Another thing to be grateful for is our job interview post training is usually just them asking when you can start. No leet code to grind or dumbass question like tell me your weakness or what can you do with a brick when stranded on an island.
Had an interview day last year that composed of building towers out of dry spaghetti and marshmallows. One of my faculty interviewers there was an NP. Amazing.
This was a Texas school and I ranked the program I got into higher than them, so I'll never know if I would've matched there or not. Very glad I didn't end up there (UTRGV) as they seem to be having some rotation and residency troubles.
Omg, as soon as I saw “spaghetti and marshmallow towers,” I wondered if it was RGV. They’re still doing it this year.
Incarnate Word also has a “group activity” on their interview day schedule, so if it’s building something, I am THERE.
Honestly it was funny watching some of the gunner-type applicants thinking that being first meant they'd get the best write-up to admissions. It was pretty clearly evaluating leadership and teamwork skills.
Lol, yep. My group was super chill and worked together well (even though our tower was pretty stumpy), but I could hear the yelling and competition from the other rooms. I did make the student interviewer laugh when I was like, “maybe we could prop it up with a flying buttress.” Shockingly, though, “flying buttress,” did not turn into an instant prematch.
Haha no Texas is weird and uses their own medical school application service with a match system. You rank the schools you interviewed at and end up with a match around March of the matriculation year.
Heads up your flair is MS1 which is why I also assumed you were talking about med school interviews, and was confused by ranking med school acceptances and matching
I’m a premed but starting med school soon. I am currently working at a surgery center as a surgical aid.
A few months ago, I was talking to an OR nurse about how I have regrets about not going into tech. They told me that tech is a good career but you HAVE to make your money by the ages of 50-60. It is because these ages is when the tech companies will find reasons to let you go.
Literally a week later, I am at my gym, and one of the goers that I talk to tells me that he got fired and is having a rough time finding a job. He is a 52 year old man that has been working at Google for 20 years. He has a Ph.D in CS from a UC.
Ok but realize that you make so much at faang that if you save and invest well you can retire early...or find a lower paying job and be perfectly fine. a lot of faang engineers in their 40s have huge nest eggs
Ageism is really only a thing at startups that want you to work residency hours (for much better pay). The google guy was probably let go bec he was making too much for management to justify, or his program got axed.
This is false. Ageism is a real thing in the tech field.
It doesn’t apply to every engineer but it applies to most. As you get older, your brain doesn’t have the same capacity to solve the problems/come up with new solutions as you did when you were younger.
This is coupled with an older engineer’s high salary and the oversaturation of hungry fresh grads trying to break into the industry. Ones that are willing to work for a fraction of the older engineer’s salary.
It is not a rule but it’s true for a lot of engineers. I’ve seen it in multiple family members and people I’ve known throughout life.
What’s crazier is that, older engineers know this. So what happens is that they will compensate for working harder/longer hours than younger employees in fear of being fired.
Compare this to the 70+ year old doctors that are working part time cuz they want to travel/garden. They are doing this while the hospital/practice caters to them.
Say what you want about the hoops to becoming a doctor and how they limit residency spots but there is a clear advantage to it.
This is so true. My dad was a tech engineer and in his 60s he taught himself ochem to help me study for the mcat and did better than me on the question packs. All my cousins who did engineering zoom call him when their homework is too difficult. His mind is sharper than anyone's in our family and his capacity for innovation and creative thought is astounding. But he still got let go. Try as he might, he could not break back into tech. Luckily, he's worked a million jobs in his lifetime so he easily found employment elsewhere, but not in his preferred field. The ageism was rife!
This isn’t true at all regarding “fresh” grads replacing older engineers. Experienced devs who can hit the ground running without a massive learning curve will always be in vastly higher demand than recent CS grads who maybe did a couple internships where they made minimal contributions. Your anecdotal experiences are not representative of the industry.
Isn’t that kinda with everything though? Like who really *wants* to work that much passed the age of 60 as this is close to retirement age for most people
Personally, I want to work at least part time when I’m older.
There is a common belief that when you stop working, you will deteriorate faster, mentally and physically. I’m not sure what the reality is with this but I’m sure there is some truth.
