How robots will replace doctors

Farhad Manjoo has a provocative thesis on the future of medicine: Robots will take the jobs. And not just the bottom-rung of jobs. “The doctors who are the juiciest targets for automation might not be the ones you’d expect,” he writes. They’re not the nurses or the primary-care docs. “They’re specialists like my wife — the most highly trained, highly paid people in medicine.”

I’m not convinced. Manjoo’s argument is that robots tend to be good at doing a very specific thing over and over again. That’s pretty much the definition of specialization. Ergo, specialists had best welcome their new robot overlords. Conversely, robots aren’t very good at having a long conversation with a human to figure out, in a subtle and sensitive way, what’s really wrong with them. But — and I recognize this will be an unpopular sentiment — are doctors?

After all, who becomes a doctor? High-achieving type-A folks who are really, really good at science. Some of them also happen to be very humane, very empathetic people. But not all of them. Perhaps not even most of them.

But then, we’re not sitting in that room wrapped in a garment made of the finest recycled sandpaper because we were hoping for a good conversation. We’re there because we’re sick, or worried we might be sick, and we’re hoping this arrogant, hurried, credentialed genius can tell us what’s wrong. We go to doctors not because they’re great empaths, but because we’re hoping medical school has made them into the closest thing the human race has developed to robots.

As Atul Gawande wrote in “The Checklist Manifesto,” “the ninth edition of the World Health Organization’s international classification of diseases has grown to distinguish more than thirteen thousand different diseases, syndromes, and types of injury.” And that doesn’t take into account all the possible symptoms and recommended lab tests and side effects of, and interactions between, various medications. That’s complexity beyond any human’s capacity to handle. But it’s not beyond a computer’s ability.

Manjoo suggests robots are built for surgery. But most doctors right now are thinking about robots built for diagnostics. They’re thinking about a version of IBM’s Watson that can cross-check symptoms with medications with a patient’s history and come up with an array of possible diagnoses ranked by likelihood. They’re thinking about that so much that, on Tuesday, the famed Cleveland Clinic is hosting an innovation conference in which clinicians will be competing against Watson.

My prediction is that long before robots undermine specialists, they will undermine primary-care doctors. But here’s where Manjoo is right: They will do that by specializing. They will allow the medical profession to break the conversation, the human element of the practice, from the technical diagnosis. Because doctor’s offices already have people who are really, really good at talking to patients, and they’re also the people who, more often than not, actually know how to use the computers.

They’re called nurses, and patients like them quite a bit. They’ll speak with the patient and then they’ll go to the computer and type up what they have heard and refer the patient to the appropriate specialists or medications. The software will “know” more and catch more than most doctors could on their own, and the nurses, by virtue of being less expensive, will have more time to talk with the patients and inform the computer of what they said.

There’s precedent for this. Librarians, for instance, now work with the public to find information on computers. Loan officers now speak with eager borrowers and plug their financial system into a computer program. Accountants now plug their client’s income information into tax-preparing software. There are plenty of professions that used to mix technical skills and conversational skills and now mix conversational skills and computers. Eventually, medicine will be one, too.






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Amazon Silk

Listen to the engineers behind Amazon’s new “Silk” web browser talk about how it uses the cloud to take the load off mobile devices.

Sounds like it does all the asset-requesting for you from the cloud, optimizes it, then sends you down one file that gets rendered into a website. Sounds clever to me, as long as it’s secure as hell.

Rumor has it: WebKit based.

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Amazon Silk is a post from CSS-Tricks

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Rethinking Central Banking

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Maddening – persisting sociological systems inherently corrupted by their incentivization of greed; how many times does the Great Depression have to replicate before that becomes obvious even to complacent minds?

An event at the Brookings Institution launched a new report, Rethinking Central Banking,
by a team of economic eminences including Barry Eichengreen, Raghu
Rajan, Eswar Prasad, Carmen Reinhart, Kenneth Rogoff, and others. I’ve
only skimmed it so far but the presentation was interesting and the
report looks valuable. The basic thesis is that central banking has
become a lot more complicated than it used to be, and the “dominant
framework guiding central banking practice” therefore needs to change.

The first recommendation is that central banks should go
beyond their traditional emphasis on low inflation to adopt an explicit
goal of financial stability. Macroprudential tools should be used
alongside monetary policy in pursuit of that objective. Mechanisms
should also be developed to encourage large-country central banks to
internalize the spillover effects of their policies. Specifically, we
call for the creation of an International Monetary Policy Committee
composed of representatives of major central banks that will report
regularly to world leaders on the aggregate consequences of individual
central bank policies.

