Stuff You Should Know - SYSK Selects: Will Computers Replace Doctors?

Episode Date: January 4, 2020

With savvy and health-conscious people taking control of their wellbeing through apps and sites, technology is meeting the desire for individuals' responsibility for their health. But is the day comin...g soon when doctors will be obsolete, replaced by computers that read our health-related data to treat us? We explore these questions and more in this classic episode. Learn more about your ad-choices at https://www.iheartpodcastnetwork.comSee omnystudio.com/listener for privacy information.

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Starting point is 00:00:00 On the podcast, Hey Dude, the 90s called, David Lasher and Christine Taylor, stars of the cult classic show, Hey Dude, bring you back to the days of slip dresses and choker necklaces. We're gonna use Hey Dude as our jumping off point, but we are going to unpack and dive back into the decade of the 90s.
Starting point is 00:00:17 We lived it, and now we're calling on all of our friends to come back and relive it. Listen to Hey Dude, the 90s called on the iHeart radio app, Apple Podcasts, or wherever you get your podcasts. Hey, I'm Lance Bass, host of the new iHeart podcast, Frosted Tips with Lance Bass. Do you ever think to yourself, what advice would Lance Bass
Starting point is 00:00:37 and my favorite boy bands give me in this situation? If you do, you've come to the right place because I'm here to help. And a different hot, sexy teen crush boy bander each week to guide you through life. Tell everybody, ya everybody, about my new podcast and make sure to listen so we'll never, ever have to say. Bye, bye, bye.
Starting point is 00:00:57 Listen to Frosted Tips with Lance Bass on the iHeart radio app, Apple Podcasts, or wherever you listen to podcasts. Hey everybody, it's me, Josh, and for this week's S-Y-S-K Selects, I've chosen Will Computers Replaced Doctors. It's an episode so dated, I still wore a Fitbit when we recorded it.
Starting point is 00:01:17 No, but seriously, it is a really interesting episode, and even though we recorded it years ago, the stuff that we're talking about still quite hasn't come to fruition. So sit back and enjoy this peek into the future. Welcome to Step You Should Know, a production of iHeartRadio's How Stuff Works. Hey, and welcome to the podcast.
Starting point is 00:01:45 I'm Josh Clark, there's Charles W. Chuck Bryant. Our guest producer, Noel, is here. Yeah, Jerry needs a buffer day from her Christmas break. She can't say that. Sure, I can. No. She's at home on her buffer day in the freezing cold, because we record these somewhat in advance.
Starting point is 00:02:03 We are in the midst of the polar vortex, and yeah, everyone's just talking about how cold it is. We're back. This is our first recording after the holidays. It's literally freezing cold out. So welcome back, buddy. Thanks, welcome back to you too. Even though this will be late January,
Starting point is 00:02:18 it'll be a balmy, 16 Atlanta. I think the end of January is when this one comes out. All right, well, happy new year anyway. Happy new year to you too, and happy holidays to you. Thanks. Chuck. Yes, sir. You feeling good? You loose? You ready?
Starting point is 00:02:32 I'm loose. So you see this? You've seen this before. Yeah, your Fitbit, my Fitbit. Is that buzz marketing? Not really. It's just a really good example. I feel like Fitbit.
Starting point is 00:02:42 I'm not necessarily loyal to it or anything like that. They don't pay me money to mention them on the podcast. Sometimes I'll just be like, stop staring at me Fitbit. But no, I like it. I'm happy with it. I point it out though, because it's part of this, to me, and I don't think it's overconfirmation bias, it seems like there really is a growing desire among just average ordinary people
Starting point is 00:03:10 to be able to track their health, their well-being, their activity, and to do it easily. Yeah, we have tools now that make it, like that thing, super convenient. Yeah, and Fitbit's not the only one. There's like Nike FuelBand, there's Jawbone is another really good one. There's others that track your galvanic response,
Starting point is 00:03:33 so they're able to put that together with respiration and heartbeat, and come up with a pretty good assessment of how many calories you're burning at any given time, which is kind of a holy grail with this kind of thing right now. There's others that track your sleep. There's apps out there that let you track your mood.
Starting point is 00:03:52 There's sites like Quantified Self, which are basically like people trying to push wearable technology like this further into the future. There's entire websites like sharecare.com that are dedicated to health information and health support. Yeah, self-advocacy. Yeah, and there's this, it seems to me,
Starting point is 00:04:13 this desire to kind of say, hey, this is my health, this is my body, I wanna know more about it, you know? Totally. I don't wanna necessarily cut out doctors, but I wanna decide if I should go to the doctor if it's time or not, and I want to use data to do that.