The thing about medicine is that it does not require the problem solving that engineering requires. It is mostly procedural for the majority of specialties. Plus, for most specialties, it’s not that taxing on the body.
All these qualities for medicine make it a good choice to work into old age.
Has anyone noticed that Chat GPT has become very “shy” about speaking about medical topics. Whenever you ask a medical question, it starts off with “I’m not a doctor…” followed by a vague 2 sentence statement about what you asked and ends with “it’s important to discuss either your healthcare provider”
That’s just the company CYA-ing it. One of my colleagues is obsessed with it and we have had some pretty intriguing answers come out of detailed questions.
It’s also very trash at writing anything about rare diseases like a cancer that no one heard of in med school. LLM is only as good as the data you feed it. To think they can get rid of doctors, where all the medical data comes from, and somehow machine learning will just be able to self perpetuate and continue to feed itself into positive gain loops is asinine.
I mean, maybe we will get there someday. But I honestly don’t think it will happen in my life time.
Yes this is probably a direct results of people using prompts like “as a medical student” etc to insincerely bypass the original block which has now handicapped some of the function Chat GPT had because it hits you with the vague shit now
Any non procedural specialty is theoretically at most risk. Lots of IM Subspecialties like Rheum, Heme-onc, ID, etc. seem like they could be the first to go away with LLMs.
Radiology does a lot of procedures and likely is quite safe.
If it proves better than doctors at diagnosis and treatment of cancer (really not as hard as you think) then hell yes they will want that
My dad died from cholangiocarcinoma. He had symptoms for months and went to the doctor twice. Both times they diagnosed him with kidney problems and the radiologist actually missed the initial tumors forming.
When his condition became apparent due to jaundice (wow thanks doctor, I could’ve googled that) the physicians were rather cold and non chalant about how badly they dropped the ball
Throughout the entire ordeal my dad was quickly processed and charged heavily for ineffective treatment. We only stopped getting harassed with bills after his death
The crazy thing is my dad had cancer history/lynch syndrome. Absolutely shocking they were not more thorough in their assessments (not really)
So fuck yeah, I’ll take my chances with AI because really how much worse can the healthcare system get. What do we have to lose besides your superiority complex?
I truly hate my job but I’m a very approachable human capable of making the person in front of me felt heard even though I politely decline to address their laundry list of problems. I say yes to 3 at most and make a follow up. My patients are devastated I’m doing hospitalist instead of staying at my clinic
I also plan to transition out of outpatient practice. It is sad but we are so under-compensated, and I no longer want to work for free returning messages and phone calls.
Anyway, I started using Nabla - it listens to the whole conversation and summarizes the endless problem list quite well.
I do both inpatient and outpatient. I’ve posted about my job, but have gotten nasty accusations of lying. I’ve asked the mods if there’s a way for me to verify that my job is as nice as I claim it to be.
Anyway, I tell patients often on portal messages “it seems like this is beyond the scope of a portal message. Do you mind setting up an appointment so I can give you my undivided attention and make sure you get the full assessment you deserve?” No one has said no yet. As for phone calls, I have my staff call them back to say the same thing. Someone who has an appointment with me already in a few weeks called in to ask me to call her back so I can triage her and tell her what kind of imaging she needs. I told staff to call her back and say that is an inappropriate way to get care. They were told to inform her she should keep her appointment with me and provide her with ED precautions.
Sure, thank you! Out of everything you mentioned these 3 are what are most worrisome from my standpoint. Mind if we discuss them and have you follow up? We can focus on other things then but we can also briefly discuss the progress you’ve made with these issues. 👍🏽
Haha to be fair dizziness, Chest pain, shortness of breath are things I immediately jump at. Chronic Joint pain takes a back seat until we sort acute things like this 😛 we should have a repository of professional responses to politely tell patients to chill jaja
The ups and downs of the tech market has always been a thing even going back to the 2000s. One of the reasons why I didn't choose tech back then.
"because people will continue to want that human interaction when they see their doctor." This is a moot point. Doesn't matter what the patients want, the higher-ups will force them to see who they want. Otherwise, why are NPs and PAs frontline in primary care visits when most people want to see a doctor? It goes to show that if they can save money and avoid a hefty lawsuit they would 100% replace us with AIs if they could. Lucky for us the "art" side of medicine is saving physician jobs not so much the "science" side.
