As a common decision-making disease, AI can save this human interaction – Healthcare Blog

Michael Millenson

A common decision between a doctor and a patient may be “The pinnacle of patient-centered care,” But three new medical journal articles show that it has encountered more problems than the peak. But, counterintuitively, it may be that artificial intelligence saved this close human interaction.

“Common decision-making is at a crossroads,” the view in the General Journal of Internal Medicine “preserve common decision-making.” Unfortunately, it seems to be more cross-guard recommendations for “advance SDM implementation science” than crisis management.

Even a rough historical perspective shows that SDM has suffered from failure to flourish. As early as 1982 Report of the Presidential Medical Ethics Committee Announced SDM “ideal for the professional relationship of patients” and called on physicians to “respect and enhance their patients' abilities to exercise their autonomy wisely.”

Yet 43 years later, the Perspective Author – 18 members of the Healthcare Research Institute shared the decision-making learning community – admits that while some doctors respect patients, what do you think you want to do given these choices? “Many others still believe, “Will it sound OK for us to make this choice?” ” is a common decision-making process.

This attitude reminds me of the ridicule published by comedian Stephen Colbert. “Look at what we can accomplish when you work together through what I say?” he told the audience in Colbert’s Country in 2015. “This is called a partnership.”

Cancer transmission has decreased

In cancer, patient caregivers interact with the highest shares, and shared decisions were rated as one of the core components of quality care in a 1999 report. Ensure quality cancer careby the Institute of Medicine (now the National School of Medicine). Nevertheless, a review of SDM in cancer patients in the journal Psychological Oncology It was found that for doctors, “making decisions and making responsibilities for decisions remains an important part of the physician’s professional identity.” The authors wrote: “Fear of losing this identity “inclines to hinder patients’ participation and implementation of SDM. ”

Not surprisingly, cancer patients who want to speak up feel as if they won’t listen or can’t really reject anything their oncologists think is clinically “best”. And, it turns out that oncologists are actually open to SDM if patients do speak and resist suggestions they think are in the best interest of the patient.

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At the same time, for those who hope that Generation Z doctors will naturally be more sensitive, Jama Views, ”When the patient reaches the answerbringing frustrating news. When patients raise the topic of Chatgpt's treatment advice among a group of medical students in the Seattle area, these tomorrow's internet local doctors are full of old-fashioned disdain for patients, “to tell us what to order.”

Dr. Kumara Raja Sundar lamented the implicit message “We still know the best”.

AI solves chronic problems

When you look closely at SDM use, abuse and non-use, it is obvious that this is a chronic problem, not an acute problem. Good will collide with cultural norms traced back to Hippocrates. Patient self-determination idea, writing medical ethicist Dr. Jay Katz The world of silence between doctors and patientsrepresents “a fundamental rest with medical practice, spread from teachers to students in recorded medical history.”

Perhaps equally important individual doctors are less likely to control their time. According to the American Medical Association, in the 1980s, 80% of doctors worked in the practice of ten or fewer doctors, and these doctors accounted for a large proportion of private practice. In 2024, private practitioners are the minority for the first timeonly 42%, about one in five doctors are engaged in 50 or more practical work.

Paradoxically, AI may push shared decisions toward what is now often a time-consuming agenda, precisely because it is able to force reevaluate detailed, personalized information about the physician’s professional identity. Similarly, the scale, scope and depth of the AI revolution will force group practice leaders, health system executives, private equity satellites and all others now attract so many doctors to adapt to the democratization of medical knowledge.

There may be no choice. People with breast, lung or prostate cancer can already go Well-funded start-ups This will help them transfer medical records to a platform that compares their treatment plans with the clinical practice guidelines of the National Comprehensive Cancer Network. Alone, cancer survivor and entrepreneur An online platform has been launched To create a personalized agent AI, a sophisticated search of medical literature available to every cancer patient is conducted. and real-life evidence in cancer care, Now sold to clinicians and researchersinevitably, it will be used directly to the patient. Meanwhile, online venues such as Denteruseai alternatives help guide those who want to be a comprehensive partner on how to use the new tools.

The question is no longer whether there is a common decision, but how to proceed. Family doctor Sundar recommends “relationship humility”, and doctors “see access to AI information as an opportunity for deeper conversations rather than a threat to clinical authority.”

He added: “If patients arm their message, our task as clinicians is to recognize them, not resist.”

Michael L. This first appeared in his column Forbes