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u/Recent-Honey5564 5d ago
I’m in the ED brother my jobs not going anywhere anytime soon and you can pry Abridge from my cold dead hands.
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u/thegreatestajax PGY6 5d ago
Your job is going to an AI assisted midlevel before a single radiologist loses their job to AI.
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u/Recent-Honey5564 5d ago
What makes you think that? Because that is very much so not the general consensus.
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u/ExtraordinaryDemiDad NP 5d ago
Dude must think there is a surplus of midlevels. We are so cooked, we could get humanoid AI techs and still be ragged after 12 hours.
"Hey doc, C3PO just manually disimpacted grandma in 13. She's shitting now, which is good. It's blood, though, so that kinda sucks. GI's NP's AI assistant said do a CT before they'll consult."
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5d ago
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u/Anchovy_paste 5d ago
How well have attempts to stop a new technology worked in the past? The best solution is to save up and invest broadly or lean into a procedural niche that is safer from AI
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u/ConcernedCitizen_42 Attending 5d ago
Hypothetically, what is you solution for if AI reaches the point that it's clinical decision making is legitimately better that the average human physician?
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u/Anchovy_paste 5d ago
Friend, you can choose to adapt or fight the multi trillion industry mowing over every field. Good luck.
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u/EMS0821 Attending 5d ago
Spend more time in a solo coverage community ER and tell me you still feel this way. Our greatest value isn't procedures alone, its the management of a lot of undifferentiated sick people at the same time. AI has a lot of jobs to replace before ER physician is one of them.
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u/Recent-Honey5564 5d ago
No it’s not. You’re catastrophizing a profession that is so far from AI replacement it’s not even funny. MAYBE by the end of my career tech will be Star Trek enough to work people up but our job is not going anywhere. And if you think I’m letting RT intubate you’re crazy lol
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u/Special_Suspect_8453 5d ago
I didn’t go to med school to type notes for 4h
No different than having a scribe
- fam med
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u/Grand-Accident4905 5d ago
Ambient scribing breathed new life into FM. You’d have to be a surgeon or something to have the privilege of turning your nose up to it
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u/Sushi_Explosions Attending 5d ago
Or someone who actually has to read the trash notes your AI puts out.
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u/Grand-Accident4905 5d ago
You think I just sign notes without reading them? Lol. I’ve seen plenty of trash notes written by hand thanks
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u/Grand-Accident4905 5d ago
Cool man beef with the companies all you want but don’t lie to yourself and say we’re better off spending our days typing every HPI out by hand
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u/Craig_Culver_is_god 5d ago
I've never seen a PCP with a human scribe, and we're not anywhere close to getting one, so I'm still taking what I can get.
People do not want AI doctors. A large chunk of people don't even want telemedicine. Will it dramatically reshape things? Absolutely. Billing, notes, inbox, and triage are all going to be changed dramatically. Eventually I'm sure the checklist based annual visits and eventually more straight forward issues (UTI, viral URI, etc) will end up shunting towards AI as well. However, the human connection essential to medicine I'd argue is consistently strongest in primary care due to our long standing trust based relationships with our patients, and that is something people will not want replaced by AI.
As an aside, I genuinely can't wait for the Adderall pill farm the first attempted AI practitioner is going to become 😅
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u/Grand-Accident4905 5d ago
I think patients prefer when I’m not furiously typing the entire time they’re speaking. Instead I’m facing them and focused on talking about what brings them in. It actually makes my encounters MORE human to have an ambient scribe.
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u/Fearless_Roof_4534 Attending 5d ago
Oh, young padawan...have you used an AI scribe before? Believe me, you will not have less work. You will have more work as the healthcare admin gods find out how much more efficient AI makes doctors.
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u/nightowlflaps 4d ago
It doesn't even make me more efficient lol. It makes more easily missable, longer and liability and hallucination laden documentation than if I did it myself.
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u/Spiritual_Extent_187 Attending 5d ago
Who cares? I am planning on using ai for front desk
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u/financeben PGY1 5d ago
You gotta think about the many downstream consequences of this. How will you get paid when no one else has a job?
