Two recent articles in December 2024 in medical literature Journal of American Medical Association (Jama) aroused my reflection. The first editorial, who commented on the results of the performance of artificial intelligence (AI) in medicine, questioned the possibility of allowing it to reduce the need for human intervention, even Surpass. The second commented on the development of the medical unions. The links between these two data messages should be seen.
AI has the real potential to quickly convene an incredible amount of data, find matches, prefer the likelihood of diagnostics. But will we reduce the use of doctors? It is possible but unlikely.
It is true that AI has the value of helping doctors to record facts, offer diagnoses, but 33 years of learning medicine and its exercises, above all, explained the internal limits of medicine. While medical studies have never brought so much data, the statistics of the population (demonstrations at the level of treatment of treatment developed on small samples) rule that for several patients an estimate of the expected effect of our interventions is still associated with variability/unpredictability and that neither AI nor the doctor can offer a better way .
We are sorry to say it, but in a large number of cases the drug is trained and is still practiced with more shadow areas than light, grayer than contrasts. In the context of uncertainty, the development of the medical spirit over the years allows you to deduce what could happen, to propose the possibilities of treatment either in the face of an uncertain diagnosis, or to follow undecided literature in the best way. Medicine still requires a judgment that exceeds therapeutic algorithms, professional recommendations, ChatgPT proposals.
To return to his contribution and AI, the use of recent years has mainly created overload work for doctors. Electronic files were widely created for administrative rather than clinical management purposes. It is no longer rare that the consultation between the patient and the doctor is largely devoted to filling the boxes on the computer, not the management of disease and symptoms.
AI could reduce it, but first it would be necessary to massively invest in improvement of current electronic sets and must not be satisfied with the beta versions (minimal options) that the government has preferred for decades. AI also forces a doctor to a finer and sharp clinical reasoning. The application will create a constant and new element of professional stress, still little assessed in terms of its impact on dispenses, who are humans and not machines.
This is probably not a foreign trend towards medical unionization in the United States for ten years. Building largely caused by excesses in connection with electronic files, release caused by the loss of influence that leaders want, tirelessness of helplessness in the face of missing resources and gradation of care is not according to scientific literature. The working conditions of doctors and I am not talking about wages, they have deteriorated to the extent that the representation of the Union must be replaced by the fact that the proverbial medical hegemony no longer allows to ensure the conditions of exercise that ensure better care.
Doctors in hospitals are considered practice. However, these privileges are significantly raised, pushed out by an apology by a restriction of resources, while their duties, their “social contract”, are increasing and expanding. Medicine was previously described as a practice with the obligation of resources and without results. Of course, it means in the face of illness. We are now talking about the duties of results in terms of productivity, performance, adherence to administrative rules developed without much respect for medical and scientific literature. The denying science is not just political …
If the negotiations between the government and the medical federations are really beginning, let us not forget that it only affects the enjoyment and not the conditions of practice that defines the ability to care in a favorable and security context for all.
I have recently been told that in some hospitals, doctors were now asked to make more and more domestic acts in the offices. Some may consider it harmless, but even if they are asked to focus on diagnostics and advise the best ways to promote life, administrators see a medical profession an easy systematic plan of Denigration doctors who tend to attribute them to everything. But without being real to influence the course of things.
And even if the courts impose more duties than hospitals in most judgments. It would therefore not be surprising that the medical federations quickly decide to intervene to protect their members from administrative excesses that affect them every day and which were reinforced last year by Dubá reform.
The network of health suffers from many pitfalls with duties that can be attributed to several, including doctors. But as Jacques Chirac said: Let us be careful not to become a critical mind in the spirit of systematic denigration. During the negotiating period it is too easy to demonize the claim. AI never replaces the tense hand and the cohesion of the health system is more important for patients than on demonstrations and principles.
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