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"The first rule of any technology used in a business is that automation applied to an efficient operation will magnify the efficiency. The second is that automation applied to an inefficient operation will magnify the inefficiency." -- Bill Gates

In the lifetime of my adult sons the world stopped being predominantly agrarian and rural and hit a point where more than half of all people on the planet live in cities. It wasn't hugely long ago -- a hundred or two hundred years -- that most people lived in little villages or tribes and didn't travel all the far and knew most people they dealt with.

The local doctor -- or medicine man -- was often one of the older, best educated and wisest locals. He tended to come to your home with a little black bag and in the course of walking through your house to check on you if you were ailing and not able to get out of bed, he saw a great many things about your life without having to ask.

This informed his conclusions about what was wrong and about how to treat it. And it did so in a way that was largely invisible to the recipients of care.

Doctors likely often didn't explain that the house was filthy or the spouse was obviously abusive. Topics like that tend to be socially unacceptable and people don't like being criticized in that way, but if someone smarter and more experienced and better educated and wiser walks through your life and then prescribes something "for your health" and he has a track record of fixing the problem, you do as you are told because you were told it.

And then modern medicine invented a lot of diagnostics and what not and office visits by the patient replaced home visits because we haven't invented a Tricorder that can replace a little black bag and let you bring all that diagnostic power with you.

Human health is no longer treated like the logical outcome of all your life choices and your physician is no longer the wisest person you know giving you good advice that takes into account a great many factors you never talked about with him. People get treated like specimens in a petri dish in a way that implicitly denies the fact that their physical state of health is the sum total of all their life choices.

In tribal cultures, medicine men were typically people who tended to both spiritual and physical health. The two were not viewed as separate from each other.

Medicine has become commercialized in a way that doesn't really serve the interests of the patient and if you try to point that out you are likely to be written off as some paranoid fruitcake and conspiracy theorist.

There are a lot of good things about modern medicine, but there are also a lot of systemic issues and this article is correct to point out that AI tends to magnify those sorts of things.

Last, health is best understood as a moving target in 4D. Data capture does a poor job of approaching it that way and I'm not aware of any programs that are well equipped to do a good job with that.

Human doctors were historically put on call for up to 24 hours at a time as part of their learning process in part so they would see a patient's condition evolve over time while the doctor was still young and healthy enough to endure this grueling process. Having seen it for a time as part of their training, they retained that knowledge when they were older and could recognize a stage of a moving target.

I don't know how much that is still done, but I don't think we really frame AI in that way. I don't know how we would get there from here either. I still haven't managed to learn to code, what with being too busy with my own health issues all these years.



It's a lot like the emergence of scientific forestry as described in "Seeing Like a State" - instead of local knowledge and care/attention to individual circumstances by a generalist, the field has become standardised and based around things which can be easily measured.


Exactly, the article blames ML, but these issues of concentration of power and of knowledge are at least as old as State-istics !


> Human doctors were historically put on call for up to 24 hours at a time as part of their learning process in part so they would see a patient's condition evolve over time while the doctor was still young and healthy enough to endure this grueling process. Having seen it for a time as part of their training, they retained that knowledge when they were older and could recognize a stage of a moving target.

Closer to 36 hours at a time, I am sad to report


> Human doctors were historically put on call for up to 24 hours at a time as part of their learning process in part so they would see a patient's condition evolve over time while the doctor was still young and healthy enough to endure this grueling process. Having seen it for a time as part of their training, they retained that knowledge when they were older and could recognize a stage of a moving target.

Isn't it more because, unlike most other fields, the medical field systematically refuses to learn best practices to hand-over information? So they prefer to have a heavily sleep-deprived resident they can abuse rather than a better way to document and to pass information.




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