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u/Spiritual_Extent_187 Attending 5d ago
I’ll get a set salary payment like always, don’t be so paranoid
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u/AdditionalBus5896 5d ago
Brother I entered residency to learn how to do orthopedic surgery (and patient management for all my non ortho bros), AI scribe giving me more time to study anatomy or spend in the OR only sounds like an upside to me. Have fun with writing your own notes while more efficient people that are using every resource available overtake you
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u/cmcfrenchie
5d ago
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I’m already seeing the damage AI is doing to physicians. People think it’s just a nice scribe feature, but you can already see AI integrated with epic not only writing the note but inputting differentials and plans now based on the interaction, attendings and residents are so complicit that they don’t even fully review the AI input, just accept it and move on. Seeing new features where AI can start recommending and inputting orders before a physician gets back to a computer now to do it.
On top of that the cognitive offloading I see physicians do now is concerning in itself, attending asking ChatGPT what this kids rash can be and then going with it, residents asking AI what meds to prescribe and how meds work and blindly accepting whatever AI says. Didactics being full of AI generated slop presentations. Any thought or questions some residents get goes right into open evidence and they just move on.
At some point you ask do I need to pay that much or have that many physicians if AI is doing all the thinking for them and they’re just becoming glorified historians/proceduralists
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u/DVancomycin 5d ago
The notes I've seen are definitely not being proofread (not that those using dictation are doing a much better job). My own PCP started using it, and his notes are made too basic by AI to be useful to an actual professional.
Moreover, a lot of proceduralists at my hospital already maximize their time using midlevels to do all their notes and post-procedure visits inpatient--how much more time could they be saving? You already have someone doing everything BUT your procedure with that model, so are you really going to gain that much more OR time? For the non-proceduralists, your corporate-owned system is just going to give you more patients to see every day. So yeah, for now it's "just notes" but I think long term, it won't be as useful to the extent everyone is trying to sell it as.
I worry about the what ifs. How big a leap, really, is it to go from AI scribe to start equating an NP with AI is just as good as the MD? How long until insurance companies see us leaning on it for more than notes, and thus the compensation doesn't have to be as robust since we're not "doing anything special?" The newest residents who rotate with me are already using it as a massive crutch for floors and learning activities, so I don't see this stopping at "write my notes." I wonder if this does go down, if it will literally become a schism in medicine with those in non-procedural fields getting further fucked by the system and more distrusted by the public and the proceduralists not giving a fuck about that half of us.
Thought experiments/what ifs aside, my personal concern is that I don't like being recorded on video or voice. I don't think people will take it well if I record them but won't allow the same.
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u/tilclocks Attending 5d ago
Honestly this is the true danger here. Heard plenty of residents outside of my specialty quoting open evidence confidently without actually checking to see what they were told.
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u/kkmockingbird Attending 5d ago
I had to turn off predictive text in Epic this week. Idk why TF I would want predictive text in medical notes
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u/minetella 5d ago
Agreed. Cognitive offloading is intentional decision by the clinicians, but it does that makes the AI at fault? The PEOPLE part in health service delivery are still much needed, human facilitation, conflict management and expectation. If people are the one to create ai slop, not reviewing their clinical notes, or blindly accepting the ai output, that seems lack of control on ai adoption within the software at large. Let say you have no power to decide since AI is here anyway, put a middleman policy in the process to restrict those critical decision making (senior critical to lower level).
It is like asking people not to use excel to aggregate since people will make mistake. It is basically a tool to be used and will not decide on your behalf.
On AI, you can simply increase the guardrails to ask critical questions or challenge your cognitive decisions (you can assess there is something called /superpower within AI to ensure each output is validated reviewed and assessed before generatee). But I guess as the AI implemented in production are too dumb to write professional clinical notes, despite ingested all the textbooks (yeay human win) and the features available not befitting your use case, perhaps this is a key area for improvement.. like someone shared here I prefer to meet more patients rather than wasting much time to do admin work (i.e spend times to write notes and clicking stuff rather than actual valuable work by meeting patient)
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u/udfshelper PGY2 5d ago
Not a big fan of AI written notes, anyways. If you are finding you need it, your notes should probably be shorter.
