To the Editor:
Re “A.I. Has Made Me a Better Physician,” by Rachael Bedard (Opinion guest essay, Sept. 27):
I graduated from medical school more than 50 years ago, long before A.I. was a possible partner in patient care. Dr. Bedard applauds A.I.’s improvement of her doctoring. She fears that A.I. will negatively affect doctors in training.
The real issue is recognizing that medical education is not an either/or proposition. Before A.I. was available, educating physicians to observe and reason resulted in the best diagnosis and treatment. Today, educating future doctors to appreciate that A.I. yields expansive information often not available to physicians in the past adds to the best diagnosis and treatment.
One caveat: A.I.’s pronouncements must be vigorously assessed and validated.
Medical care is a process of arriving at the best decisions based on incomplete information. More information for physicians to contemplate can reduce missing essential facts. Rather than praise or deride A.I., acknowledge that patients will benefit when physicians embrace both human observation and reasoning and A.I.
Together they enhance a physician’s ability to consider as much information as possible, to sift through the competing priorities of a patient’s maladies and arrive at the best decisions for diagnosis and care.
Alan Jay Schwartz Elkins Park, Pa. The writer is a retired anesthesiologist and medical educator at the University of Pennsylvania.
To the Editor:
Dr. Rachael Bedard’s concern regarding the experience gap between attending physician and resident isn’t the problem. It’s a fact of training, and time closes it. Every attending was once a resident.
What worries me is the passivity she describes.
The habit that protects patients is older than any chatbot: Assume the answer is wrong until you have proved it right. Check the number against the patient. Ask where the claim came from. My medical school and residency pounded that habit into us because textbooks, attendings and lab values could be wrong, too.
The consequences of being wrong are literally life and death. And once it becomes part of the record, you own it, not your source. The first thing you do when you look at an image or lab value is check the name and date.
If trainees accept a chatbot’s answer without challenging it, the tool did not create that passivity. Training allowed it. A school that graduates students who cannot read does not get to blame the library.
The fix is not to take the tools away. It is to test trainees without them, and to demand that the A.I. explain its reasoning rather than simply hand over answers.
In the meantime, shouldn’t the attending witnessing this behavior force her residents to justify their decisions? An answer ends the thinking. An explanation starts it.
John C. Ferguson Honolulu The writer is the president-elect of the American Board of Facial Cosmetic Surgery and the founder of EdAI Systems, which develops A.I. tools for medical education assessment.
Americans’ Mental Health
To the Editor:
Re “Psychiatry Needs a Reset,” by Maia Szalavitz (Opinion guest essay, Oct. 6):
Ms. Szalavitz felt “enormous relief” on being diagnosed with autism spectrum disorder, and rightly argues that labels can help in treatment and in patients’ understanding of themselves. But such labels can also lead to stigma and discrimination that hamper patients from pursuing diagnosis or treatment at all.
In 2022, around half of all Americans with mental health problems did not receive any treatment. Moreover, the care most patients receive is inadequate. President Trump’s cuts to government insurance programs have unfortunately worsened these gaps.
We surely need to develop better diagnostic categories, but must also improve public attitudes and access.
Robert Klitzman New York The writer is a professor of psychiatry and the director of the bioethics master’s program at Columbia University.
Just Like in China
To the Editor:
Re “China Has Never Felt This Angry to Me,” by Helen Gao (Opinion guest essay, Oct. 4):
Ms. Gao writes about China today: “Success itself is cause for suspicion and outright hostility: If I am falling behind, someone else must be getting ahead at my expense.”
In another context, she could just as well be describing the current state of the United States. We are more alike than different.
Pamela Roskin Brooklyn
The post Examining the Doctor-A.I. Relationship appeared first on New York Times.