Starting point is 00:04:32 Yeah, I imagine I have frustrated a lot of doctors because I'm one of those obnoxious people that goes in and it's like, well, here's what I think I have based on my research. There's nothing wrong with that. That is what you're an informed patient. That's exactly what you're supposed to do, and if you're getting on your doctor's nerves,
Starting point is 00:04:50 then go see another doctor. Yeah, I agree. I actually am in search of a new GP right now for those cousins and others. You got on his nerves. Yeah, other reasons too. Oh, really? Cold hands?
Starting point is 00:05:02 No, like poor bedside manner. Never seen the doctor, like here's my intern from Emory. Yeah. Which, great, you know, I love them getting experience, but I would like them both to be in there, not just like, smell you later and the doctor leaves. Well, that's another thing too. It's kind of like a doctor, okay,
Starting point is 00:05:21 let's just lay it out on the table here. What you've just mentioned and what I was talking about, if you put it all together, the medical field physicians in particular are currently in the beginning of what's possibly a really pickle of a state for them. I think a transition period. Yes, but they may be transitioned right out of existence
Starting point is 00:05:44 in large part. Yes, some may for sure, depending on who you talk to. There's like this whole question now, like what is the future of medicine? And more specifically in the case of this episode that we're talking about, do human physicians factor largely into that future? Yeah.
Starting point is 00:06:01 And the answer is, no, no, no. Yeah, depending on who you ask, like I said, there's this one guy, Dr. Kent Bottles, who he feels that GPs might go the way of the dodo and be replaced by diagnostic computers, maybe with avatars. Then there's other people like Farhad Manju, is a technical writer, his wife is a pathologist. He thinks, no, no, no, the GPs are the ones
Starting point is 00:06:29 that are gonna be in business. The specialists are gonna be out of business because computers are really good at specializing on one single thing, not maybe so good at a general practitioner thing. So there's lots of opinions out there on how much they'll be replaced and who might be replaced. Right, then Ezra Klein wrote a column
Starting point is 00:06:48 who basically, he basically said like, no, we will still need humans, but we mainly need humans to communicate to the other humans and facilitate the interaction between the robots and the humans. And we already have those, they're called nurses or nurse practitioners. Yeah, but he kind of, Ezra Klein is the one
Starting point is 00:07:06 that thought that a computer avatar might have a better bedside manner than a doctor. Well, let's give that one example. There's an example I kept finding while we were doing research for this, and it's actually in the article on how stuff works. There was a medical kiosk during a panel called Manmade Minds, colon living with thinking machines.
Starting point is 00:07:29 When there's a colon in there, you know it's serious stuff. And it was at the World Science Festival in 2011, basically this computerized avatar interacted with a woman whose baby had diarrhea. And the woman said, hey avatar, my baby has diarrhea. What are you gonna do about it? And the avatar said, well, tell me all the symptoms and all this stuff.
Starting point is 00:07:52 And the avatar decided that the baby's diarrhea, while present, wasn't severe enough to warrant immediate medical attention. So it went ahead and made an appointment with a human doctor for later on that week, and the mother said that she preferred the treatment by the avatar to the real life nurses at the hospitals where she lived in New York.
Starting point is 00:08:15 Yeah. So it is possible to create computers with better bedside manner than, say, your GP. Well, at the very least, it'll be consistent. And that's one of the things that, I'm not poo-pooing doctors or nurses, they're many, many, many, many great ones, but I've also had some pretty bad experiences
Starting point is 00:08:34 in emergency rooms and with doctors and nurses. With a computer, at least, it's a consistent, they're programmed to display empathy no matter what. They're not too busy and they're not, having a bad day. Exactly, they don't, they don't have any prejudices against you personally or anything like that. They're a computer.
Starting point is 00:08:54 They don't hate diarrhea. But humans respond to even programmed empathy, even synthetic empathy from a computer. I could see that a little bit. Like I've dove into the gaming world enough to know that the realism of a avatar can be convincing. And it's not like you think, oh, it's a real person, but it helps to put a human face on it.
Starting point is 00:09:21 Yeah, exactly. Literally. I saw a reference to a study that found people who are being treated for anxiety disorders tended to share more about their experiences and themselves with an avatar than with a human psychiatrist. Oh, it's interesting because they're not embarrassed
Starting point is 00:09:42 to tell a real person. That makes sense. I might open up more to a computer. Right, so we've got that part, like the bedside manner. It is possible that we can create machines now, and are creating machines now, that have at least equal, if not better, bedside manner than some physicians.