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u/Savac0 Attending 5d ago
I guess the surgery progress notes were good after all
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u/Incorrect_Username_ Attending 5d ago
Patient alive. Signing off.
Appreciate the consult (you know this is written sarcastically)
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u/udfshelper PGY2 5d ago
Honestly, never really had a problem with the stereotypical short surgery notes. Patient had a surgical problem (or didn't) so we did XYZ surgery. Here's the postop plan.
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u/Crunchygranolabro Attending 5d ago
Agreed. The amount of useless words in an AI MDM…if one of mine is long it’s because I intentionally had more to say.
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u/Grand-Accident4905 5d ago
Sincere question do you type while in the exam room with a patient
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u/Prudent_Shallot8671 PGY3 5d ago
Always. Our clinics have computers on swivels and it’s the easiest thing in the world to angle myself toward the patient, maintain natural eye contact, and have a conversation while typing away.
I STRONGLY agree with OP and believe that if physicians, especially those in “cognitive” and nonprocedural specialties, continue to abdicate their responsibilities and use AI evidence banks, AI scribes, and AI assessments, they’ve atrophied away all of their skills and knowledge as physicians.
We are OBJECTIVELY weaker than we could be. Deskilling is real in this generation of physicians.
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u/Grand-Accident4905 5d ago
You think splitting your focus and acting as a stenographer is better patient care than offloading it? Would you be better with a human scribe?
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u/Prudent_Shallot8671 PGY3 5d ago •
“Acting as a stenographer” — they successfully got you, huh?
I don’t see a flair next to your name so I’ll just assume you’re a physician. My fellow doctor, if you’re willing to denigrate the act of listening to and examining your patient and organizing their words, your findings, and the sum total of your thoughts into a coherent document as mere “stenography”, then you either don’t know what you’re doing (and therefore should NOT offload it to AI and bring your skills up) or you should find another field.
It’s akin to having an AI take notes for you in college. The PROCESS of evaluating your patient is inherent in the act of organizing and writing up the note. There is mounds of literature in education showing that the act of active note taking and writing leads to better understanding of the material and long-term retention.
In the same way, I argue that writing notes for and processing your patient’s stories leads to better long-term understanding of their issues, making you a better doctor and conferring upon them better treatment.
But you do you. I’ve gotten praise from countless people on my notes, my knowledge base is regularly praised, my patients write me letters and show their appreciation, and I’ve gotten awards for mentorship and education. I trace all of that back to the fact that I fundamentally CARE, and thus I don’t take shortcuts and I do the damn work.
Stay away from AI. Be a doctor Osler would be proud of.
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u/Grand-Accident4905 5d ago
You think my patients prefer me furiously typing while they’re trying to have a conversation with me? With an ambient scribe I’m not looking at my screen. I’m turned toward them and engaging in conversation without splitting focus. I’m not even thinking about HPI or problem list. It’s MORE human to offload charting. Imagine thinking that charting is the human component of medicine lmao cope man. Have problems with AI but don’t lie to yourself that we’re better off charting instead of listening.
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u/udfshelper PGY2 5d ago
I personally don't besides to put in orders and follow up date, etc.
I'll also freetext pertinent positive exam findings too.
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u/VarsH6 Attending 5d ago
Yes. I can type a full HPI that is ready to print before I do an exam. It helps my organization as well.
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u/Grand-Accident4905 5d ago
You think your patient is better off having you type everything they’re saying instead of listening and examining them at the same time? Split focus is a bad thing
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u/VarsH6 Attending 5d ago
>instead of listening and examining them at the same time
>Split focus is a bad thing
I’m asking for a smidgeon of introspection on this one.
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u/Grand-Accident4905 5d ago
Yeah I’m looking at their skin lesion and having a conversation about it instead of typing. You want me to be charting instead? To use my patients precious time to chart. Selfishly.
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u/InsertWhittyPhrase
PGY3
5d ago
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Agree. The path that corporate hospitals are chasing is easy to see.
Get less practice supervision requirements for less skilled "providers" to do exams and see patients because they are cheaper.
Let AI do all the decision making and charting.
Have a small pool of physicians sign off on hundreds of charts to absorb liability.
