The University College London Hospital (UCLH) in Bloomsbury London is launching a pilot program replacing some A&E (Emergency Room) physicians with robots.
In response to staff shortages and long wait times, the initiative launched by UCLH and Alan Turing will utilize artificial intelligence to triage patients and reduce wait times.
Robotic technology is already being used in the operating room, rehabilitation centers and for pharmaceutical dispensing. It’s just a matter of time that they become our main caregiver.
But will patients be pleased?
Where’s there’s demand, there’s supply. Patients tired of wait times, crowded waiting rooms, loss of sick leave hours to sit around a medical office or emergency room for half a day will want speed and efficiency. Kiosks may replace front desk clerks, taking your initial information (chief complaint, name, insurance info.), scanning it and offering you a number, like one given at a bakery.
Those embarrassed by having symptoms suggestive of having an STD will have less of an issue conveying this information to a machine than a human being. Gas, discharge, odors may be easier to discuss with someone or something that won’t wince.
Many patients cite seeing a medical provider and not being examined or asked to undress before an exam. Time constraints, or avoidance of being accused of wrongdoing, have caused some providers to refer out for heart, gynecological, and rectal examinations. Primary care providers who enter the room, say a few words and then promptly leave saying they will “bring in the nurse to review instructions” may not be missed by the patient receiving similar service from a robot.
We use Google, Wikipedia and Siri to answer our health questions currently. No wait time, no office visit, no cost….so a robot answering our questions in layman’s terms will be an easy task.
However, and this is the kicker……
There is no way to replicate the sixth sense humans have when it comes to something being wrong with you. Artificial intelligence cannot provide a “gut feeling.”
Let’s take a urinary tract infection, for example. I have had patients who were new to my office complaining something “felt funny” when they urinated and cited blood in their urine. A urinalysis may show inflammatory cells, and a robot may correctly diagnose the patient with a bladder infection. But I as a clinician may be suspicious that this new patient has something that is leaking blood into the urine, from the gynecologic tract maybe? And I’ve diagnosed endometrial and cervical cancer in cases where patients thought they were merely having bladder infections.
One patient presented to me in the emergency room feeling “odd” and suspecting a “UTI.” She was in her 60’s and started to complain of nausea. Her urine had inflammatory cells so while a culture takes 3 days to complete, I gave her a prescription for antibiotics in case the infection would spread during that time. But her nausea was concerning. The patient requested an injection of nausea medication prior to leaving so I obliged, giving her Compazine. While observing her for a few minutes, post injection, she began to have shortness of breath. We decided to look at her heart and came to the conclusion after more testing that she had suffered a heart attack in her sleep the night before and the “odd feeling” she felt the next day wasn’t due to her UTI (which she coincidentally had) but was from a heart attack. She was treated immediately and recovered nicely.
Would a robot have picked up on that? Multiple web resources include nausea in the list of symptoms associated with a UTI, so could be “blown off” by a robot bundling it with the patient’s urinary complaints. But I learned that nausea could be the first sign of a heart attack, especially in women.
Another case I had as an urgent care physician was the following:
A gentlemen came in saying he “felt fine” but his wife made him come in because he was burping the night before. Multiple bouts of eructation jogged an ancient memory of mine…..when as a little girl I saw a movie where the pilot was burping multiple times before he passed out and died. So I came to learn that chronic bouts of burps, or hiccups for that matter, could be a sign of an inferior MI (heart attack). I ran an EKG and blood work, and my instinct was right. Again I was looking at a patient who unknowingly had a heart attack the night before but thought he had something benign the next day.
So gut instinct, thinking laterally, tapping in on past experience, and acting on hunches is not something a robot can do. Humans may be satisfied with shorter wait times and receiving antibiotics when they demand them, but the education and intervention a medical provider can provide is priceless. Too bad cost gets in the way of real medicine.
It’s Elon Musk’s recurring nightmare that artificial intelligence becomes self-aware and destroys mankind. Blade Runner 2049 is the visual representation of that nightmare’s roots taking hold.
Blade Runner 2049 is a fantastic film worth seeing in theaters despite the underwhelming box office revenue in the United States thus far. The suspenseful science-fiction film that spawned this sequel didn’t do well at the box office either, so expecting this one would is a mistake of the producers. But the movie is no mistake. In fact, it was born because it was “wanted” -- or rather, needed.
I could tell you how the set design alone is an accomplishment never realized in the history of cinema, or that Ryan Gosling gives a performance reminiscent of Drive. I could tell you that computer-generated imagery has never been so vivid and felt so real. But Blade Runner 2049’s subject matter is more relevant than ever before, with bio-engineered human beings quickly becoming a reality, as evidenced in the latest edition of Mother Jones.
Replicants are bio-engineered to be exactly like humans in every way, except they’re stronger (and smarter) and allegedly unable to reproduce (that’s what they said in Jurassic Park, too), making them ideal slaves for building infrastructure on other worlds awaiting human colonization. That is until they run, as slaves are apt to do, despite an attempt by humanity to control the slaves through vivid, fabricated memories. This is all closer to science-fact than science-fiction given the vast advancement of research in genetics and artificial intelligence.
According to Rowan Jacobsen’s article for Mother Jones, “Scientists have already identified a handful of rare gene variants that seem to be upgrades of the standard version most of us possess.” For instance, “A variant of the LRP5 gene results in ultradense, nearly unbreakable bones” -- a sort of super strength that’s on display during a fight in the opening minutes of the movie.
Choosing your child’s genes is one thing, but the real fear comes with the ability to mass produce slaves, upon which, in some form, privileged humanity has and will rely for survival. That day is fast approaching and could very well be realized by 2049.
“Last year, a team of scientists in Japan took the skin cells of mice, transformed those cells into eggs, fertilized them, and implanted the resulting embryos, which resulted in the birth of 26 healthy pups...It shouldn’t be much more difficult to do the same thing with humans.” Male skin cells could be used to create embryos just as easily as female skin cells, so same-sex couples could have children that share both parents’ genes, with the parents picking the genes of their preference.
The Matrix touches on this idea that humans can be “grown,” and in vitro fertilization was already 22 years old at that time. Within the next few decades, human reproduction could not only be achieved without sex, but without both sexes. Stanford biochemist Henry Greely calles it Easy PGD (preimplantation genetic diagnosis) in his book The End of Sex.
Jacobsen reveals that “Easy PGD will be far cheaper than IVF is today,” and “prices of gene printing have already plummeted. The cost of printing a base pair of genes has plunged from $600 in 1980 to a fraction of a cent and is continuing to drop...the cost of synthesizing genes had dropped to 4 cents per pair of DNA letters and was continuing to halve every two years.” When the benefit outweighs the cost, you can be sure someone will attempt to profit.
Artificial intelligence might be a bit further behind genetic reproduction research, but creating a human-like mind that can learn and replicate feelings isn’t inconceivable. Despite Musk’s fears of AI, the Autopilot feature in his Tesla vehicles is already turning machines into taxi drivers -- giving machines the keys to the most dangerous tool on the planet. One AI unit even predicted the result of the 2016 U.S. Presidential Election. Another, designed by Google, learned and beat Go -- a game more complex than chess.
So we have a means for slave-making already in the works. Surely the first avenue investigated will be the creation of sex slaves, a la Ex Machina. Regardless of the avenue investigated, the result will be the same. Replicants will question the definition of humanity because of the inhumane actions of humans creating self-aware, stronger, smarter beings to act as slaves. Replicants will begin to see themselves as an upgrade -- an evolved race -- and when the first replicant is born rather than built, their beliefs will be substantiated.