Artificial Intelligence as a Partner in Patient Care
Abraham Verghese, MD, MACP and fellow Department of Medicine faculty Nigam Shah, MBBS, PhD, and Robert Harrington, MD have authored an opinion piece on humanism and artificial intelligence. The piece, “What This Computer Needs Is a Physician” (JAMA, January 2018), insists that “the two cultures – computer and the physician – must work together.” What’s at stake are “critical social interactions between colleagues and with the patient, affecting the lived experiences of both groups,” say Verghese, Shah and Harrington.
While embracing what artificial intelligence can offer, the authors want to preserve collegial rituals (like consultations around the chart rack and in the radiology suite) and elements of the physician-patient relationship (like personal communication and connection during the physical exam). They say, “More time for human-to-patient interaction might both improve care and allow physicians to record, and accurately register, more phenotypes and more nuance.”
In this way, they believe “artificial intelligence could bring back meaning and purpose in the practice of medicine while providing new levels of efficiency and accuracy.” This means learning from mistakes made in the implementation of electronic medical records, which the authors say “serve their frontline users quite poorly.” Instead of repeating that scenario, they envision a collaboration between doctors and data/technology: “Clinicians should seek a partnership in which the machine predicts (at a demonstrably higher accuracy), and the human explains and decides on action.”
This collaborative model, Verghese, Shah and Harrington say, “can lead physicians to good decisions, but only if they keep human intelligence in the loop, bringing in the societal, clinical and personal context. … Physicians must proactively guide, oversee and monitor the adoption of artificial intelligence as a partner in patient care.”
The emphasis on the bedside is nothing new to us here at Stanford 25, and this vision of the future is something we can all aspire to: one in which humanity and technology are side by side, serving the doctor and the patient.
Humility is an underappreciated skill in a time of global budgets, evidenced based approaches, and cost-containment. The bright, well-read, talented medical students who may lack humility are not uncommon.
Patient-centered care is an important aspect of the National Strategy for Quality Improvement on Health Care. As such, healthcare institutions are strongly focusing on the patient-physician relationship and the patient experience.
The editor-in-chief of Medscape, Dr. Eric Topol, visited Stanford to sit down and do an interview with our Dr. Vergese for the Medscape One-on-One online video series.
Peter Conrad, a sociologist at Brandeis University, spoke of the rise and fall of the medical authority in the doctor patient office encounter in his many scholarly articles. With the internet becoming the “elephant in the doctor’s office,” the dynamic of medical authority has certainly changed…