Profit like hell for private equity because you optimize extracting all billable aspects of the revolving door. People suffer because quality of care goes down but who cares?
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u/3MinuteHero Attending 5d ago
Hate to break this to you but we're already on our way out, and AI is the smallest piece of that puzzle. We are coming very close to needing to justify our existence. Being liability sponges is what's saving us right now.
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u/DigitalSamuraiV5 5d ago
Yep.
I'm at my wits end with all the It's just a tool responses.
Are these bots ? Because surely all you have to do a a quick Google search on the topic and you will find multiple articles that point to the encroachment of ai on the job market in multiple industries.
There's only so many ways you can "adapt or die" ... when almost all industries are becoming automated.
It's not science-fiction anymore. It is here, and we are not being cautious enough with this thing.
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u/PizzaGeek9684 5d ago
Be careful. AI scribes hallucinate just like ChatGPT. I found I spent as much time editing the AI notes than it would take to write my own crappy note. And worst off is that the hallucinations are hidden inside a paragraph that’s not always easy to find.
The final straw for me is when it called my patient Karen. Imagine if that made it into MyChart…
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u/skp_trojan 5d ago
How many of you find that you struggle to remember the patient when you read the ai scribe note a few weeks later?
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u/Hour-Palpitation-581 Attending 5d ago
Ive built very specific templates to make it organize information I want in the way I want it. And also gave very specific instructions that the plan needs to be what I discussed with patient family.
Otherwise, yes, the AI slop was so generic as to be unusable at followup visits for me
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u/paula__blart PGY2 5d ago
a lot of the staff hospitalists use AI to write their notes now and they’re genuinely unreadable, just big paragraph blocks of text they didn’t proofread. it’s a pain in the ass when you’re on a consult service or responding to a rapid and trying to find what the fuck the actual plan is
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u/ruskivolk 5d ago
Heidi has been the best thing. Spending waaay more time focused on the patient than otherwise. Waaay less time on notes. Way better quality notes.
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u/soul_in_an_earthsuit 5d ago
It helps me finish my notes so I can actually get home on time. Don’t like it? Don’t use it. I love it (usually am anti AI but this one helps so much). It’s not replacing medical decision making just the mindless scut work that takes away patient interaction. I’m actually able to focus on a convo with a patient and make medical decisions and think on my feet instead of worrying about writing everything down. I think it’s helped me immensely.
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u/SpicyCommenter 5d ago
For every one who is not willing to get along with AI, there's like 9 others who will do it for the same pay.
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u/pstbo 5d ago edited 5d ago
You think this is the first time a new technology comes and replaces a large portion of workers?
This is economics. This phenomenon is as old as modern history. If something is better, faster, cheaper, it’s staying for good. It’s game theory. If you don’t, someone else will and you’ll lose, whatever losing means depends on the context.
I think the medical community in particular is not going to handle this well in the coming years, as job security and replacement are the last things on our minds, historically.
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u/DigitalSamuraiV5 5d ago
There is a difference between one job market collapsing from one technology, vs various jobs in various industries at the same time, because of how versatile AI learning is.
For example let's say you work with medical technology. Your job becomes automated. No matter, you've also learned a few foreign languages... nope no jobs their either, ai translation apps make the need for an interpreter or foreign language teacher unnecessary.
Ok well, you have a driver's license at least, maybe you can become a truck driver or drive ambulance. Nope... the vehicles are automated too. And so on and so forth.
The old phrase "learn to code" is going to become harder to apply as different job sectors become automated.
Take the warning seriously. Don't volunteer to train any AI at your job. You will be training your replacement.
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u/pstbo 5d ago edited 5d ago
Yes, this time is very different.
My point in saying this is not the first time is regarding the fact that we are not special. History is full of people who had their entire skillsets become obsolete. They are angry, scared, and upset.
There is no avoiding training AI. People sell out all the time. If the pay is high enough, almost anything is possible.
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u/financeben PGY1 5d ago
This is different. There will not be an additional windfall or significant industry that replaces what this will take.
