I just finished reading a really good book, “The Space Barons” by Christian Davenport. In it Elon Musk and Jeff Bezos, rocket rivals, are doing their best to bring down the cost of space flight and reprise the role of D. D. Harriman in Robert Heinlein’s novel, “The Man Who Sold the Moon.” By utilizing advanced technology they propose to deploy relatively inexpensive, reusable rocket boosters. I like the idea of applying advanced engineering and computers to bring down the costs of things.
Some wag once said if aviation or automobile development had mirrored the evolution of the computer, you would now be able to drive to California from New York for a quarter, in six hours. Or, you could fly to the moon for $1 in a day. Or something like that.
Computers make a huge difference. We need to apply them to the practice of medicine to lower the costs. And to the automobile and aviation industries, too, apparently.
But let’s start with medicine. MRI studies are way too expensive. Well, everything in medicine is way too expensive. It’s a for profit industry now, not a calling. It was a calling back when there really was no way to help a patient except to hold his hand and console him, or to make her comfortable while she passed away from an untreatable disease. Today, people can actually be cured! Epidemics of infectious diseases or Type II diabetes can be prevented!
As a result some people think there is a vast conspiracy to immunize them or starve them. Many have become hypochondriacs. They expect to die from that gas pain, which resulted from the CardiacArrestBurger they downed with a six pack of their favorite local brew or energy drink. Unnecessary measles outbreaks, obesity, diabetes, and visits to the ER help drive the cost of medicine upward.
No politician wants to try to balance the budget when everyone who might receive free medical care will expect to live to be 105. Well, no politician wants to try to balance the budget. At one time, the Republicans did, until they they realized they could vote themselves a huge tax refund and still get to complain about the ‘loafers on welfare’ at the same time. Besides, who knows if our trillions of dollars in debt mean anything?
Where would free market competition and technology help with the expense of medical care? Suppose the government, some individual, or group sponsored several contests, like the Ansari X Prize for first reusable spacecraft. This ignited the free market space race of which Bezos and Musk are only the tip of the iceberg. A similar prize by Raymond Orteig sent Charles Lindberg to Paris, and is widely blamed for the cramped seating in present day airliners. The first maker of a portable, handheld, cheap MRI would win $20 million dollars. MRIs don’t produce radiation and are thus probably safe in the layman’s hands, as is ultrasound imaging. The spin-off technology would be exciting, even if every household could afford their own MRI.
MRIs by themselves won’t solve the problem. We would also need contests to develop an artificial intelligence (AI) to interpret the information obtained by the machine. Radiologists are paid too well to read every MRI or ultrasound image taken. The radiologists should be called upon when the AI is stumped. Later, when the AI is sufficiently trained, the radiologists will likely consult it when they are flummoxed. They could help each other, and lower costs.
We’ll also need a contest to help develop a diagnostic AI. Not everyone needs an MRI. People have infectious diseases, inheritable syndromes, autoimmune diseases, cancers, and other problems that only good diagnosticians can solve, or at least diagnose. A third AI may be needed to determine the best treatment for each individual.
Once these advanced technologies are in place, I would envision the interaction of an injured weekend athlete with a private MRI and Cloud AI to go something like this:
“Doctor Alexa.”
“Yes, John.”
“I fell playing Pickleball today and hurt my wrist.”
“Please scan your wrist with the MRI wand.”
“Done.”
“You have sprained radialulnar and ulnarcarpal ligaments in your left wrist. Ice and elevate it. Take two aspirin, and use the wrist support I just printed in the 3D printer. They might take a couple weeks to heal.”
“Thanks. Can’t we do anything about the pain right now?”
“If you do what I said the pain will diminish greatly.”
“But that might take twenty minutes….”
“Grow a pair, John. This is a minor injury.”
“What did that cost me?”
“Three cents in electricity and $1.51 in Cloud AI time.”
“Thanks.”
“No problem, wimp.”
Similar interactions would take place with sick individuals.
“It’s a virus, idiot. You don’t need an antibiotic.”
“A bland diet does not include jalapeño peppers, pizza, and beer.”
Some people might even be cured. Even though only a small percentage of the population has difficulty understanding scientific principles, they account for an inordinate amount aggravation for the rest of us. The next step would be an AI with which preschoolers would interact to help prevent stupidity and the development of conspiracy theories that plague humanity.
If you do print this opinion, please add:
Bill Yancey is a retired physician and the author of two recently published novels: “Abandoned: MIA in Vietnam” and “An Autopsy of Vultures: Murder and Mayhem in an Active Adult Retirement Community.”
Bill Yancey
735 Copperhead Circle
St. Augustine, FL 32092
904-466-1003
wmbyancey@bellsouth.net
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