I figured this was “CEO said a thing” journalism [1], but buried in the last paragraph is a real scorcher:
> “Undeniable proof that confidently uninformed hospital administrators are a danger to patients: easily duped by AI companies that are nowhere near capable of providing patient care,” [Radiologist Dr.] Suhail told Radiology Business. “Any attempt to implement AI-only reads would immediately result in patient harm and death, and only someone with zero understanding of radiology would say something so naive. But in some sense, they’re correct: Hospitals are happy to cut costs even if it means patient harm, as long as it’s legal.”
Well, let's not forget the conflict of interest on the other side as well, of someone having invested decades of professional experience into a very lucrative field already getting obliterated by AI in some narrow fields.
Getting rid of radiologists is as much nonsense and saber rattling as suggesting using AI would harm patients.
The answer is clearly just the same as in software development or any other AI impacted field: Let the best professionals handle 10x+ the volume. What that means for all the rest of employees is the question of the century though...
Well, let's not forget the conflict of interest on the other side as well, of some tech genai cuck having invested decades of professional experience into a very stochastic field where if they dupe enough hospital CEOs to harm their poor patients they may make enough money to afford to use the hospitals with real radiologists.
If hospitals are so concerned about cutting costs, getting sued is probably worse. However they are all insured against malpractice. I would be careful about insurers who could default if they find too many malpractice claims.
Isn't it also in the insurer's best interest that the hospitals do good work? They'd be another force against hospitals using AI to diagnose or misdiagnose people.
Of course, given that these are legal cases, it would take years for any consequences to be turned into actions.
To be frank I'm more concerned about non-litiguous countries here as the potential downsides are much lower to roll-out "AI radiologists". Some of those countries have multi-month or even year-long waitlists for specialist consultations so it might even be more tempting from a healthcare management level.
For folks with long wait times, maybe the advantage of "immediate access to AI radiologist" beats out "wait for human radiologist"? Would be interesting to weigh those harms against each other.
> For folks with long wait times, maybe the advantage of "immediate access to AI radiologist" beats out "wait for human radiologist"? Would be interesting to weigh those harms against each other.
The harm of getting surgery to get tissue removed due to a false positive seems a pretty big.
It's an interesting one. From some ex-colleagues, waits in the UK can be up to 5 years for a consultation, not to mention the actual procedure itself. When asked if they would rather use AI for a first initial screening, almost all of those colleagues immediately said yes.
Brother-in-law graduated med school in the early 90s and has been a practicing ER physician since. We discussed this recently and he related that his advisors told him not to go into radiology back in the late 80s because the assumption was that computers were going to take over the field. He's not too far away from retirement and it's only now that we're starting to see some signs of this prediction from 30+ years ago.
As others in the thread note, there are plenty of concerns around operational use of AI solutions in the medical space, but radiology has a much larger target painted on it than other practices as a fair portion of the job (but certainly not all!) can boil down to high-skill pattern recognition from visual inputs. The current list of AI-enabled devices going through FDA approval is public, more than 3/4 of the list are targeting radiology use cases: https://www.fda.gov/medical-devices/software-medical-device-...
The issue with radiologists is that on average they are able to spot ~35% of correct diagnoses, while the world's best radiologists ~45%. AI might get us to ~50% which is ~15% better than an average radiologist (who still needs to review it).
Its fine to ask for sources. It's also fine to not give sources when relaying information in freeform comments. It's not fine to ask for sources in the tone you are using though, as though you are annoyed and simply expect sources to always be included with claims. There are better ways of accomplishing your goals.
Someone drops very specific percentages about diagnostic accuracy....numbers that, if true, have serious implications for patient outcomes, and your concern is that I did not ask nicely enough for a source? I could not think of a more HN typical response...
I did not even call the claim false, even if it almost deserve it...I said, essentially ...let's see the references so we can treat this as fact rather than opinion.
What you did is write a longer and more prescriptive comment about my tone than anything anyone has written about the actual substance :-)). You tone policed a one line request for evidence while giving a complete pass to unsourced medical statistics presented as fact.
If we are ranking things that erode discourse quality, I would say you are higher on the list.
If you give specific numbers then I expect sources. If you give out incredibly bold claims then I also expect sources.
It's one thing to talk casually, in which case I agree with you. But as soon as hard numbers are on the table, it's no longer casual, and if you do not provide sources then the assumption has to be that you pulled the numbers out of your ass and you are not to be trusted.
To get around that, just don't provide numbers and don't speak authoritatively. It's very easy, I don't know why people speak authoritatively if they know they can't back it up.