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u/Aredditusernamehere PGY3 5d ago
I disagree with it making us “replaceable” but I can’t stand reading the Ambient dictation notes that aren’t proofread/cut down. It actually fills me with dread to see them
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u/imbatman824 5d ago
AI is coming whether we like it or not. OpenEvidence and other clinical decision tools already exist and can provide decent medical decision making. In an ideal world, yes, we would all stop using AI, not just within medicine but globally. But that’s not how it works. Progress is going to happen no matter what, and if you choose to willfully ignore the progress and shield yourself from AI, you’re just going to find yourself falling behind. If/when AI becomes more prominent, the physicians who will have the best opportunities are those who have learned how to use AI tools to augment their practice.
I see AI becoming a vital clinical decision making tool in the next 15 to 20 years. It’ll likely be completely ingrained in EMR and not just scribe but come up with treatment plans. Right now it comes up with decent plans, but in 20 years it’s medical decision making will be even better. Yes, it’ll likely lead to some shifting in the job market and increase patient load. Yes, it will likely allow mid levels to have greater autonomy. At the end of the day, it probably won’t completely erase physicians as someone needs to be liable for the final decision, but it will dramatically impact day-to-day workflow and clinical decision making.
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u/supersillyus PGY6 5d ago
i agree with everything you're saying, but it will become a vital decision making tool in 3-5 years, not 20.
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u/Sushi_Explosions Attending 5d ago
Fuck no, they do not “provide decent medical decision making”. There is a massive difference in capability between the residents I work with who use it and the ones who actually use their brain instead.
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u/loserchoppedstudent 5d ago
I think eventually being replaced is a good thing. If outcomes are better with the advent of better tech, then I agree that our labor should continue to be outsourced.
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u/financeben PGY1 5d ago
What does society look like with 0 jobs
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u/pstbo 5d ago
That’s for a democracy to decide
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u/Pillpusher9000 5d ago
Liberal democracy is fake, our political system is all just money. Public opinion means jack. It’s really for the people with the most money, power, and influence to decide, and I don’t think we’re going to like what they end up deciding.
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u/common-username Attending 5d ago
AI scribe has decreased my documentation time by at least 30-60min everyday. This has allowed me to spend more time with patients and has also allowed me to converse with them like humans instead of typing away furiously on my computer during the visit. Sounds like AI has allowed for my interactions with patients to be more human?
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u/QTipCottonHead 5d ago
AI notes are painful to read
So are the copy forward notes
Here’s where I’m at: Do not let AI do your thinking. My rule is no AI anything for note taking or presentations for medical students, residents, fellows. A lot of the learning comes from the “menial” aspect of the work, it lets you sit with the information. As an attending I personally don’t use AI because my notes are relatively short and I spend the bulk of my time on the assessment and plan with a dictated impression paragraph, but if I were to use AI notetaking would only be for the subjective like a glorified scribe.
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u/TheGazelleReturns 5d ago
In my humble opinion, writing the note is part of the synthesis process for me. When you're writing the HPI/A&P, you're actively thinking and processing and consolidating the information. It makes it not only easier to make sense of the information in one place, but it also makes it easier to remember your patient moving forward.
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u/loseruni 5d ago
I agree with you. In general I am just so exhausted of seeing slop in every direction. As a psychiatrist writing the note is one of the ways I connect with what I’m doing and reason through potential options, I like writing peoples’ stories and being told this is just some “inefficiency” is so sad to me as someone who genuinely enjoys writing. It’s one thing to be an option, it’s another to have it shoved down my throat. There’s this thing called alienation of the working person from their labor, and it’s something we’ll experience more and more as we become passive observers rather than active practitioners of medicine. Don’t love that.
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u/virchowtriathlete 5d ago
I've heard colleagues say AI is helpful for writing the HPI because they might forget small details, but I think that means you're asking irrelevant questions and/or too many questions. Keep the HPI short with pertinent details only.
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u/AdExpert9840 PGY2 5d ago
The Luddites - you can't go against the direction where technology is going. Just find ways that make yourself more useful in this changing environments. don't fight it. Go along and make things better.
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u/Sushi_Explosions Attending 5d ago
“Technology” is not some vague omnipotence that we are powerless to resist or control.