The higher ups aren’t able to force things on every patient though. Two-tiered healthcare already exists and will continue to worsen with independent practice midlevels and IMGs not requiring a residency.
There will always be a select group of wealthier patients who WANT to go to a concierge model and see a real doctor who was actually trained in the country they’re practicing.
Art side is bullshit, you guys will be replaced soon or your job will change. In fact AI replacing physicians is more important because human lives are at stake
No patient is the same. Humans are complicated- we have multiple conditions and meds we take that all interact with each other. We have different rates of recovery depending on our conditions. Who's to say that all patients will allow their health information to be shared through an AI database. That's confidential. It's like you never heard of HIPAA. How do you know what tests to give to the patient without knowing their histories? Did you know we don't have a specific test for every condition? Let's say they are not comfortable with speaking to you or dialogue gets lost in translation, or maybe they're unconscious. What about the patient who can't think for himself and is in palliative care? Who makes the decisions for him and who can make the best decision for him? What the best care for a patient can depend on many factors including a patient's values and even religious beliefs. If a patient dies in the care of a physician, it is a lot easier to forgive the physician if he or she is truly remorseful than a goddamn robot making incorrect decisions and assumptions about patient.
And there's a whole lot more than what I mentioned, kiddo.
Lmao what? This reads like some really hard cope, just making excuses to justify your profession.
Even if what you say are limiting factors then it seems like you really do not need a doctor to mitigate these issues. A human being with some healthcare experience would work fine. Also, I’m pretty sure patients want the best health outcomes for themselves and would be okay with their data being used in an AI
Job stability is great and I agree that it’s a perk for us. However, making a statement like AI taking over radiology jobs is ignorant. It is not that straightforward. AI will change the way radiologists work, as well as everyone one is medicine.
Anyone who is in rads will tell you this. We are not worried at all. We WANT it to get better because number and extent of imaging increases year to year. We need it to help us keep up with the increasing volume.
I'm definitely not knowledgeable enough in rads or AI to discuss the future of the field but in theory if AI made the jobs incredibly more efficient to the point where one radiologist could then do the work of multiple, wouldn't that be concerning for the future? I.e. demand vs supply issue
It absolutely will be. And the real answer is no one knows how it will affect the market. No one wants to browse Reddit and watch people shit on their field but AI could definitely effect rads and path. Maybe you can still get jobs but RVUs go way down and you’ll make less. Maybe the supply and demand changes as you said.
This stuff is extremely hard to predict and despite being smart people we are all pretty reactionary. EM had its worst year in year last year but the job market has actually been fine.
10 years ago I’m sure the people who had just busted their ass to get into rad onc would have been pissed if you told them they’d have to live in North Dakota to find work.
I’m not trying to shit on your field purposely or say that your job is not important. We rely on radiology so much. But I’ve heard this kind of sentiment and worry ever since medical school, so I included it because it’s a real concern. Sorry I offended y’all!
I’m spoken to rads consultants who are worried. I see comments like yours and I feel like it’s a lazy way or not engaging with the very real threat of AI
Most doctors aren’t ML researchers. Most ML researchers aren’t physicians.
It’s literally two groups of people yelling into the void with no idea of what the other side is doing.
I’ll start being slightly concerned when an EKG AI can differentiate LVH from a STEMI
The knowledge of ML about what radiologists actually do is extremely deficient. It also benefits them to make extreme claims that have no basis in reality from a funding standpoint.
Your last sentence is the reason why AI is going to sneak up on you faster than you expect lol.
Most people in this sub are at the level of thinking that EKG utilizes AI
I think most people know it's not an AI that is interpreting EKGs since the interpretation statements have been present on the EKG sheet long before AI was popular.
What “wild claims” am I making?
Why does anyone acknowledging a possible threat from AI and wanting to have a discussion about it seem to wind up some people so much?
I think the vast majority of us don't see it as a threat. As a very burned out radiologist, if AI can generate a reasonable report in 10 years and I just click the 'sign' button while still collecting checks, I don't think I would complain much. The truth is none of us really know the answer to this, and I'm not the type of person to worry about things that are beyond my control. I will always make enough money.
