small portion of Neijing acupuncture – today's meridian acupuncture or dermatome-based acupuncture -- have already changed many conventional medicine practitioners' professional perspectives forever (Read this)! And it even helped in saving a 130 years old non-conventional medical profession which would have otherwise been history (Read this)!

AI may easily replace a triage job, but won't substitute the human touch from a dexterous hand which can perform the job of diagnostic palpation and therapeutic manipulation of a magic bullet.

Keep reading my Newsletter – The “hidden” Truth of Acupuncture Science. Knowing this truth which has been deeply buried in the dust of 2000 years will help all healthcare professionals - who started to feel the threats from AI technology - easily find their way out.

References

A Book Review. 2002, Sickening Medicine. https://www.qcc.cuny.edu/socialsciences/ppecorino/medical_ethics_text/Chapter_3_Moral_Climate_of_Health_Care/Reading-Sickening-Medicine.htm (accessed on March 5, 2023)

David Epstein and ProPublica, When Evidence Says No, but Doctors Say Yes. The Atlantic 2018. https://www.theatlantic.com

Davis Liu, MD, Vinod Khosla: Technology Will Replace 80 Percent of Docs, Aug 31, 2012. https://thehealthcareblog.com/blog/2012/08/31/vinod-khosla-technology-will-replace-80-percent-of-docs

Erika?schwartz, Don't let your doctor kill you! Modern medicine doesn't train them to see patients as individuals, The Daily Mail 2015 https://www.dailymail.co.uk/health/article-3310928

Ivan Illich, Medicalisation and Primary Care. J. Royal College of Gen Pract., 1982, 32, 463-470.

Ivan Illich, Medical Nemesis, Pantheon Books, N. Y. 1976

Jiayi Shen et al, Artificial Intelligence Versus Clinicians in Disease Diagnosis: Systematic Review. JMIR Med Inform. 2019

John Horgan, Medical Nihilism, 2019, Oxford University Press

Krittanawong C. The rise of artificial intelligence and the uncertain future for physicians. European Journal of Internal Medicine. 2018;48:e13–e14. doi:?10.1016/j.ejim.2017.06.017.

Liat Clark, Vinod Khosla: Machines will replace 80 percent of doctors. 04.09.2012, https://www.wired.co.uk/article

Robert Mendelsohn. Confessions of a Medical Heretic. 1979