There is substantial pressure on central banks to acknowledge the
importance of still other issues, such as the high costs of public debt
management and the level of the exchange rate. Central banks are more
likely to safeguard their independence and credibility by acknowledging
and explicitly addressing the tensions between inflation targeting and
competing objectives than by denying such linkages and proceeding with
business as usual. Central banks should make clear that monetary policy
is only one part of the policy response and cannot be effective unless
other policies–fiscal and structural policies, financial sector
regulation–work in tandem.

I’m sure the report is right that central banking needs to be more
broadly conceived than before, but I have a question. What, if anything,
remains of the traditional case for central-bank independence once this
is done? The report seems to take it for granted (as above) that
central-bank independence should be preserved. Why? The standard case
rests heavily on the simplicity of the assignment–low inflation–and
the lack of any long-term trade-off between that goal and full
employment. (The standard case chooses not to worry too much about the
short-term trade-off.) Complicate the assignment and the trade-offs and
central banking starts to look more like politics by other means.

An honest technocrat, with no intention of ever running for elected
office, might dare to say that central bank independence is desirable
because politics in so many countries (not least in the US) is broken.
Admittedly, by the same reasoning, most other government functions
should likewise be shielded from voters and politicians. I only wish they could be, our recklessly honest technocrat might say–but in those other
cases it is too late. Central-bank independence is not yet a lost
cause. Let us hang on to it as long as we can–and extend it across more
functions, if possible.

An advocate of democracy–not to mention voters and their elected
representatives–would  find that hard to swallow. My point is, if you
rethink central banking, you also need to revisit the case for central
bank independence, and not much of it may withstand the examination.

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The Cost of Corporate Communism

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A well-structured argument related to observations any thinking person must occasionally have about our immorally incentived system of economics.

Originally posted on the Huffington Post

Lately I have been using the phrase “Corporate Communism” on my television show. I think it is an especially fitting term when discussing the current landscape in both our banking and health care systems.

As Americans, I believe we reject communism because it historically has allowed a tiny group of people to consolidate complete control over national resources (including people), in the process stifling competition, freedom and choice. It leaves its citizens stagnating under the perpetual broken systems with no natural motivation to innovate, improve services or reduce costs.

Lack of choice, lazy, unresponsive customer service, a culture of exploitation and a small powerbase formed by cronyism and nepotism are the hallmarks of a communist system that steals from its citizenry and a major reason why America spent half a century fighting a Cold War with the U.S.S.R.

And yet today we find ourselves as a country in two distinctly different categories: those who are forced to compete tooth and nail each day to provide value to society in return for income for ourselves and our families and those who would instead use our lawmaking apparatus to help themselves to our tax money and/or to protect themselves from true competition.

If you allow weak, outdated players to take control of the government and change the rules so they are protected from the natural competition and reward systems that have created so many innovations in our country, you not only steal from the citizens on behalf of the least worthy but you also doom them by trapping the capital that would be used to generate new innovation and, most tangibly in our current situation, jobs.

We are losing the opportunity cost of all the great ideas that should be coming from the proper deployment of that 23.7 trillion in capital. Everything from innovation in medical delivery systems to accessible space travel, free energy to the driverless car; all of these things may never come to bear because those powerful individuals who have failed, been passed over by technological advancements, innovation and flat-out smarts, have commandeered our government to unfairly sustain their wealth and power.

Unfortunately, they use our wealth and laws not only to benefit their outdated, failed companies, but also spend a small pittance of their ill-gotten gains lobbying and favor-trading with politicians so the government will continue to protect them from competition and their well-deserved failure.

The massive spike in unemployment, the utter destruction of retirement wealth, the collapse in the value of our homes, the worst recession since the Great Depression have all resulted directly from the abdication of proper government.

Even with all that — the only changes that have been made, have been made to prop up and hide the massive flaws on behalf of those who perpetuated them. Still utterly nothing has been done to disclose the flaws in this system, improve it or rebuild it. Only true rules-based capitalism ensures constant adaptation and implementation of the latest and best practices for a given business, as those businesses that don’t adapt fail, and those who deploy the latest innovations to their customers benefit, prosper.

The concept of communism is rightly reviled in this country for the simple reason that it is blind to human nature, allowing a small group of individuals near-total control, while sticking everyone else with the same crappy systems — and the bill. America spent countless lives and half a century fighting against this system of government. So why are we standing for it now?

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Sen. Chambliss urges Panetta to avoid cuts to F-35 in preview of fall debate

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Smart liberal strategists would publicize his heresy to highlight hypocrisy, potentially render competitive a seat and provide opportunities for re-opening debate on what “draconian budget cuts” really are.

Chambliss said cuts to the fighter program could cause the U.S. to lose its aerial advantage in war. 

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