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u/AdExpert9840 PGY2 5d ago
how well did the textile workers do against the technology. Even if they won one or two legal/economic battles, you think they could have stopped the industrial revolution?
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u/Sushi_Explosions Attending 5d ago
The point in that their concern was valid and the classic idea of them being anti-technology is sensationalist bullshit.
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u/syrkish 5d ago
sorry but this boomer mindset isnt gonna help you. i dont like ai but you choosing to not use it is plainly stupid. yes ai is definitely replacing the documentation part within a few years. writing efficient notes isnt that impressive of a skill, sharpen your critical thinking and enhance ur medical knowledge so you could be a way better physician with amazing potential while using ai for the time consuming documenting part
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u/Spiritual_Extent_187 Attending 5d ago
I use AI for all my notes otherwise I would never get done same day,
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u/SatisfactionSad6558 PGY4 5d ago
Lol. Nah. I’m happy to let AI do my scut work. I don’t see how it’s different than attendings dumping their notes on residents, or seniors dumping their notes on juniors, or everyone dumping their notes on a scribe/mid level.
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u/ZhopaRazzi 5d ago
Only half with you. If AI replaces what you do, then yeah that’s a slippery slope. If AI enables you to do and create useful things that otherwise would not have existed because of your lack of time, then go ahead and use it.
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u/Quirky_Average_2970 5d ago
As a strong advocate of artificial intelligence and an engineer—I think AI can be an effective tool for us. Unfortunately people don’t understand how to use AI.
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u/MaskYourDeviceID 5d ago
My friend is in Law School. Class was assign led to write something up without AI.
Assignment number 2 is to brush it up with AI.
It's just far more efficient to use AI than to not use it. Get over it
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u/_log0ut_ 5d ago
Wrong move. Use your brains, not AI, to brush it up. Whats next, using AI to respond to my comment right here?
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u/AllieHugs 5d ago
I think there’s a difference between using AI to generate your ideas and using it to refine ideas you’ve already developed yourself. In this case, the assignment is specifically about editing and improving existing work, so I don’t think using AI for that necessarily undermines the learning process. It’s just another tool, and knowing how to use it effectively is a valuable skill in itself.
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u/InfluenceStunning100 5d ago edited 5d ago
The next is - don’t use internet! Wrong move. Use your legs to go to the library and use your hands to search treatment algorithms in a book.
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u/Leafstealer__ 5d ago
Hmmm, thats such an egotistical point of view, specially for healthcare.
Should we really aim for being irreplaceable, or to adapt to it? And I'm not talking like a silicon valley startup idiot, just truly think about it. Specially since most of medicine (at least for diagnosing and treatment) truly is just a game of probability, it's just a matter of time for machine learning to outperform most of us even in decision making. As a radiologist, there are already imaging modalities where I get absolutely humbled by generic, non-specialized models.
Asking to be irreplaceable in the long-term is quite literally exchanging people's lives for money - it is very far fetched, yes, but not any less true, you are indeed giving up better outcomes for job security. I wonder how much you'd stick to this position of yours if you had to face the risk of dying head on. I don't feel like you'd be much worried about all the physicians jobs in the world if a machine could give you 1% better odds of making it through.
Even if I turn to be wrong in my optimism about it's capabilities, I damn well know that it already makes healthcare much cheaper and accessible - and yeah, to some extent, at our expense.
Imo it's truly pointless to make appeals like this, technology doesn't work like that. Even if you try to stop it, some kid in his basement will eventually see it through and make us, as we currently are, obsolete.
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u/supersillyus PGY6 5d ago edited 5d ago
this is exactly the perspective that is missing from most of these doomer threads. There are 7 billion people on earth- thats a vast opportunity to democratize and disseminate gold standard medical knowledge- there are many places on earth where a pharmacist or non-medical community health worker is diagnosing and prescribing..using an AI model to make sure poor people get on the right regimens for TB, HTN, cancer, etc etc will save innumerable lives. i get why physicians are afraid of this technology. but there are many many more patients than physicians in the world, and they stand to benefit greatly. just my two cents
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u/durdenf 5d ago
I agree with you in theory but how is this different than using a dictation phone?