Maybe radiologist mean something different in my country, but here radiologist don't diagnose (i mean, except you see them for a broken bone or something), oncologist do. I did an observation internship with a radiologist when i was 20 (95% of my family are doctor/nurses/PT, i wanted to know what a degree in physics could help me do in the field, and radiologist was the only path to medecine from my initial formation where i only lost a year, and not two). You spend your time calculating doses, finding patient history, and calibrating machines, it's much more a technician role than a MD. In any case, and even if in the US radiologist diagnose cancer, that's such a small part of their job it shouldn't matter.
^ Knowing this, I would believe the best course of action for a hospital administrator would be to implement a "blind workflow" to reduce risk & lawsuits.
A radiologist should separately review a scan, an AI separately review it, and then combine the 2 results for review.
I worry that rational takes like this end up completely lost in the battle between motivated parties who yell far louder, but have minimal investment in actual outcomes for those who will be depending on these technologies. The debate over self-driving vehicles is another example.
Here we go again. There's something about radiology that makes it the perfect bait for nerd sniping. I guess it's probably the misunderstanding that it is exclusively pattern recognition.
Here are my opinions, after a 20 year career as a diagnostic radiologist, and 45 years as a hobbyist computer programmer
1. There are no products currently on the market that can replace a radiologist.
2. If you can't fully and completely replace radiologists, you will still need them around in significant numbers.
3. Because of the infinite variation in human anatomy, physiology, and pathology, it is my opinion that AGI will be required to fully and completely replace radiologists.
4. Once AI is strong enough to replace radiologists, it will be strong enough to replace every other job as well.
5. Based on current RVU compensation models, any cost savings achieved by hospitals replacing radiologists with AI will quickly be lost by reimbursements being adjusted down. There is no way an insurance company will pay the same for an AI interpretation and a human interpretation.
6. There are significant unanswered medicolegal questions that will need to be addressed before AI can operate unsupervised.
In conclusion, I will work as a human radiologist until I retire in 10 years
After 20 years as a doctor, if any AI rivals my expertise (mental/neuro disorders) then, I believe, it will deserve the Nobel prize. There are so many fuzzy factors and interconnecting mechanisms in the human biochemical factory, examined with both rigor and intuition, that one cannot encode even for one patient. Medicine is easy as science but difficult as art.
Being on topic, the best is to enhance the doctor's opinion with an AI helper but never completely remove him/her.
Surely they could offer a cheaper 'unregulated, no guarantee' AI interpretation with a confidence rating, and an optional follow-up 'are you sure?' expert assessment at full price.
OTOH they're probably planning to charge full price anyway, but massively reduce costs, because, profit.
Fellow panelist David Lubarsky, MD, MBA, president and CEO of the Westchester Medical Center Health Network, said his system is already seeing great success in deploying such technology. The AI Westchester uses misses very few breast cancers and is “actually better than human beings,” he told the audience.
“For women who aren’t considered high risk, if the test comes back negative, it’s wrong only about 3 times out of 10,000,” Lubarsky said.
Sounds like 3 wrongs are an acceptable level of risk for this CEO. It would be interesting to put radiologists up against AI to see which have better results, but I would still rather a human read my chart and then have AI give the second opinion, rather than the other way around.
I stand to be corrected, but last time this cropped up about a year ago, there was a pretty severe mismatch in the use of the word "AI".
The NYT ran a story about "AI taking over radiology", where they talked to radiologists at the Mayo clinic (who have an AI research lab), who flatly told NYT that no - AI will not be replacing radiologists, the AI is not good enough.
Here is the rub though, the "AI Lab" was doing research using local CNN's with ~30M parameters. Basically 2017 consumer GPU tier AI tech.
I don't know yet if there has been a modern transformer of datacenter scale that has been explicitly pre-trained for medicine/radiology, along with extensive medical/radiology RLHF.
Okay so demand for imaging is up, so we should GET RID of the radiologists? How about we AUGMENT them with AI so that they can do their job better and faster? Why does it need to be either or?
How about we started replacing all companies that are replacing humans with AI using AI as well? As they decided to one-way participate in the economy (suck the money, not give anything back), we can make sure the one-way trend is done with rapidly. The cost of running a company will approach zero in the future. We now have massively profitable companies that are making record layoffs; something doesn't compute.
This should not be surprising. The CEO's primary objective is likely to increase profits and so this will be his/her primary focus. Even if the technology is not ready for prime time just making announcements like this likely helps increase negotiating pressure on radiologist group contracts and salaries.
