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Comment by kurthr | Hacker News Reader

What percentage of the diagnostic radiologists won't bother to even review the AI output? 3%, 10%, 30%? It'll increase as the AI improves. Unless the image is sent to multiple radiologists or their metrics (eg spotting AI errors) are updated, we'll get crap results.

I know one top tier diagnostic radiologist and he could tell which piece of equipment an image was taken on (or if something is out of calibration) with a fairly quick glance. Regularly on the phone with techs and technologists to get things fixed or reimaged. He retired recently.

From his telling most of the work has been outsourced to India for the last 10-15 years. He only gets the really challenging stuff.

edit: Interestingly, it seems like breast imaging is still done more in house and there are regular reviews, but that's from a different source.

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We already have an issue in the US at least, of doctors waxing about how their favorite part of their job is the relationship with their patients, and how they take an “evidence-based approach” and take time to listen to their patients… only for them to do the polar opposite in reality.

This is just going to be another case of patients needing to take ownership of their own care. It’s no longer “tell the doc your symptoms and they’ll figure out what’s wrong”, it’s now “tell the doc what you think you have and if they interrupt you and brush it off, go to another doc” until someone agrees with your diagnosis and gets you the referral or test or prescription that you need. For those who know what I’m talking about, I’m sorry. For those who don’t- you’ll learn this lesson someday.

You really have to double check everything yourself, which sucks if you are weaken.

I was at the hospital last week for a pretty bad condition and my IV was badly set. I told the nurse to change it for 4 days, they kept refusing, trying to adjust it.

Eventually I just told the doctor what was happening, and he said "oh, that's why your readings were messed up, I was wondering why I had to change your drug dose every day".

They changed my IV in the next hours, and my conditions improved overnight.

I discussed that with some doctor and nurse friends, and they all told me to never, ever trust a health practitioner you don't know very well. You need to be very proactive in your treatment, because they are exhausted, have many people to treat in a row and are only humans.

To be fair, this is not how doctors want to practice medicine.

He’s retiring, which means his knowledge is mostly lost unless he teaches. What if he spent some of his time labeling images so AI learns and the machine says “recommend reimage“ or “possible fault” for millions who don’t have your doctor.

> What percentage of the diagnostic radiologists won't bother to even review the AI output?

If someone’s not going to do their job, why does AI matter at all? Why wouldn’t they just use the same boilerplate text for everyone today?

Because it's a lot easier to rationalize not doing your job when it is (or at least seems to be) being done OK. There's a lot of rationalizing of decisions, when you've spent your life saying you're the expert helping people. Also, a lot easier for management to hand out a LOT more work since it looks like it's being done right.

It's like the lawyer using ChatGPT to file legal briefs... he'd feel bad and be obviously incompetent, if he didn't file anything at all, but didn't feel bad (or feel the need to check anything) once it "looked right".

I don't mind if lawyerGPT is used to help my one-off case, time enough to get that right for human eyes.

However, since I'm the final set of eyes judging my care I'll be asking to see a doctor who has never been assisted by AI and is in fact not a mind-atrophied cyborg. Who knows when this opinion will morph into harmspreading and wrongthink that gets you escorted to the schizo wing instead. AI might yet be paraded as safe and effective.

>What percentage of the diagnostic radiologists won't bother to even review the AI output? 3%, 10%, 30%? It'll increase as the AI improves.

In my opinion, an AI system like this (diagnostics) shouldn't even be implemented until it is statistically the case that "won't bother to even review the AI output"-level poor performance on the part of radiologists produces better outcomes than a traditional non-AI system. Then we don't have to worry about what happens when the radiologist isn't good enough to review their work product: the answer is that the medical care is at least better than it would have otherwise been. Deploying a system like that would improve medical outcomes with minimal disruptions.

That said, I think we'll reach that point (statistically provable that an AI system is making better diagnoses than the average radiologist) sooner than most people probably think, maybe a couple of years and then [regulatory approval] years until it's actually used. That doesn't mean radiologists shouldn't exist, though. A radiologist fits into a much larger organisational framework - they file paperwork, they hold responsibility, they are ostensibly available to call and ask about a specific quirk, etc. Even with a 100% perfect AI at the task of "what disease, if any, is indicated by this image?", that still doesn't automate a radiologist's job. A lot of other stuff needs to happen first.

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