For some context, the USMLE is taken during medical school. The amount I have learned about actually practicing medicine since graduating is probably an order of magnitude more than everything I learned in medical school! I still learn stuff, all the time, and I’m not just talking about new research.
So, while impressive and clearly part of the future world, we shouldn’t get too far ahead of ourselves with the current models.
Edit: oh I should add that there are more clinically relevant exams that would be more likely to reveal d clinical usefulness, for example “board” exams. These are taken after training, usually before practice. Not knocking LLMs, just ensuring that people don’t misunderstand passing the USMLE as being clinically useful.
I agree that we shouldn't get ahead of ourselves with the current technology, but what you said earlier applies to practically every industry and science. What you learn at the actual job is always far more up to date than what you learn in school, no matter if it's being a engineer, doctor or just a lowly programmer.
Yes but the difference is most engineers, and pretty much all lowly programmers are unlicensed. AI or some non-human accessible in the countryside so you don't have to order questionable "fish" antibiotics or "cat" anti-parasitic would be a nice step up from the current gatekeeping of medicine from people with limited access.
The only significant ways I'm aware of that people get needed rx medications outside of physicians and mid-level practitioners is to leave the country or use "vet"/"animal" drugs. What are the simpler other alternatives currently available?
The medical cartel loves to cloak their policies under the auspices of safety. In the end you'll find their policies magically result in massive profits for bureaucrats and chokepoints that constrain the supply of gatekeepers. This is not accidental.
Incentives. Plenty of people would go into rural medicine if it wasn't paying crap and dealing with nothing but elderly Medicare patients because of the lack of health insurance for people just marginally above the Medicaid line. Of course this means there's basically no support currently for the hospitals and more than half are being bought up by private equity anyways and shipping it all to the smallest bottom line.
What if the AI is trained on board exams and other high signal testing/examination materials? Surely it will become superhuman in its medical abilities?
Ive never experienced anything in my care with doctors that I couldn’t understand with a days worth of research into things like UpToDate. It isn’t complicated. It is largely memorization and application of an algorithm which is just borderline useless for complex conditions that are emerging more modernly.
Have you ever had anything besides a bad cold? Tell me you understand every acronym in this article, and the ability to explain it succinctly to a patient much less to be able to hand off a case to "another" physician https://www.nejm.org/doi/full/10.1056/NEJMoa2206714
Doctors and nurses have saved me many times from some very close calls because of decades of experience, training and intuition. That is of course not to mention the friend who beat a deep brain tumor on their brain stem that everyone else told them was inoperable, and now are in medical school themselves for neurology. No LLM is going to pull that out of itself, possibly ever, and certainly not GPT-4 (no one else had ever had the surgery done before, it was novel).
How do you know that you actually understand a topic as well as a doctor? How do you verify that? It's not unusual for people to think they comprehend a topic at expert level, when in fact they do not. The correlation between confidence and understanding is not a reliable measure. That's why doctors are trained by more expert colleagues who can judge their true understanding, have to take exams, etc.
I think most people with complicated chronic diseases for more than a few years end up knowing more than most doctors about their condition and related conditions. Doctors are more breadth than depth. But the problem is that depth is what is absolutely necessary in these situations. But there is a lack of that among specialists too, or at least they are not willing to go outside of insurance mandated covered procedures and testing and it creates a really useless and frustrating scenario for the patients.
Doesn't matter how much GI doctors know when all they do is scope you. Sure doc scoping is sure going to help people with atypical intolerances, IBS, and any number of modern chronic conditions for which treatments are inadequate. They have to do better!
> You have to hope your hospital uses CPT codes and not, say, DRG coding, or something else entirely, otherwise you'll need to look up those codes too.
This is a bit of a misunderstanding. CPT codes are part of professional services billing, while DRGs are exclusively for inpatient acute care billing. If you are admitted to a hospital, you’ll probably have to deal with both.
Err it’s more that tick-borne diseases cause anemia.
There are lots of things that cause anemia! And someone with unexplained anemia deserves a complete work up (especially with hemoglobin levels in the 4-5 range), including for tick-borne illnesses, especially if they have been in an endemic area. But lots of other things worth checking too, many more dangerous than tick-borne illnesses.
Just want to point out that Atrial Fibrillation and Atrial Flutter are (usually) very benign, chronic conditions. Many people have for years without symptoms.
Ventricular fibrillation, ventricular tachycardia and torsades are acutely deadly. You have seconds to minutes to get a normal rhythm back.
The charts colors made me feel like they were implying a-fib was the worst rhythm listed. (Though they list the severity in the descriptions in small text)
While atrial fibrillation does not present anything close to the immediate and critical threat of the three you mentioned, it should not be ignored, as it increases the risk of stroke and embolism through blood pooling and clotting in the left atrial appendage of the heart.
When it is not asymptomatic, it is difficult to ignore anyway.
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It's really amazing to see travel nurses come back to work at a place they just left. They are now doing the same job as before, are getting paid almost twice as much with better schedules and are working next to people that they know and are friends with.
It's honestly surprising that more haven't taken the jump and is really shocking that hospitals aren't doing more to retain critical staff.
Its hilarious that nursing shares this problem with the tech industry and probably with most other industries. Every company is extremely allergic to giving raises and is happy to let their workforce churn constantly. You would think they believe that experience has no value.
But on the hiring side, experience is one of the most widely accepted signals of value.
1. Hospitals pay their nurses $X, which is way too low
2. Nurses quit because they're underpaid and overworked
3. Hospitals have a nurse staffing crisis and so pay travel nurses 2 * $X (or more!)
4. Hospitals are in a panic over the cost of travel nurses, yet instead of paying their nurses more to keep them around and eliminate the need for travel nurses, they ask the government to cap the cost of travel nurses
My mind is exploding over the ridiculousness of it.
“JAFFA, March 10 (Reuters) - Israel’s parliament on Thursday passed a law denying naturalization to Palestinians from the occupied West Bank or Gaza married to Israeli citizens, forcing thousands of Palestinian families to either emigrate or live apart.”
Abhorrent but not about preventing marriages, at least not directly
Interestingly, the blurb talks about forcing families to split up. Does this law override permanent residency visas there?
"Can Non-Jewish People Settle In Israel?
Under the Law of Return, it is possible for non-Israeli family members of Israeli citizens to gain long-term residence status in Israel, including spouses/partners, children, and grandchildren, if they themselves are not Jewish.
Where a non-Israeli national is married to an Israeli citizen, they can initially acquire a temporary residence in Israel after six months. With this temporary status, they can then access the social welfare system in Israel, including healthcare. Citizenship is then possible after four years, however, the process for securing this is quite rigorous, as the Israeli immigration authorities want to be assured that the relationship is genuine.
Where a non-Israeli national is in a relationship with an Israeli citizen but they are not married (i.e. a civil partnership), it takes three years to gain temporary resident status in Israel. Permanent residence in Israel is possible after six years (as opposed to four for those who are married). However, those in a civil partnership cannot acquire citizenship, just permanent residency, regardless of how long the non-Israeli national lives in the country."
https://immigrationlawyers-london.com/global-mobility/perman...
Does naturalization in this particular context confer citizenship with voting rights? I’m curious if blocking shifts in the electorate is a motive for this move.
It is useful. Regardless of the virtue - or strong lack thereof - of the new law, the current headline here is misleading about what was actually passed.
I disagree that the current headline is misleading. If the substance of the article does not justify the headline in your view that's fine, but understand that most families consider being forced to remain separated to be a prohibition on being a family.