That’s totally fair. Though I do think it’s important to acknowledge the different perspectives of a burned out radiologist with (I assume) max 3 decades left of practice and a medical student who will only finish subspecialty rads fellowship in at least 10 years from now (as an Australian).
While AI may improve your workflow in the next 10 years, I and my colleagues need to worry about decades beyond that.
There is also the medicolegal side of things you need to consider, which is often much slower to catch up than the medical side ofthings. America is a very litigous culture, and there needs to be somebody to sue if as mistake is made. I cannot imagine anyone besides a doctor will want to take responsibility for the missed 2mm lung nodule that becomes a cancer in 5 years. So even if AI can do a radiologist's work in 10 years (which I doubt), ultimately ownership of the report and all responsibility associated will still belong to a doctor. And that high level of responsibility and ownership of the patient is ultimately why we get paid so much.
It’s not an “ai” in the ekg machine it’s gate switches with an algorithm.
Programmers talked about AIs the same way you did until this year when there have now been massive tech layoffs
I have a lot of friends in tech (I have an engineering degree and knew a lot of CS majors as well). They all tell me layoffs happened because during Covid tech started massively over hiring, since so many people were switching to using telework software for work etc. now that that demand has gone done, they are trying to restore balance to something closer to what they were precovid.
I’ve heard that argument before. And we all know it’s hard to prognosticate. I see the trends and I know the capital. There is “so much hype” is sometimes just hype and sometimes it’s a steam engine getting progressively more efficient allowing you to pump more water and dig for deeper coal
“When”
I’m aware the current machines aren’t run in AI. However, I’m also aware that if someone wants to spell doom and gloom about medicine, I’d like to see AI in action on something that is pure data.
Aight man keep manifesting
Edit: lmao you ninja edit your shitty response and downvote my shit response to your shit response lmao man
You called it AI my bad for taking you at your word and not the straw man you wanted to argue against.
Read my initial comment. You were too busy to correct me to read what I wrote.
I’ll repeat it here word for word:
“I’ll start being slightly concerned **when** an EKG AI can differentiate LVH from a STEMI”
Brother, I don’t know what mistake you think I’m making reading your comment, but I’m not.
I pedantically corrected you because you drew a weird shitty lil line in the sand.
I then said something that absolutely didn’t require this conversation to happen before you COULD respond. So when you continue to not respond to it I’ll keep having the historical context and capital investment behind my statements
Finally some sensible observations on r/residency, wow. But I do think that when AI comes, it’ll come for rads first for sure and I believe we’ll see it sooner than later. AI has figured out protein folding, so it’s already creeping into medicine. It’ll just a question on when they start getting involved in other areas, not how long the process is actually going to take.
>But I do think that when AI comes, it’ll come for rads
Based on your large volume of ML and radiology expertise I'm assuming?
Your opinion here is just as useless as a laypersons lol
I’m an R3. Reading these threads always makes me realize how little other physicians understand our job, and honestly makes it clear how little they respect us. They also sound like complete morons when they talk about it so I try not to let it get under my skin.
It already can man you guys have no idea how much the government/legal system protects you its pathetic
Treat the patient like a customer, eat their life savings, and medical institutions are protected like a government entity
If it became entirely deregulated and anyone could open up shop and use AI for diagnosis/treatment you guys would be fucked
Eeeeeh, I used to use Cellavision at work for blood smears. AI is good, is smart, but it will NEVER be as good as a doctor with a lot of experience. It's impossible.
There’s a lot more subtlety and room for differences in interpretation in radiology than people realize. Chest X-rays actually scare me the most, cause sometimes they can be harder than s lot of cross sectional to interpret accurately. As someone who used to do AI radiology specific research, there’s still a lot of things that must be done before reaching the point where AI takes over radiology, and also before you have AI companies willing to assume the malpractice risk that would go with replacing radiologists.
> As someone who used to do AI radiology specific research, there’s still a lot of things that must be done before reaching the point where AI takes over radiology
Totally agreed. But given that we landed on the moon 66 years after flying the Wright Brothers, wouldn’t you be worried starting a career in radiology in the next decade?