Starting point is 00:10:00 Okay, so bedside manner, one of the big things that doctors bring to the table, check. Computers have that. Yeah, it's different now than it was in the old days. I feel like just the whole quality of personal care has gone down. It's not necessarily the doctor's fault. There's a lot of reasons to place the blame,
Starting point is 00:10:17 but it's not like when you were a kid and you feel like you had your family doctor who knew you maybe even gave birth, not gave birth to you, but. He gave birth to you. You're my son. Yeah, exactly. Just invested, like you gotta stick with the same doctor
Starting point is 00:10:31 if you want that kind of care, I think. Right, and there's another benefit besides bedside manner that comes with that kind of care, that kind of personal care, is an awareness of your medical history. Yeah, sure. Not just that, but oh, well, your dad died of congenital heart disorder, something like that.
Starting point is 00:10:49 So you may be at higher risk of it. Totally. Just that kind of awareness has been typically lost too, even though we have medical histories and they're in our charts and they're in our files. An intimate knowledge of a patient's medical history is pretty much lost in today's modern practice of medicine. Yeah.
Starting point is 00:11:11 That's another thing that computers could conceivably top doctors on, which basically falls under the umbrella of diagnosis, or diagnostics. Yeah, I mean, there's two sides to this. There's diagnoses and treatment, and some programs, a little bit of the history, this goes back to the 1970s at the University of Pittsburgh.
Starting point is 00:11:36 They developed software to diagnose problems. Mass General since the 80s has been working on their DX plan, which provides ranked list of diagnoses. Whereas the, what's the computer, the Watson? Watson, who won a Jeopardy. Yeah, that's more based, it looks like, on treatment options than diagnosis at this point. It's both.
Starting point is 00:12:00 So they're using these for, well, yeah, but they said it's not, they haven't, I don't think they wanna leave it alone with diagnosis yet. No. And to do its thing. There's already something out there for diagnosis that's meant to support physicians. From what I understand with Watson,
Starting point is 00:12:17 if there's a doctor of the future, it's Watson. Yeah. He has a lot of advantages over not just human doctors, but other artificial intelligence healthcare machines, I guess, so you could clumsily call it. He has a knack for natural language. So let's say there's like a structured formula or formulaic type of language
Starting point is 00:12:45 that the medical field is supposed to use, right? Yes. Like, health records don't always necessarily contain that language, they might contain natural language, which is really confusing for computers to take in and absorb. Yeah, you know, humans can pick up on meanings of things that robots and software cannot.
Starting point is 00:13:08 Right. Like inferences and... We might be using sarcasm, although there's probably not gonna be any sarcasm in your medical records. Yeah, but like figurative language and stuff like that, computers, a language is a big part of the problem. Or more to the point, with the diagnosis,
Starting point is 00:13:23 patient says he feels like he has a hive of bees in his stomach. Like that might mean something to you or me, but to a computer, it's like patient swallowed a bunch of bees or something, right? Watson has the advantage of saying, oh, okay, well, there's a sensation of bees in the stomach. There's not actually bees in the stomach,
Starting point is 00:13:42 so let's figure this out. Right. And Watson, or anything that he eventually becomes, will be able to go through medical records, current medical research, the patient's medical history, diagnostic tests that were done, blood work, instrument tests, and put it all together and then spit out a list of diagnoses
Starting point is 00:14:08 with different confidence levels. So the one at the top is the one that Watson says is, he is 98.997% sure as what's wrong with this patient. And as a diagnostician, that's pretty impressive, and that's using all the available data that's available also to human physicians, but they simply don't have the time to take it all in. Yeah, I think some research said that 80% of doctors
Starting point is 00:14:38 spend less than five hours a week reading medical journals. A month. A month? Yeah. Yeah, so these things can read thousands in seconds, so it's sort of a matter of efficiency really, and like if doctors don't have time to read all this stuff, I know we looked into this one,
Starting point is 00:14:59 sort of a savant diagnoser, is that a word? I don't know. Diagnostician? Diagnostician, yeah. Dr. Daliwal in San Francisco, he's sort of legendary for diagnosing things to the point where he does it on stage as almost like a parlor trick.
Starting point is 00:15:16 I would love to see it. I would too, they give him 45 minutes and a bunch of symptoms basically, like really confusing because they're trying to stump them. And generally he comes out on top, but he even uses a program, a diagnostic program called Isabelle. Right, that's the one I said earlier that's already here.