Didn't we just hear predictions about this from Geoffery a few years ago that turned out to be false? I could have sworn I heard Jensen talk about how the inverse has happened?
Don't we have more radiologists than we did five years ago?
> “For women who aren’t considered high risk, if the test comes back negative, it’s wrong only about 3 times out of 10,000,” Lubarsky said.
I mean, if I were a choosing person and I could choose to have a human radiologist review AND an AI review I think I would prefer that. 3/10,000 sounds like a very good rate but a false negative on a cancer diagnosis is life threatening, no?
Why AI is able to do everything except CEO and social media hype up work? Why engineers and doctors still need CEOs to do their job?
From the votes I see that this is unpopular opinion but apparently there are close to 400 million companies in the world, of those 60K are publicly traded.
I am sure that there's enough data to train top notch CEO on this, since they are required to keep records all the time and give speeches for living.
Surely privately owned companies where the CEO is also the owner wouldn't like it but replacing the CEO with an AI in institutions with professional CEOs seems overdue. The radiologist AI certainly will be much better served by AI CEO.
I find the whole field of radiology to be utterly baffling. There are doctors who specialize in, and hopefully understand, specific diseases and/or parts of the body. But we have radiologists who are supposed to be able to look at images, taken by quite a variety of technologies and parameters, of any part of the body, and are expected to accurately interpret the findings, possibly without any relevant context.
In my personal experience interacting with the medical system, it’s, unsurprisingly, quite common for an actual specialist to look at the same images a radiologist looked at, and see something quite different. And it’s nearly always the case that a specialist or a reasonable careful non-specialist who is willing to read a bit of the literature or even ask a chatbot [0], will figure out that at least half of what the radiologist says is utterly irrelevant.
So I think that the degree to which ML can perform as well as a radiologist is not necessarily a great measurement for ML’s ability to assist with medical care.
[0] Carefully. Mindlessly asking a chatbot will give complete nonsense.
110 comments
> “Undeniable proof that confidently uninformed hospital administrators are a danger to patients: easily duped by AI companies that are nowhere near capable of providing patient care,” [Radiologist Dr.] Suhail told Radiology Business. “Any attempt to implement AI-only reads would immediately result in patient harm and death, and only someone with zero understanding of radiology would say something so naive. But in some sense, they’re correct: Hospitals are happy to cut costs even if it means patient harm, as long as it’s legal.”
[1] https://karlbode.com/ceo-said-a-thing-journalism/
Getting rid of radiologists is as much nonsense and saber rattling as suggesting using AI would harm patients.
The answer is clearly just the same as in software development or any other AI impacted field: Let the best professionals handle 10x+ the volume. What that means for all the rest of employees is the question of the century though...
> Getting rid of radiologists is as much nonsense and saber rattling as suggesting using AI would harm patients.
Did a chatbot tell you that? What makes you think it is so?
Of course, given that these are legal cases, it would take years for any consequences to be turned into actions.
>If hospitals are so concerned about cutting costs, getting sued is probably worse.
That hasn't stopped them any other time they cut costs. Have you ever spoken to a nurse who works in a hospital?
> For folks with long wait times, maybe the advantage of "immediate access to AI radiologist" beats out "wait for human radiologist"? Would be interesting to weigh those harms against each other.
The harm of getting surgery to get tissue removed due to a false positive seems a pretty big.
As others in the thread note, there are plenty of concerns around operational use of AI solutions in the medical space, but radiology has a much larger target painted on it than other practices as a fair portion of the job (but certainly not all!) can boil down to high-skill pattern recognition from visual inputs. The current list of AI-enabled devices going through FDA approval is public, more than 3/4 of the list are targeting radiology use cases: https://www.fda.gov/medical-devices/software-medical-device-...
I did not even call the claim false, even if it almost deserve it...I said, essentially ...let's see the references so we can treat this as fact rather than opinion.
What you did is write a longer and more prescriptive comment about my tone than anything anyone has written about the actual substance :-)). You tone policed a one line request for evidence while giving a complete pass to unsourced medical statistics presented as fact.
If we are ranking things that erode discourse quality, I would say you are higher on the list.
It's one thing to talk casually, in which case I agree with you. But as soon as hard numbers are on the table, it's no longer casual, and if you do not provide sources then the assumption has to be that you pulled the numbers out of your ass and you are not to be trusted.
To get around that, just don't provide numbers and don't speak authoritatively. It's very easy, I don't know why people speak authoritatively if they know they can't back it up.