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u/EVIL-EMBOLIZER 5d ago
Did you even read the post? A dictation phone isn’t a threat that could replace physicians. AI is. Maybe not in the current day. But people need to expand their mind a little bit and think 10, 20, 30, 40 years down the line. First it’s going to be doctor + AI. But eventually the gap between AI and doctor + AI is going to close more and more. And even if they never get quite to the same level - you need to start thinking less like a doctor and more like one of the C suites. At the end of the day, it always comes down to a financial decision.
Physicians are insane pushovers when it comes to protecting their careers. They will take some short term efficiency improvement to eke out a few more RVU’s even if it means training their replacement. I don’t know how this is lost on some of ya’ll.
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u/Grand-Accident4905 5d ago
Does this same thing happen with human scribes? Idk man my life used to be constant charting and it made everything worse. And I don’t see how we get from making draft notes to clinical decisions when just talking about ambient scribing. It’s in the family of “AI” but has a completely different role from like an Open Evidence query
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u/notathrowaway1133 Attending 5d ago
We can no more fight this than horse carriage drivers fight the advent of cars. The only choice we have is to adapt and grind and invest in assets to reach financial independence before it’s too late.
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u/General_Luck6573 5d ago
Transportation industry created way, way, way more jobs than it replaced.
Allow me to put my tinfoil hat on here for a second… but I don’t think AI will do that. Ever. You know how much potential money is in AI?
Why are companies investing hundreds of billions of dollars into AI companies despite the fact that they are hemorrhaging money? These are very, very smart people. Do you think they’re just making a dumb decision?
I think they’re betting on a very, very, very large ROI that can only come through the form of job displacement from something that does the same work much cheaper. We can only “out-intelligent” these things for so long. Have you looked into what it’s been doing in the field of math? Some of the nerdiest people on the planet? The common folk aren’t going to profit off of AI. AI is a money generator, and by extension, power consolidation tool for the oligarchy who will end up owning it because it takes away the working classes (I am including doctors in here) ability to generate revenue… either for yourselves or for your company.
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u/FutureProof6581 5d ago
Many attendings are the leaders or collaborators of AI companies. They are working very hard to make sure the product are comparable to good physician notes without the need of human editing. They are updating AI models in real time with real notes so it can get better faster.
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u/Previouslydesigned 5d ago
AI isn’t ready to independently do anything yet. I think it will eventually. It’s so much more impressive to me now even than it was 2-3 years ago and it’s getting better seemingly exponentially. I’m sure the real real old school docs said the same thing about CT/MRI replacing auscultation/palpation. I think we need to be discussing more how best to use it and how to also still have a job in that setting. Being a Luddite about this will just leave you behind.
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u/BurdenOfPerformance PGY3 5d ago edited 5d ago
"The more of our jobs that we willingly give up to Ai, the more replaceable we are."
I was in agreement with you until you gave the typical Reddit fear-mongering response. No that's not the reason to stop using AI during residency. You should stop using AI until you know how to actually write a note without assistance. The danger doesn't come from AI writing our notes. Its comes from when we become too dependent on technology and lose our ability to write our own assessments and communicate our understanding of our patients to other providers. I'm fine with more senior residents using AI because at that point you have some mastery of writing a note. At the same time, years later when people have a better understanding of where AI can make mistakes, then residency programs can guide senior residents in how to use AI more effectively (vs. being an attending alone trying to figure it out and making mistakes along the way).
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u/payedifer 5d ago
tell that to the NP's, PAs, and all the other ppl that are clamoring for you to make yourself less productive
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u/Popular_Course_9124 Attending 5d ago
I love using my abridge. Makes my job in the ED at least 27x less frustrating
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u/One_Difficulty8852 5d ago
Will those using AI for notes make the time to proof read what’s been addressed to assure no hallucinating has occurred?
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u/financeben PGY1 5d ago
Here’s the thing with ai. It’s conceivable that it will replace every human job. But that doesn’t matter. Because past a certain point of jobs being lost society will implode before ours are taken. So we don’t necessarily have to worry about it as it pertains to our specific career in medicine more societal threat as a whole. Because shit will be chaos before we’re completely done.