Starting point is 00:15:35 Yeah, so doctors are using these to help themselves out, but he says that he's never had Isabelle offer a diagnosis that he has missed, but he's like the dude though. Yeah, and he also admits it. He's like, I'm a freak of nature. Right, go ahead, quiz me. Exactly, he also reads like case histories,
Starting point is 00:15:54 like for fun, that kind of stuff. He's not a normal physician. He's a complete and total outlier. If every physician were like this guy, then there probably wouldn't be this conversation going on right now, but most physicians aren't. And it's not just with current medical research
Starting point is 00:16:14 that they're just not aware of because they haven't had time to pick up the Lancet the last few months. But it's also their training too, like if a doctor's in practice for 20 years, the brain and the human brain tends to create habits because it likes to expend as little energy as possible. It's trying to be as efficient as possible.
Starting point is 00:16:32 And I think the same thing happens with medical practice. You're trained, you understand, you come out of medical school with a lot of book learning, and then you put it to practice and you kind of find your niche. And along the way, you forget a lot of the stuff that you haven't done in 20 years or haven't learned about in 20 years.
Starting point is 00:16:48 So it's not just current stuff, it's old stuff too. And if you feed the physician's desk reference into Watson or one of his compatriots, like all of that knowledge can be quickly indexed and researched to try to spit out a more accurate diagnosis. Yeah, I think that's a great idea. It's like a partnering up with computers, not necessarily replacing doctors.
Starting point is 00:17:10 But what they're doing with Watson is very much moving toward replacing doctors in that sense. Well, here's a scary stat. One in five diagnoses in the United States are incorrect or incomplete, one in five. And a lot of times it's not that the doctor's a jerk or not any good, but like you said, they just maybe haven't seen these cases
Starting point is 00:17:31 that were written about in some obscure medical journal that the computer has scanned and indexed, you know? And Dollywall, Dr. Dollywall himself, that freak diagnostician. Dollywood? Yeah, pretty close, which is a wonderful place by the way. I know you love Dollywood. Dr. Dollywall himself says a lot, even with me,
Starting point is 00:17:52 a lot of it is intuition. And intuition can be wrong. That's a criticism though of computers as doctors. They lack intuition. Like there's kind of even a larger, even larger than this computers replacing doctors' conversation going on. It's kind of a conversation or a debate
Starting point is 00:18:12 over whether intuition or data trumps one or the other. Like which one is the right way to go? Yeah, this one stat too. It says according to an expert, I'm not sure what that means, it sounds hinky. But they said only 20% of the knowledge physicians use to diagnose is evidence-based. So that means 80% is intuition.
Starting point is 00:18:34 Yeah, which also jibes and dovetails with that one in five being wrong or one in five being right. I like the idea of intuition to a certain degree for sure. But there's also gotta be like data backing it up. Sure, right. So in your perfect world, and it sounds like we still have physicians, but they go back and double check themselves using a program.
Starting point is 00:18:57 Yeah, but I could also be down with simple, what do they call it in here? Something-based diseases. Rules-based chronic diseases. Yeah, like minor things that are pretty easy to diagnose. Well, they're not even necessarily minor, we just understand them so fully that we say type two diabetes is going to behave
Starting point is 00:19:21 and present itself like this. Yeah, but I wouldn't mind going like, it seems like once a year I get like an upper respiratory infection, it's been three or four years in a row. And I know what the treatment is, I know how it feels. It'd be great to go into a machine and have them take some stats and blow into it
Starting point is 00:19:37 and hear my wheezing and give me a steroid shot and a Z-Pack and a breathing treatment and send me on my way. That's always what clears it up. Would you care if it was a robot that gave you that shot? Not at all. But I definitely would want more personal care if it was something-
Starting point is 00:19:57 What if it was a robot with a nice avatar? A sexy avatar? Maybe, or just a friendly one. Yeah, that was a little, it would touch your forearm here or there. Yeah, well, that might be a little creepy. Oh, really? Yeah, if like, it was an old timey doctor
Starting point is 00:20:12 who like gave you some IpaCac if you had diarrhea and just sent you on your way, drink a Coke. But it wouldn't send you on your way, it'd give you IpaCac and then it wouldn't let go of your forearm. Yeah, so strong. Well, surgical robots, that's a thing. I mean, we're kidding around,
Starting point is 00:20:26 but they've been performing robotic surgery since the early 80s. Doctor assisted until 2010 when they were in Montreal, they performed the first fully robotic surgeries when they removed a prostate with a fully robotic surgeon and a fully robotic anesthesiologist. Doctor McSleepy.
Starting point is 00:20:51 Doctor McSleepy. Yeah, and that's the real name. The robot surgeon was DaVinci, which is like the basically gold standard for robotic surgical or surgical robots. Yeah, they had in 2013, 350,000 robotic surgeries performed in the US. So it's big.