A radiologist should separately review a scan, an AI separately review it, and then combine the 2 results for review.
I worry that rational takes like this end up completely lost in the battle between motivated parties who yell far louder, but have minimal investment in actual outcomes for those who will be depending on these technologies. The debate over self-driving vehicles is another example.
AI at 50% would be notably worse (also where are you getting that number?)
> "and is “actually better than human beings,” he told the audience.
“For women who aren’t considered high risk, if the test comes back negative, it’s wrong only about 3 times out of 10,000,” Lubarsky said. "
What's the false negative rate for human beings? And what about women that are considered high risk? Is it better or worse?
> Sandra Scott, MD, CEO of the One Brooklyn Health, a small hospital facing tight margins, agreed with this line of thinking, according to Crain’s.
Does this CEO of a small hospital realize that their hospital will take the legal responsibility if there's no doctor to sue for malpractice?
Here are my opinions, after a 20 year career as a diagnostic radiologist, and 45 years as a hobbyist computer programmer
1. There are no products currently on the market that can replace a radiologist.
2. If you can't fully and completely replace radiologists, you will still need them around in significant numbers.
3. Because of the infinite variation in human anatomy, physiology, and pathology, it is my opinion that AGI will be required to fully and completely replace radiologists.
4. Once AI is strong enough to replace radiologists, it will be strong enough to replace every other job as well.
5. Based on current RVU compensation models, any cost savings achieved by hospitals replacing radiologists with AI will quickly be lost by reimbursements being adjusted down. There is no way an insurance company will pay the same for an AI interpretation and a human interpretation.
6. There are significant unanswered medicolegal questions that will need to be addressed before AI can operate unsupervised.
In conclusion, I will work as a human radiologist until I retire in 10 years
Being on topic, the best is to enhance the doctor's opinion with an AI helper but never completely remove him/her.
OTOH they're probably planning to charge full price anyway, but massively reduce costs, because, profit.
“For women who aren’t considered high risk, if the test comes back negative, it’s wrong only about 3 times out of 10,000,” Lubarsky said.
Sounds like 3 wrongs are an acceptable level of risk for this CEO. It would be interesting to put radiologists up against AI to see which have better results, but I would still rather a human read my chart and then have AI give the second opinion, rather than the other way around.
The NYT ran a story about "AI taking over radiology", where they talked to radiologists at the Mayo clinic (who have an AI research lab), who flatly told NYT that no - AI will not be replacing radiologists, the AI is not good enough.
Here is the rub though, the "AI Lab" was doing research using local CNN's with ~30M parameters. Basically 2017 consumer GPU tier AI tech.
I don't know yet if there has been a modern transformer of datacenter scale that has been explicitly pre-trained for medicine/radiology, along with extensive medical/radiology RLHF.
>amid rising demand for imaging
Okay so demand for imaging is up, so we should GET RID of the radiologists? How about we AUGMENT them with AI so that they can do their job better and faster? Why does it need to be either or?
Are you sure?
"You're right to push back. Upon reinspection, it appears to be something else."
Don't we have more radiologists than we did five years ago?
Perhaps they cost a great number of money?
> “For women who aren’t considered high risk, if the test comes back negative, it’s wrong only about 3 times out of 10,000,” Lubarsky said.
I mean, if I were a choosing person and I could choose to have a human radiologist review AND an AI review I think I would prefer that. 3/10,000 sounds like a very good rate but a false negative on a cancer diagnosis is life threatening, no?
From the votes I see that this is unpopular opinion but apparently there are close to 400 million companies in the world, of those 60K are publicly traded.
I am sure that there's enough data to train top notch CEO on this, since they are required to keep records all the time and give speeches for living.
Surely privately owned companies where the CEO is also the owner wouldn't like it but replacing the CEO with an AI in institutions with professional CEOs seems overdue. The radiologist AI certainly will be much better served by AI CEO.
In my personal experience interacting with the medical system, it’s, unsurprisingly, quite common for an actual specialist to look at the same images a radiologist looked at, and see something quite different. And it’s nearly always the case that a specialist or a reasonable careful non-specialist who is willing to read a bit of the literature or even ask a chatbot [0], will figure out that at least half of what the radiologist says is utterly irrelevant.
So I think that the degree to which ML can perform as well as a radiologist is not necessarily a great measurement for ML’s ability to assist with medical care.
[0] Carefully. Mindlessly asking a chatbot will give complete nonsense.
Agree that AI should replace CEOs. They’re often biased in unhelpful ways that AI isn’t and it costs people wellbeing.