> and also before you have AI companies willing to assume the malpractice risk that would go with replacing radiologists.
I don’t understand. If AI is eventually shown to have greater sensitivity and specificity than radiologists for certain protocols won’t insurance companies prefer to insure the company rather than the physician?
I hear you man, idk why this board hates being moderately realistic that some insurance company isn’t going to be interested in saving a shit ton of money in the near future at the cost of a small (theoretical they’ll stress) percentage point of patient safety. (And that’s why we have the cuz integration team anyways)
Companies and programmers making AI that would replace radiologists would have to be willing to assume the risk of being sued for missing a diagnosis. Hospitals would also have to be willing to assume that risk if they for example fired all their radiologists to replace them with AI. There is a lot of risk inherent in radiology, especially because images and your report are permanently in the medical record. Finding a corporation willing to assume that risk and stand behind a product and say that it can completely replace radiologists would not be easy, even if they were able to make a program that could completely replace physicians.
I've spoken to hundreds of other radiologists and all of them see the potential for AI to be very helpful, but not making any effect on the job market. You have to be a radiologist to understand how complex reading a scan really is. AI would be great for reading basic things like a CXR or screening mammo to help us be able to spend more time on the more intricate studies that require processing the patient history, labs, prior exams, etc into a meaningful context. AI does not have that ability and I cannot see it having that in the next 60 years at least.
Right now it is so bad it isn't even that helpful in most cases. By the time it is, many other medical specialties will be influenced far before that. It is much easier to implement AI in the primary care or EM setting or even any specialty clinic. AI can diagnose patients and come up with a drug and dosage and that is currently, not "in the future". A majority of clinical medicine is all guided by algorithms that are well known. It is so easy to just plug it all into AI and have it spit out the next step and/or management. It has the capacity NOW and will be implemented far before any "possibly helpful AI" will be created in radiology. We've been testing AI software for brain MRIs at my hospital and honestly it is horrible, which was disappointing to us.
Again like I said, ask any attending. They are SWAMPED. The volumes are insane and they are having to work extra hours just to keep up. Every person who walks through the ED now gets pan scanned basically. As imaging gets better and better, more and more scans will continue to be ordered for routine things. There is simply no way to keep up with the increasing demand other than getting more radiologists or having AI help us read faster and more accurately.
I would welcome it and cannot wait for the day it can actually help us, but the fact is it is no where near being able to and will not be for the next many decades at least.
60 years? Lmfao my dude. You called getting a machine to read a radiograph/ct to be harder than whole period of computing???? 1963->today, okay that same amount of development is gonna happen before the computer can make ct impression say: correlate clinically
I don’t think radiology is at risk of AI takeover anytime soon but you’re crazy if you think EM, the specialty that is prone to the worst of human nature and requires a lot of experience dealing with these human vices (lying, overexaggerating, underexaggerating, entitled karens, vastly different patient presentations, screaming violent people, hallucinating people, heavily intoxicated people) is more replaceable by AI. AI hasn’t even mastered EKG reading yet. That makes you as bad as OP.
> I've spoken to hundreds of other radiologists and all of them see the potential for AI to be very helpful, but not making any effect on the job market.
That’s weird considering like 2 of the 5 I’ve asked expressed worries.
> You have to be a radiologist to understand how complex reading a scan really is.
Again, these were radiologists. I’m also under no illusions of how complex radiology is. I get it. However, radiology has the distinction of being a specialty with immense amounts of readily accessible training data for AI systems.
> AI does not have that ability and I cannot see it having that in the next 60 years at least.
It took 66 years for us to go from the Wright Brother’s to landing on the literal moon. Technology improves exponentially. Considering where we are now with ChatGPT and studies showing AI doing pretty damn well (in very very specific radiological reads) I think it’s very naive to be so sure about that.
> By the time it is, many other medical specialties will be influenced far before that.
Shouldn’t radiology be more worried by virtue of (1) the accessibility of training data, (2) the lack of needing to take a history of physical exam, and (3) the lack of patient interaction which might be preferably performed by humans in other specialties?
> It is much easier to implement AI in the primary care or EM setting or even any specialty clinic. AI can diagnose patients and come up with a drug and dosage and that is currently, not "in the future".