Starting point is 00:21:09 It is. But the DaVinci is a doctor basically sitting in a little, it looks like an arcade game. And using robotic arms to mimic his or her movements on more microscopic levels. Right, so the robot has more precise movements and can make smaller movements than the doctor. It's, what's the opposite of telescoping?
Starting point is 00:21:35 Like going downward in scale, whatever that is, it's taking the movements of the doctor and reducing them in scale. Let's call it reverse telescoping. Reverse telescoping, those movements, which is a pretty awesome achievement in and of itself. The doctor's being fed 3D graphics of what the robot is seeing
Starting point is 00:21:57 and just kind of working from there. What we're moving towards apparently is fully roboticized surgeries. I was talking to Joe McCormick from Forward Thinking. And he was saying that there was, there's something called the Raven Four, I believe. And basically you just say, this is going to be a gallbladder surgery
Starting point is 00:22:20 on a six foot, six male age, whatever. And here's his, here's the CAT scan of his abdomen. So go removes gallbladder and you press enter and the thing goes in there and like removes the guy's gallbladder and slows him up. Yeah. That's fully robotic, like fully autonomous robotic surgery. It's like you press a button and it does it.
Starting point is 00:22:44 You're not actually controlling a machine that does it. Exactly. The machine's doing it at your behest, but you're not controlling it, yeah. And we're right on the cusp of that. And apparently it's already happening. Yeah, but there are some issues. I looked into it and found that a lot of injury reporting
Starting point is 00:23:02 and robotic surgery is not being reported. It's substandard. And this woman, Sheena Wilson, had robotic surgery for a hysterectomy in 2013. And apparently this intuitive surgical system had, there had been a bunch of injuries that she didn't know about and she had her rectum burned badly and said, if I would have known
Starting point is 00:23:27 that this system had these issues, I would not have elected to take part in it. So there's a lot of under reporting, the FDA, they have no authority to force a doctor to do this. And apparently there's every reason and every link in the chain not to report these things. Yeah. And the FDA not enforcing this kind of thing,
Starting point is 00:23:51 not enforcing reporting is ridiculous. Yeah. You know, the thing is that things like that happen and there's under reporting with human surgeons as well. Oh yeah, sure. Not just robotic, it's like overall apparently surgical injury and accident reporting is not compulsory. Yeah, and here's a few points though,
Starting point is 00:24:12 counterpoints I guess is, one, it's not always the robotic component of the surgery that was the cause. Yeah, that's a good point. Two, a lot of times they say they don't know about this until like a lawsuit is filed. So it could be weeks or months later. What the physician doesn't know about it or the patient?
Starting point is 00:24:29 The FDA might not get a report on it. And like six months later, you file a lawsuit and that's how it comes to light. But the FDA is definitely concerned and are supposedly working to improve this fast. Very concerned. They're very concerned. And another problem too, in that same article,
Starting point is 00:24:47 a lot of these robotic surgical systems, you still have to have the correct amount of training. And the feeling of some experts is that, or at least this one guy, Enrico Benedetti, he's a head of surgery at the University of Illinois, Chicago, says a lot of it just comes back to training. Some of these doctors aren't getting adequately trained in these machines enough to perform this surgery.
Starting point is 00:25:10 Yeah. Like what happens when I do this? Oh, that happens. It's not good. I've got another alarming stat for you too. Hold on, hold on, hold on. Before that, let's do a message break real quick. Stuff you should know.
Starting point is 00:25:29 On the podcast, pay dude the 90s called David Lasher and Christine Taylor, stars of the cult classic show, Hey Dude, bring you back to the days of slip dresses and choker necklaces. We're gonna use Hey Dude as our jumping off point, but we are going to unpack and dive back into the decade of the 90s.
Starting point is 00:25:46 We lived it, and now we're calling on all of our friends to come back and relive it. It's a podcast packed with interviews, co-stars, friends, and non-stop references to the best decade ever. Do you remember going to Blockbuster? Do you remember Nintendo 64? Do you remember getting Frosted Tips? Was that a cereal?
Starting point is 00:26:04 No, it was hair. Do you remember AOL Instant Messenger and the dial-up sound like poltergeist? So leave a code on your best friend's beeper, because you'll want to be there when the nostalgia starts flowing. Each episode will rival the feeling of taking out the cartridge from your Game Boy,
Starting point is 00:26:18 blowing on it and popping it back in as we take you back to the 90s. Listen to Hey Dude, the 90s called on the iHeart radio app, Apple Podcasts, or wherever you get your podcasts. Hey, I'm Lance Bass, host of the new iHeart podcast, Frosted Tips with Lance Bass. The hardest thing can be knowing who to turn to
Starting point is 00:26:36 when questions arise or times get tough, or you're at the end of the road. Ah, okay, I see what you're doing. Do you ever think to yourself, what advice would Lance Bass and my favorite boy bands give me in this situation? If you do, you've come to the right place, because I'm here to help.
