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Comment by elif | Hacker News Reader

I'm way more interest robotic diagnosis than robotic treatment. It's so hard to trust dentists have your interest above their financial interest

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This sounds more like a systemic issue than a technological one. New tech will most likely only support the current system (profit over people, in your case), and not magically make things fairer or more social.

Probably it's both. If it would be really that easy to tell honest dentists (and society) would have no problem exposing the fake ones.

But in many cases dentists do protective/proactive treatment... that "brow spot looks like something, and maybe it's nothing, but let's make sure ..." ... which, yes, is reducing the number of cavities (by definition), but you have to get through the process. And if you have those spots for decades there's a good chance they would have continued to be nothing for more decades.

Even with Xray it's an educated guess. (I mean in cases when someone goes for a checkup.)

... but there's the non-tech aspect, meaning that the application of dental sealants seem to be spreading slower than warranted.

On the flip side, if you're waiting for society to change for your problem to be solved, you'll be waiting for a long time.

Doubly so if you are waiting for the Supreme Court to affirm your rights. Aside: After watching Biden win a rigged primary and be forced to resign with no vote just based on political pressure, my disillusionment with voting was complete. I’ll still do it, but just so I don’t have to lie to well intentioned people when they ask me if I did.

I have an example that disagrees.

I had a stomach bug, and a Physician was insistent I get xrays. I put my symptoms into chatGPT, and it agreed that the xray was unnecessary.

I saved hundreds of dollars, I learned my doctor was corrupt, and tbh... I already knew what I had before going to the doctors. I only needed the doctor to write the prescription.

Have you considered that your doctor might have had an actual reason to want you to get an X-ray and that maybe chatgpt is wrong? Absolutely wild to me that you distrust a human but feel like a glorified autocomplete is somehow completely trustworthy. They can both lie, but at least the human knows they are lying.

Buddy, the xray was to find a stone or something.

Anyway, chatgpt was right, physician was wrong.

So... we are denying reality now?

EDIT: I should mention, literally every patient was offered an xray. We were in a communal area. It didn't help that their ads across the wall were full of pseudoscience too.

Oh my god

Yeah, it's gotten to this point. Fucking unreal.

Whenever there's information asymmetry that financially benefits one party you have to be cautious. It's been shocking how many times people I know have sought second opinions on recommended dental work only to be given a completely different recommended treatment that's thousands of dollars cheaper.

Example from a friend: Dentist 1 - you need ten fillings today! Dentist 2 - You have a few risk spots but let's just keep an eye on it.

Went with the second recommendation and didn't have any issues and that was a decade ago.

Using robots does not change any financial incentives. This is true for operations as well as diagnosis.

Diagnosis is currently extremely subjective. I believe that GP is suggesting that robotic diagnosis will be more objective and determinant. Ostensibly, because financial considerations will not be part of the input to the diagnosis routine.

That said, financial considerations will probably still be a big part of the treatment routine.

> Ostensibly, because financial considerations will not be part of the input to the diagnosis routine.

Devices that overreport are likely to be more popular and more common than devices that underreport. That is in part due to the financial incentives associated with diagnosing.

Excellent counterpoint, thank you. I hate to admit to being cynical enough to be convinced.

> Devices that overreport are likely to be more popular and more common than devices that underreport.

I think you're on to something. I bet Henry Schein execs/shareholders haven't felt this much energy since patients first saw their dental issues on 36 inch TVs.

To tie in the sibling threads: devices that underreport will also be popular, just with the insurance companies after the fact to help them deny covering procedures. Your lung biopsy come back benign? CignaAI says you shouldn't have had it in the first place so out of pocket for you!

I'd like to see it change the way dental insurance works, so that e.g. an AI diagnosis will legally be fully covered by the insurance, and anything that can't be verified through that would be considered an elective procedure. In the US dental insurance works basically opposite of health insurance - they only cover the basic checkups and you have to pay for any real medical needs. It's like if car insurance only covered oil changes and tire rotations but not accidents

Isn't it already a problem now where insurance companies are denying people cover because some machine learning blackbox says so?

You want to trust a ChatGPT system to decide if you should have dental surgery? What happens when you are in crippling pain but "computer says no"?

You wont be able to ask for a second opinion on anything though. Presumably if they are all the same software they'll give the same opinion.

What makes you think that the robot won't have a financial interest? The company that makes it will want a profit. The dentist that buys it wants to make a profit. If there's an AI under the hood, it might decide that someone needs to pay for its electricity habit.

That being said, I agree that it's a difficult part of the fee-for-service model.

If the robot's decision-making process is transparent then 100% agreed. I just know, however, that (at least as long as state-of-the-art 'AI' consists of huge models trained on big data) the advice given by any free-on-the-internet bot will have built-in biases towards paid recommendations and similarly insidious things.

That's what second opinions are for. Not sure how a robot helps this.

That is what ChatGPT is turning into for many...

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