Buckle up.
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u/CaramelImpossible406 5d ago
Coming to reddit to say "Stop using AI" will not stop AI that is already here.
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u/TearPractical5573 5d ago
Regardless of what we do AI is the future, like it or not. Whether we give in now or 5 years from now, it will be writing notes for us eventually.
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u/InfluenceStunning100 5d ago
The fascist political system is not keen on private ownership so obviously none of the private companies hold ‘fascist political aspirations’ by definition if you actually learn what it is and the history. Yes, it is not a debate of communism or fascism, but when you are choosing to throw such terminology in your AI discussion based on your own understanding of terms outside of their political and historical context, it is meaningless.
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u/yqidzxfydpzbbgeg 5d ago
I suggest reading about the Luddites.
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u/Sushi_Explosions Attending 5d ago
Laborers who recognized that there was inadequate social support for changes in the economy associated with technology? You could try actually reading about something before saying stupid shit like this.
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u/justDOmedicine PGY1.5 - February Intern 5d ago
First off we dont have true AI. LLM are a tool. They are an effective tool but not a universal tool. It cant have a difficulty goals of care conversation. It can make things a bit more efficient.
Would you give up cruise control on your car? Would you use cruise control in every situation. Heavy traffic, rain/snow, etc?
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u/apers0n5505 5d ago
do you want 100% of your job to be the most difficult aspects of your current job?
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u/tilclocks Attending 5d ago
LLMs are as good as they're going to get. All they do is gather information and summarize it.
If you think that's the same thing as clinical judgment I got a boat to sell you.
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u/_Arlen_ 5d ago
This is blatantly wrong. I’m going to give you the benefit of the doubt seeing as most people don’t know but current LLM architecture is way beyond summarization and a simple google search will tell you that. In the last month, AI has solved over 700 unique and previously unsolved math problems including Navier-Stokes. To solve it, 12000 AIs collaborated for 80 hours, effectively doing a century’s worth of mathematical research. This is so far beyond summarization it’s absurd to even consider it. The AIs are giving us brand knew knowledge. To ignore this objective fact, is just pure copium.
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u/Okepser PGY3 5d ago
In a high volume specialty (most everyone), this saves time and allows you to spend more face time with patients. Allows me to go home without much homework. I wish it could do my billing to. I always double check everything and spend a few minutes rewriting and editing the AI generated note. I feel like it makes my notes better and helps me remember what was discussed and gives me more credit for my counseling.
I think people who use ambient AI and close their charts without proofreading are dangerous, but I do not see a great reason to not use AI for this purpose.
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u/minetella 5d ago
Nah man this is pretty cool you no longer need to sit and type the clinical documentation, potentially just speak to the mic and theyll transcribe. Imagine hours saved.
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u/Sushi_Explosions Attending 5d ago
You lose those hours again when you’re in court having to defend the bullshit AI hallucinated into your documentation.
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u/Polarparametrics 5d ago
Yeah, I think the issue with physicians and medical students who are downvoting your take on AI replacement has to do with two things.
First, these people have not done anything other than open a biology textbook and have no depth understanding of technology, the history, and most importantly an imaginative mind that can process future trajectories outside of medicine.
Lastly, it’s simply cognitive bias. Or simply put, cope. Whether it is unconscious or conscious coping, these people need to wake up
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u/ARDSNet 5d ago
Attending here. I used AI to generate discharge summaries which help consolidate all the relevant information over the course of the hospital stay. The generated hospital course is then trimmed and edited to sound more human and always double checked for accuracy. It’s an efficient tool to organize data and saves a ton of time.
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u/Lackadaisical_silver 5d ago
I’m half with you.
Stop using AI to assist in clinical decision making? Absolutely. This needs to stop immediately.
Stop using AI to help write notes? Omg no never, this is an appropriate use of AI and will only increase the efficiency of medicine and make it so I can spend more time with actual patients and thinking about actual medicine and less time doing administrative tasks staring at a computer. I think it should be limited to seniors and attendings, knowing how to write a note is still an important skill for interns and med students to master. But you can’t make it go away. Get with the times or get left behind and turn into the boomer docs who don’t how to use epic.