Starting point is 00:26:50 This, I promise you. Oh, God. Seriously, I swear. And you won't have to send an SOS, because I'll be there for you. Oh, man. And so will my husband, Michael. Um, hey, that's me.
Starting point is 00:27:01 Yep, we know that, Michael. And a different hot, sexy teen crush boy bander each week to guide you through life, step by step. Oh, not another one. Kids, relationships, life in general, can get messy. You may be thinking, this is the story of my life. Just stop now. If so, tell everybody, yeah, everybody,
Starting point is 00:27:19 about my new podcast, and make sure to listen, so we'll never, ever have to say bye, bye, bye. Listen to Frosted Tips with Lance Bass on the iHeart Radio app, Apple podcast, or wherever you listen to podcasts. Okay, tell me your alarming stat. All right, John Hopkins did a study that found as many as 40,000 patients die
Starting point is 00:27:50 in intensive care each year in the U.S. due to misdiagnosis, 40,000. Man. And another study found that system-related factors like lack of teamwork and communication or just poor processes were involved in 65% of diagnostic error and cognitive factors, and 75% with premature closure is the most common,
Starting point is 00:28:12 which is basically just sticking to that initial diagnosis and not being open-minded to other second opinions. Yeah, so there's this thing called anchoring bias that was in that New York Times article with Dr. Dallowall, the guy who created this program that's now around to support diagnostics, where a physician will say, I think it's this, but let me put in the symptoms and ask Isabelle,
Starting point is 00:28:37 which is the name of the program, and it's named after the guy who created the program's daughter. Oh man, that story is rough. Yeah, when she was three, took her to the hospital, and the doctor said, well, she has chickenpox, and she did indeed have chickenpox, but that's all they looked at.
Starting point is 00:28:51 They completely missed a pretty nasty case of necrotizing fasciitis, which we've talked about before, flesh-eating bacteria, and she almost died from it. It was disfigured from it as a result. So her father, who is a money manager, said, I'm going to take whatever computer programming skills I have and put it toward this program, Isabelle, which is meant to say, yes, you're right with this diagnosis.
Starting point is 00:29:16 I agree with you, or have you considered these other diagnoses? And he said, had Isabelle been around, and his daughter's doctors consulted it, they would not have missed the necrotizing fasciitis. Well, it makes sense. As an assist, there's this company called Lifecom that said in clinical trials
Starting point is 00:29:33 that if you use a medical diagnostic program as an assist, those engines were 91% accurate without using exams or imaging or labs even. Really, just symptoms. That's crazy. That's really, really, really good. Yeah. Like that's an A.
Starting point is 00:29:54 That's an A, that's a low A. It's still an A. But as an assistant, I think it's kind of a no-brainer. Don't you think? Oh yeah, I think so. I don't know why. All I can think of is possibly worrying about feeding the beast that will take your job,
Starting point is 00:30:12 or just having too much of a caseload to take the time to double check your work on a computer, would be the only reasons why doctors aren't using that. Well, the smartphone is becoming a potential self-diagnoser. There's all these cool things on the horizon that you can use your phone for. There's one called Alivecore,
Starting point is 00:30:35 which you can take your own ECG test. Yeah. And potentially, for the cost of getting one ECG in a hospital, you could send a year's worth of daily ECGs you took yourself to your doctor. Right. And then you carry all that info and all of your other medical info from all of your apps
Starting point is 00:30:53 that will eventually be integrated into one or two apps that will probably come pre-loaded on your iPhone in the next couple of years. And you've got your medical history right there. Yeah. I mean, most of these require a little clip-on, like something called Cell Scope, that's like you clip it onto your little camera lens,
Starting point is 00:31:11 essentially. And it's like, what are the little magnifiers with the lights that doctors use to look in your ears and eyes? Yeah. You know those. Clipped onto your iPhone. And it produces, you can do imaging for skin moles
Starting point is 00:31:24 and rashes and ear infections. They have one called iNetra that you could potentially give your own eyes, get your own like glasses prescription done. That's neat. And then you just order it online. You just upload the information to some website and they send you your glasses.
Starting point is 00:31:42 And then there's one called Adiment that smells your breath. It smells gases in your breath. And it could detect like lung cancer even. Yeah. Apparently you have real metabolic changes to the smell of your breath when you have different types of cancer, not just lung.
Starting point is 00:32:00 Like bees can detect breast cancer. If you breathe into like this special glass sphere with bees around it, they can be trained to detect lung cancer. And they come back with the correct results a lot of the time. Wow. So a lot of these are on the horizon.
