Here is another from Wired

[Nancy Anthracite]

https://www.wired.com/story/chatgpt-can-help-doctors-and-hurt-patients 

I guess neither programmers or doctors will be needed soon!  :-)

--

Nancy Anthracite

[Kevin Toppenberg]

I have worried that the advent of the internet would allow a few centralized teledoctors fill the roll of primary care doctors scattered all across the United states.  It would be more efficient, cheaper, a possibly more convenient for patients.  But it would also likely fail to really take care of patients, in all the little ways that are different from the ability to correctly identify and interpret, for example, Kayser–Fleischer rings as a sign of copper deposition problems.

Now I have another worry -- that doctors will be cut out of the loop entirely!

Kevin

[David Whitten]

I don't think very many people are aware of the intricacy of providing
patient care.

Many people don't know the plethora of ways someone can be sick,
and assume their experience is the most common norm.

Not counting diseases that are genetic in nature, there are many
diseases that are geographically related, or physical environment related.

Any telehealth-only system will never handle all of the variations
that can exist,
because there are huge numbers of things that are documented poorly,
or regionally,
or in some way that it makes it difficult to provide to a single
doctor or system.

As difficult as it is to provide customer support to multiple
consumers, even when the
product is essentially the same across all the customers, I don't know
how anyone
thinks it would be possible to provide health care support from any
centralized system,
even when there are people remotely providing care from all over the
care geography.

Dave Whitten
713-870-3834

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[ivaldes]

They practically have been already. The rise of massive corporate chains and even insurance companies wholly owning large treatment facilities means many physicians have very little autonomy.  Most physicians are employees now. There are fewer and fewer independent opportunities to market VistA to. Big business likes to do business with other big business which means the big only get bigger.  VistA is the last open architecture system that has significant use. It isn't the technology much anymore, it is the business processes (support, training, billing, marketing) and perceived vendor viability is all that matters to many organizations big and small. We can argue about the merits of that among ourselves, but most make purchasing decisions on word of mouth, market share, and brand name recognition. I've seen poor performing 3rd party software make big bucks because they have the business processes.  Those take just as long if not longer to build than the software. 

[Sam Habiel]

> They practically have been already. The rise of massive corporate chains and even insurance companies wholly owning large treatment facilities means many physicians have very little autonomy.  Most physicians are employees now. There are fewer and fewer independent opportunities to market VistA to. Big business likes to do business with other big business which means the big only get bigger.  VistA is the last open architecture system that has significant use. It isn't the technology much anymore, it is the business processes (support, training, billing, marketing) and perceived vendor viability is all that matters to many organizations big and small. We can argue about the merits of that among ourselves, but most make purchasing decisions on word of mouth, market share, and brand name recognition. I've seen poor performing 3rd party software make big bucks because they have the business processes.  Those take just as long if not longer to build than the software. 

Ignacio, thank you for a very insightful post. This ought to be printed and framed.

--Sam

On Sun, Apr 30, 2023 at 6:47 PM ivaldes <ival...@gmail.com> wrote:

On Thursday, April 27, 2023 at 3:38:53 PM UTC-5 Kevin Toppenberg wrote:

Now I have another worry -- that doctors will be cut out of the loop entirely!

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[Matt King]

I don't think there is any way to stop it, though. That's exactly why we should be trying to figure out how to use it in our own systems.