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In this episode of Plain English, host Derek Thompson interviews Stanford Medical School Dean Lloyd Minor about the current reality versus hype surrounding artificial intelligence in medicine. The conversation examines four major claims about AI's potential in healthcare: its ability to diagnose diseases, design new drugs, accelerate clinical trials, and work with wearable devices to fight chronic illness. (02:56)
Derek Thompson is the host of Plain English and a staff writer at The Atlantic. He covers technology, economics, and culture, with a particular focus on how emerging technologies impact society and business.
Dr. Lloyd Minor is the Dean of Stanford University School of Medicine and a renowned expert in otology and neurotology. He described a significant inner ear disorder in 1998 and developed surgical procedures to treat it, establishing himself as a leading voice in medical innovation and education.
Large language models like GPT-4 are already demonstrating remarkable diagnostic capabilities, sometimes outperforming human doctors in identifying rare diseases and complex medical conditions. (02:38) However, Dean Minor emphasizes that while AI can access vast databases of medical information and identify patterns humans might miss, it won't eliminate the need for physician diagnosticians in the near future. The technology serves as a powerful diagnostic aid that helps doctors synthesize complex medical information more effectively, particularly for rare conditions where a human doctor might not have encountered similar cases.
AI's exceptional ability to detect subtle abnormalities could lead to overtreatment and increased healthcare costs, similar to what happened with earlier medical technologies like echocardiograms. (18:19) Minor explains that when echocardiography was first introduced, minor variations from normal readings often led to unnecessary procedures until medical professionals learned to interpret the clinical significance of these findings. The same pattern is likely to occur with AI, requiring a learning curve to distinguish between clinically significant findings and benign variations.
There's a significant risk that physicians might become overly dependent on AI tools, potentially losing essential diagnostic skills. (21:00) Minor uses the analogy of medical education being like learning a foreign language - requiring vocabulary (medical knowledge), grammar (how body systems work), and synthesis skills. While AI excels at providing medical information, doctors must maintain their ability to critically evaluate AI recommendations and push back when something doesn't seem right, preventing the de-skilling effect observed in some studies.
AI has made genuine advances in drug discovery, particularly through tools like AlphaFold that can predict protein structures with remarkable accuracy. (27:28) However, despite four years since AlphaFold's breakthrough, no AI-designed drug has reached patients. The challenge lies not just in designing molecules, but in predicting their complex interactions throughout the human body. Minor explains that understanding off-target effects requires comprehensive knowledge of cellular metabolomics that we don't yet possess, making drug discovery a longer-term prospect than initially hoped.
The most immediate and practical application of AI in healthcare appears to be helping interpret the vast amounts of data already being collected by wearable devices and medical tests. (47:43) Thompson's personal experience with ChatGPT analyzing his blood panel demonstrates this perfectly - the AI provided the same analysis as his doctor but instantaneously. Minor suggests this represents AI's sweet spot: taking complex data points and providing reasoned analysis that helps both patients and doctors understand significance and risk factors without requiring medical training.