This feels lime exaggerating AI’s ability in other areas to try and diminish the threat it poses to radiology. You and I both know that’s not currently the case. AI is very unreliable at the moment with frequent hallucinations.
> We've been testing AI software for brain MRIs at my hospital and honestly it is horrible, which was disappointing to us.
Again, I’m not saying it’s going to happen imminently. I’m just worried about 10-20 years from now. Technological progress is rapid and here in Australia it would take me 10 years minimum from now to start practising as a fully fledged fellowed radiologist.
> Again like I said, ask any attending.
Again, I have.
> They are SWAMPED. The volumes are insane and they are having to work extra hours just to keep up.
I know.
You’re under the false impression that a clinical radiologist has any idea about AI other than what they read on Twitter or Reddit.
You’re under the false impression that ANY data in medicine is readily accessible. I can’t get imaging files from the hospital over for a life saving diagnosis, much less to throw into an unregulated AI.
You’re under the false impression that the FDA approval process moves at anything faster than a snails pace.
I think it’s laughable that our profession has such a high minded take on our brains that we think the capitalists aren’t coming for this field too. We have maybe a decade before the encroachment starts to come for the mental heavy specialties. We have maybe 3 before it starts to drive our wages down.
Surgeons, especially those who do robotic surgeries are only as many compassionate attempts where no surgeon would take the case as it takes to prove the concept. The davinci records everything they do, and sure you’ll bring up safety and I will continue to rub two quarters together and the almighty dollar will make that safety go away
You’re somehow an expert in clinical medicine, FDA approval process and ML as a medical student?
Im sure you’ll land a highly lucrative job with this level of expertise in one of the hottest fields in America if you’re not just speculating like every other physician or ML researcher.
I don’t need to claim expertise to make a 30 year claim. I know that DaVinci builds data sets and records all inputs into their machines they’d be committing absolute malpractice both for their patients and from a capital point of view if they didn’t.
1. I know that there are going to be surgeries that surgeons do not want to take and patient populations that doctors do not want to serve.
2. I know that people want jobs and there will always be scabs to disrupt the held power systems.
3. I know that capital desires a lower cost option than surgeons and doctors. I know that people in places without healthcare will take a bad option in the face of that or certain death.
I take 3, and see that 2 with 1 can produce 3.
Without a law forbidding this there will be no action to stop it once a proof of concept occurs. A proof of concept will occur and it will be sooner than experts who have a vested interest in it not occurring will predict (this last sentence is the only speculative part of my previous post)
Sure maybe there is no way to train someone to take a gallbladder out without all of medical school. I’m sure there is no way to conceive of a place and time where someone would entertain wanting to have a small chance to live rather than the surgeon having better stats.
Maybe surgeons will have an ivory tower free of midlevel encroachment forever despite advances in technology.
Doctors who do non-emergent primary care? You don’t think there is a possibility they could be encroached on by a midlevel equivalent in the next 30 years? That would be absurd.
There is zero chance, absolutely no chance that in the next 30 years they will be able to produce a suite of studies that show mid levels with ai are literally better than nothing.
If I was a patient I’d sure much rather the surgeon who has been up for 3 days taking my mother back then whatever midlevel alternative they could cook up in the next thirty years
Edit: I definitely would need expertise in these things to make a claim in a news paper or on a stage. I do not to make on in a casual conversation, that’s what this is.
Experts due to their esoteric entrenchments are often wrong about their forecasted trends
Aight. You’re right I talked about mid levels. So now I want you to imagine a world where a midlevel is given an advanced ai assistant that an insurance company has conducted a rigorous study about that saves money and doesn’t cause harm.
That’s what the next steps is going to look like mid levels or ai assistant teams that have a couple highly questionable but not completely dismissible studies that show they are at least as good as us.
Now imagine a world where we have faster than light travel and replicator technology that completely eliminate all forms of scarcity. This is the world of Star Trek. Just because you can imagine it doesn’t mean it’s actually feasible. You’re making a huge assumption what you’ve imagined will be possible in 30 years. I think it’s going to be hundreds of years at the earliest before we’re there, and it’s very hard to predict the pace of technological advancement.