Starting point is 00:32:16 They're not like in heavy rotation yet. No, but... But it's pretty neat. All of them reveal this idea that no one cares about your particular health and wellbeing more than you. Unless you're one of those dudes who doesn't really care than your wife does.
Starting point is 00:32:34 Or your mom, you know? Emily probably cares more about me than me. Right, but the point is the doctor, the insurance company, the hospital, while they're all in the field because they do care about your health. Of course. They can't possibly care about it more than you
Starting point is 00:32:51 or your loved one does. So the idea of giving you the ability to keep all of that information yourself and easily hand it over to them or potentially down the road a computer version of them, I can't think of any better revolution in medicine right now than that. Agreed.
Starting point is 00:33:07 I think it's pretty exciting. Yeah, I think we're gonna live into the triple digits, buddy. Yeah, and I think there will always be a need for doctors and nurses. I don't think anyone will be wholly replaced, but a little robot assist, yeah? Yeah, okay.
Starting point is 00:33:22 Let me make one more point. All right. So you've heard of genomics? Yes. There's also this thing called protonomics, which is basically your protein version of your genome. And it's all of the proteins in your body
Starting point is 00:33:35 that you have, that you're manufacturing, that you're losing and all the changes and fluctuations in them. And the idea is that you can get a full workup of your protonome and your genome. And eventually you can add that to your medical history as well, what your EKG readings been over the past year,
Starting point is 00:33:55 any weight you may have gained or lost or anything like that, what your breath smells like, metabolically speaking. And not only have your current state of health, but personalized, your version of that personalized down to your genes and proteins in your body. So a treatment could be specifically tailored to you. Wow. That's gonna be really tough for a human physician
Starting point is 00:34:20 to do that on their own. To top that? Yeah, the amount of data available already is overwhelming human doctors. When you add this other kind of stuff on it, it's just pulling away from them more and more. Yeah, and medical record keeping is, I know there's been issues with that
Starting point is 00:34:37 and digitizing that and keeping up with medical records. And if you could be your self-advocate and keep up with your own medical records, might be kind of nice. So I feel like we answered the question. Which is? Yes. No more doctors?
Starting point is 00:34:51 I don't know, I think in the future, I will always have humans to interact between us, I think. Because we're always gonna want somebody to yell at or be like, what is this robot doing? Or can you help me? This robot just gave me some IVACAC and won't let go of my arm. Or it burned my rectum.
Starting point is 00:35:07 Yes, we're always going to need humans. It's just, I don't know, will we need physicians? And if we do, will they be super specialized like just the Supreme Court of Physicians? Yeah. Who knows? It's pretty exciting. But we will see this change one way or another
Starting point is 00:35:23 in the next 15 years under my prediction. Totes, it's happening. Yeah. Okay, good one, Chuck. Yeah, man, kick off the new year. Yeah, really. If you wanna learn more about computers possibly replacing doctors,
Starting point is 00:35:37 you can type those words into the search bar at HowStuffWorks.com. And since I said search bar, that means it's time for a message break. Stuff you should know. On the podcast, HeyDude the 90s called David Lasher and Christine Taylor, stars of the cult classic show, HeyDude,
Starting point is 00:35:58 bring you back to the days of slip dresses and choker necklaces. We're gonna use HeyDude as our jumping off point, but we are going to unpack and dive back into the decade of the 90s. We lived it and now we're calling on all of our friends to come back and relive it. It's a podcast packed with interviews,
Starting point is 00:36:15 co-stars, friends, and non-stop references to the best decade ever. Do you remember going to Blockbuster? Do you remember Nintendo 64? Do you remember getting Frosted Tips? Was that a cereal? No, it was hair. Do you remember AOL Instant Messenger
Starting point is 00:36:28 and the dial-up sound like poltergeist? So leave a code on your best friend's beeper because you'll wanna be there when the nostalgia starts flowing. Each episode will rival the feeling of taking out the cartridge from your Game Boy, blowing on it and popping it back in as we take you back to the 90s.
Starting point is 00:36:43 Listen to HeyDude, the 90s, called on the iHeart radio app, Apple Podcasts, or wherever you get your podcasts. Hey, I'm Lance Bass, host of the new iHeart podcast, Frosted Tips with Lance Bass. The hardest thing can be knowing who to turn to when questions arise or times get tough or you're at the end of the road.
Starting point is 00:37:01 Ah, okay, I see what you're doing. Do you ever think to yourself, what advice would Lance Bass and my favorite boy bands give me in this situation? If you do, you've come to the right place because I'm here to help. This, I promise you. Oh, God.
