Column: AI is transformative, but doctors are paramount

Narain Batra. Copyright (c) Valley News. May not be reprinted or used online without permission. Send requests to permission@vnews.com.

Narain Batra. Copyright (c) Valley News. May not be reprinted or used online without permission. Send requests to permission@vnews.com.

By NARAIN BATRA

For the Valley News

Published: 04-19-2024 6:52 PM

A few years ago, I was on a return flight from New Delhi to Paris and New York, when the chief flight attendant suddenly broke up the humming silence and asked passengers to ring the call bell if anyone was a doctor. One physician, a tall and handsome young man, quietly rang the bell and was ushered to the front of the plane where another flight attendant was in distress because of a panic attack. The doctor provided treatment and the patient was stabilized. A good doctor in the neighborhood is a great blessing.

“Wherever the art of medicine is loved, there is also a love of humanity.” Thus spoke Hippocrates, the ancient Greek physician regarded as the father of medicine and of the Hippocratic oath — “First do no harm.” But now when health care has become a most essential human right, much more is expected from doctors.

Today, doctors are serving in the killing fields of Ukraine and Gaza, risking their own lives to save others. During the COVID-19 pandemic, doctors and medical professionals played heroic roles, working endless days and nights, to save as many people as they could from a massive global health crisis.

But unbeknownst to many of us, artificial intelligence played a crucial role in the development and global distribution of COVID vaccines. Early this month Dr. Saeed Hassapour, director of the Center for Precision Health and Artificial Intelligence at Dartmouth College, organized a symposium that drew some of the most brilliant AI experts, physicians, and researchers, including, among others, Dr. Curtis Langlotz, a Stanford professor and president of the Radiological Society of North America, known for his work in applying AI in medical imaging, and Dr. Faisal Mahmood, an associate professor at Harvard Medical School, credited for his contributions to digital pathology and AI in cancer diagnosis, prognosis and biomarker discovery.

The interdisciplinary gathering of experts discussed how AI can provide valuable insights from vast amounts of digital health data, leading to more efficient and personalized care. There was a strong emphasis upon the importance of ethical integration of AI tools into health care practices and the need for medical professionals to be trained in how to use these technologies responsibly and effectively.

AI algorithms can assist radiologists at every step of the imaging process; for example, providing inputs to help decide which imaging tests to order; enhancing image quality; detecting imaging problems to ensure faulty images are retaken; conducting preliminary assessment; and serving as virtual assistants for reporting observations and following up with patients. The goal is to eliminate human errors.

As Dartmouth President Sian Beilock pointed out in her opening remarks at the symposium, researchers are developing AI tools to help diagnose colorectal cancer and identify novel biomarkers for breast cancer, offering quicker and more accurate detection to facilitate timely treatment. Digital mental health technologies, such as web-based and mobile tools, are being developed to transform mental health care. These tools can influence mental health outcomes of users by predicting behaviors and symptoms, and engaging in interventions and therapeutic approaches based on the predicted symptoms.

With its capacity to sift through massive amounts of digital health data, AI can detect patterns that are hard for humans to see, thus helping radiologists to detect subtle signs of cancer with greater accuracy and informing which course of treatment is most likely to work for a patient with a certain medical history.

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But the wonderful world of AI medicine dawning upon us also raises important and complex questions about security, privacy, biases, ethics and equity. That brings us back to the pivotal role of doctors, and how best to educate them in the era of high expectations generated by the advent of AI.

Under their white coats, habitual smiles and calm demeanor, let’s not forget, doctors are people, too, with the same human frailties as any of us — families under stress, fear and hopes about growing children, divorces, addictions and most of all the pressure to keep up professionally.

The stories our culture tells about medical professionals reflect this reality. Just think about actor Hugh Laurie’s television portrayal of Dr. Gregory House. A brilliant and unconventional diagnostician, the title character of “House” also toils under compromised ethics and a messy personal life, including substance abuse. Revered for his work, he is unable to hold steady family or friend relationships.

The case of Dr. House may be emblematic of a larger social problem of the medical community. According to American Addiction Centers, “Few careers have such odd working hours and so many traumatic situations as those in the health care industry. The high levels of stress and physical pain that often come with this job open the door for numerous types of addiction,” adding that “approximately 5.5% of medical professionals struggle with illicit drug abuse.” Equally serious is the problem of physician burnout despite radical advancement through artificial intelligence. In 2022, for example, 71,309 doctors gave up their profession.

Medical schools and hospitals don’t talk enough about these issues. Perhaps the next Dartmouth Dialogue or symposium should be about doctors as human beings. Along with the integration of AI with health care, the foundation of medical education needs a reset. It should rest firmly on the humanities — medical humanities, as someone suggested in a recent dinner conversation I had with some Dartmouth alumni and friends. The art and science of medicine, the liberal arts, and the humanities — music, theater, comedy, literature and visual art — go together to make a good doctor in the age of artificial intelligence.

Narain Batra, under the auspices of the Osher Institute at Dartmouth, is scheduled to deliver, on Friday May 24, a public lecture, “Superintelligence: Why We Need It.” He lives in Hartford.