Context: I’m a second year medical student and currently residing in the deepest pit in the valley of the Dunning-Kruger graph, but am still constantly frustrated and infuriated with the push for introducing AI for quasi-self-diagnosis and loosening restrictions on inadequately educated providers like NP’s from the for-profit “schools”.
So, anyone else in a similar spot where you think you’re kinda dumb, but you know you’re still smarter than robots and people at the peak of the Dunning-Kruger graph in your field?
infuriated with the push for introducing AI for quasi-self-diagnosis and loosening restrictions on inadequately educated providers like NP’s from the for-profit “schools”.
That’s because these decisions are not being made with data, considerations for patient safety, and so on.
It has everything to do with bloated hospital administrations who eat up all the money and spend pennies on actually helping patients. It’s usually not fucking doctors who are like “you know what would be cool, if I could replace half my nurses with an AI in my phone. I would save so much money!”
It’s just one more pot to piss money away into while saying it improves something.
CEO’s and other business leaders regularly ignore data and evidence they don’t like. Look at the Return to Office fight, they don’t care about the data, they don’t care about employee satisfaction or retention, or savings in real estate. They are miserable and they want you to be miserable, too. They have more than enough money for them to weather all the bad decisions they make, because the worst parts of their bad decisions fall on the weakest and poorest in society, as usual. So they could give a damn what anyone thinks of their shitty ideas: their shitty ideas are going to happen, because they’ve got the purse-strings.
These ideas don’t come from regular people. They come from an entire class of people who is completely disconnected from what any of these decisions do. They are only making decisions for a number on a spreadsheet, and sometimes they don’t actually give a shit if the number goes down as long as they get to continue feeling in control of other people. They literally don’t care that their decisions are dumb and will hurt people, they’re going to do them anyway.
IMHO, this has fuck-nothing to do with Dunning-Krueger and everything to do with decisions made by rich out of touch twats.
I’m a software engineer, and this is my life. I know I don’t know a whole hell of a lot of shit, but I can sure as fuck tell that a LOT of people I come into professional contact with are largely faking it - and more importantly, don’t admit when they reach the bounds of their actual knowledge.
Yep. My work is dependent on outside contractors who claim big knowledge to get the contract, but then deliver broken code and no documentation. Faking knowledge is more lucrative than having knowledge. And negativity is so structurally frowned upon (you can get fired for not being positive enough) that these grifters rarely get called out.
you can get fired for not being positive enough
This is a sign of a broken organization
We use our NPs like project managers; or, in a way that is progressive and not a death panel, a health manager. Get tests, pass results and ideas back to the GP who signs off on them, go get more tests, book a surgery, line up everything for a referral, suggest drug mods and swaps, etc. My mom just got one and she’s finally sorting her shit out. It’s so great to have like a tiger parent running your medical life.
NPs working under a physician with actual oversight is fine. The ones I have problems with are the ones that have a physician sign the hundreds of notes a month while maybe reviewing a handful, and worse, the ones pushing for independent practice without even that sham of oversight involved.
I am a person whose parents were medical-professionals, whose dad was a medical-researcher & doctor.
I have been gaslit by doctors all my life.
IF diagnosis IS evidence-based decision-tree,
THEN an expert-system can do it, without the bias of human-doctors.
However…
IF diagnosis ISN’T evidence-based decision-tree,
THEN authority-based-medicine is the only valid medicine, as doctors hold to be true, while claiming that their authority-based medicine is “evidence based” medicine.
I’m not the only person to have noted that doctors don’t allow evidence-based medicine to threaten authority-based medicine:
https://www.edge.org/response-detail/25433
That article got turned into a chapter in the book, edited by John Brockman, “This Idea Must Die”.
( I do not agree with all the articles in that book, but that particular one is both right & too-soft )
EITHER Davidson’s & Harrison’s Medicine textbooks are valid basis for diagnosis, in which case an expert-system MUST be capable of doing objectively-valid diagnosis,
https://www.amazon.com/Davidsons-Principles-Practice-Medicine-Penman/dp/070208347X/
https://www.amazon.com/Harrisons-Principles-Internal-Medicine-Twenty-First/dp/1264268505/
XOR doctor-authority has some “special non-deterministic magic/sorcery” that an expert-system cannot replicate.
There IS no escape from logic & fact.
PS: you can read the Residency subreddit to see an ocean of evidence for medical-residency being a year-long identity-forming hazing-ritual, as it objectively damages doctor-learning, doctor-performance, doctor-health, doctor-empathy ( iirc there are several PubMed items on that one ), etc, yet it is still being enforced, in spite of how it measurably produces opposite-to-claimed changes.
You can also read how the researchers Logan, King, & Fischer-Wright discovered that doctor-culture is the exemplar of narcissitic-culture, and gave the simple test that there was only 1 hospital ( when they wrote their simplified-language-for-business-people book “Tribal Leadership”, to cause change ) in the US which didn’t have narcissistic-culture ruling it:
https://www.amazon.com/Tribal-Leadership-Leveraging-Thriving-Organization/dp/0061251321/
Walk into any hospital, & see if human-validity/human-dignity has been sooo eradicated from the lower staff, that they consistently won’t meet your gaze, as a professional entering the hospital.
I forget the name of the hospital which had demonstrated that human-validity CAN live below doctors, but their research earned much from that particular one.
Of course, for anyone to accept the points I raise, would require that they hold-to evidence-based knowing, instead of authority-based-“knowing”, wouldn’t it?
Feel free to downvote me to oblivion, for my testable-facts.
PPS: I’m not attacking you, I am attacking an ideology-addiction/prejudice-addicion in the culture you are being indoctrinated into embodying.
There is a book “Doctored” on the disillusionment of an American physician, and there are many, many, many, books out now, on different aspects of the ideology/prejudice that Western Medicine has become, including perhaps “Money-Driven Medicine”, “In Shock”, and others whose names I don’t happen to remember this moment.
I wish I somehow had the leverage to make Western Medicine become evidence-based medicine, but that would require supernatural-powers, at this point.
It would certainly be healthier for the people in Western Medicine.
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