Starting point is 00:37:14 Seriously, I swear. And you won't have to send an SOS because I'll be there for you. Oh, man. And so, my husband, Michael. Um, hey, that's me. Yep, we know that, Michael. And a different hot, sexy teen crush boy bander
Starting point is 00:37:27 each week to guide you through life, step by step. Oh, not another one. Kids, relationships, life in general can get messy. You may be thinking, this is the story of my life. Just stop now. If so, tell everybody, yeah, everybody about my new podcast and make sure to listen so we'll never, ever have to say bye-bye-bye.
Starting point is 00:37:47 Listen to Frosted Tips with Lance Bass on the iHeart Radio app, Apple Podcasts, or wherever you listen to podcasts. OK, so what do we have? Listen to Mail Time? Yeah. I have one called, I'm going to call it Fight Club. OK.
Starting point is 00:38:15 Hey, guys, just finished the podcast on deep refrigerating. I think I'll keep my Energy Star certified fridge. Thanks very much. But Josh did mention something about eating weeds and asked a somewhat rhetorical question. What are weeds anyway? Just plants, we say, are bad. Reminded me of some of today's common noxious weeds,
Starting point is 00:38:35 how they got their reputation. Not so long ago, lawns were a perfect blend of Bermuda rye and Kentucky bluegrass. They also included many types of clover, dandelion, and other, quote, weeds. In fact, many seed mixtures specifically included white clover, as it makes an excellent cover in soils where more common grasses won't grow.
Starting point is 00:38:52 In steps, the Scott Fertilizer Company. Post-World War II America housing tracks were popping up all over the US in the new suburbia. And Scott was encouraging returning GIs to take pride in their new lawns and to buy their products, to do so. And to wear extremely high-waisted pants. That's right.
Starting point is 00:39:07 They produced fertilizers, weed killers, and other lawn care products, some of which had a curious side effect, killing many leafy greens that came up to the point that were not considered weeds at the time, including white clover. Instead of reformulating what they did was what any red-blooded American corporation would do, they redefined what was a weed.
Starting point is 00:39:25 White clover made that list as the dandelions when, in fact, both are still in use today in cooking and medicines. Would you call that a noxious weed? No. So thanks for that, guys. And thanks for all the knowledge I've learned and have a great 2014. And that is from Robert Paulson.
Starting point is 00:39:42 Oh, yeah, Robert Paulson. He's a sharp dude. That's why I called it Fight Club. Remember that? Oh, yeah. I think I made a joke to him about that once on Twitter, and he never responded. Yeah, he writes in a lot.
Starting point is 00:39:53 Now, every time I see his name, I think, and his name is Robert Paulson. Yeah. Yeah, thanks a lot, Robert Paulson. We appreciate you. And if you're ever shot in the head in the commission of a robbery, we will dispose of your body.
Starting point is 00:40:04 Yes. If you want to get in touch with me and Chuck and you have a name that you would like us to poke fun at, bring it on. You can tweet to us at SYSK Podcast. You can post your name on facebook.com slash StuffYouShouldKnow. You can send us an email to stuffpodcast.howstuffworks.com.
Starting point is 00:40:25 And then, of course, go visit our website. Make it your home page. It's the coolest place on the web. It's stuffyoushouldknow.com. Stuff You Should Know is a production of iHeartRadio's How Stuff Works. For more podcasts from iHeartRadio, visit the iHeartRadio app.
Starting point is 00:40:42 Apple podcasts are wherever you listen to your favorite shows. On the podcast, Hey Dude, the 90s, called David Lasher and Christine Taylor, stars of the cult classic show, Hey Dude, bring you back to the days of slip dresses and choker necklaces. We're going to use Hey Dude as our jumping off point,
Starting point is 00:41:03 but we are going to unpack and dive back into the decade of the 90s. We lived it, and now we're calling on all of our friends to come back and relive it. Listen to Hey Dude, the 90s, called on the iHeartRadio app, Apple podcasts, or wherever you get your podcasts. Hey, I'm Lance Bass, host of the new iHeart podcast,
Starting point is 00:41:22 Frosted Tips with Lance Bass. Do you ever think to yourself, what advice would Lance Bass and my favorite boy bands give me in this situation? If you do, you've come to the right place, because I'm here to help. And a different hot, sexy teen crush boy bander each week to guide you through life. Tell everybody, yeah, everybody,
Starting point is 00:41:41 about my new podcast, and make sure to listen, so we'll never, ever have to say bye, bye, bye. Listen to Frosted Tips with Lance Bass on the iHeartRadio app, Apple podcast, or wherever you listen to podcasts.

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