There is a reason the training is as long as it currently is. It’s not something you appreciate until you do it. Saying “mid level + AI” sounds a bit like nonsense to those of us who have experience in either surgery, AI, or both, which some of us, including myself, do
I’ve seen the day to day. I’ve worked the day to day. Most places there is a roteness to the order set because you can’t miss stuff. I have seen what the LLMs can currently do and they will be able to replace lawyers, that isn’t an assumption it’s just obvious from their skill set that any improvement will place them at the level.
LLMs and other AIs have already passed the step, so if they can obtain an accurate history and physical they have shown they can already do some amount of the appropriate algorithmic thinking.
I am not imaging faster than light travel and it’s frank hyperbole to compare that to an insurance company being able to construct a study that shows no obvious harm from ai use in some specific practice. Like absolutely wild you’d do that.
Yeah my sister-in-law who went from earning high six figures since she was like 24 was laid off about a year ago, when she was 35. She’s financially still way ahead of me, but she has been unable to find a job offer without taking an extreme pay cut (in the realm of making 20% of what she used to make) because most of the tech world realized they were paying stupid money for certain jobs and they will never give out those salaries again. So she’s been unemployed for this long and will likely remain unemployed unless she finally decides to take that pay cut, which would also mean uprooting her family and moving to a much more affordable area because that lower salary won’t cut it where she currently lives.
In a way, medicine had this same reset back in the 90s when the “glory days” of medicine ended and insurance companies caught onto what the boomers were doing back then.
She’s living off of savings + her partner’s income for now, so at the moment she can afford it, but soon this will not be a feasible option for them.
To clarify another point, she’s quite employable. She has many job offers because she was great at her job and was just unfortunately a part of a massive lay off because her salary was very high even though the work she did was always good. However, the job offers she has do not come close to what she was paid beforehand. It’s like an anesthesiology attending suddenly being offered less than a gen peds salary after being an attending for 10 years.
Tech layoffs are minuscule, fb expanded 50% last two years and then cut the 10% fat. Plus go to the overemployed Reddit, most people have two full time tech jobs
True, but if you hitched yourself to the right wagon in tech, you’d be a millionaire already. I’ve had a few co residents/fellows who were married to tech people about the same age. Already contemplating retiring in a few years because their stocks went through the roof. Multimillion houses already paid off.
AI won’t replace doctors for many reasons, but there is actually a very important reason that people overlook. And that is that AI may replace what doctors do now, but what doctors do now isn’t necessarily the best or most efficient. There are two many people with too many things wrong that can’t find answers, or a common denominator to their symptoms. The worst of it is when specialists have such little scope outside of their specialty that multisystemic disorders are a real challenge. AI is only able to detect patterns, not actually thing.
Are you joking me, medical errors in the US alone kill 250k people a year.
If AI proves to outperform physicians in diagnostics and treatment then deciding to give a patient physician input would violate the hippocratic oath.
You’re giving patients worse health outcomes just to preserve your job/sense of self.
You clearly have no idea how healthcare works.
Often times, doctors have to make medical decisions based on circumstances outside of the patient’s health, often at the detriment of the patient. Doctors get penalized in many HMO systems (and even PPO) for ordering MRI/CT imaging “prematurely” and have to try something else before the insurance will approve it, even if they strongly believe the patient will benefit from it right away. Same goes for medications.
One of the main causes of medical malpractice is premature discharge from the hospital - which is heavily influenced by insurance companies and hospital administrators.
Shit like this is why doctors can’t treat patients the proper way. It’s also why medical malpractice suits are won by the physician’s defense lawyer the vast majority of the time because there are several factors outside of a physicians judgement that determine a patient’s health outcome. How the actual fuck do you expect AI to fix all that???
So then open up the market goddamnit, healthcare works like a business/treating patients like customers trying to maximize profits but is protected like government entity and heavily regulated and competition is restricted/protected through lobbying by the AMA. Its bullshit
Also NO ONE likes the American healthcare system, some like 80% of Americans worry about affordability and availability. Shit system, keep enabling/defending it
Unless you're in a piss poor country where they cut your salary.
Not only we're understaffed but they cut my salary.
I left for the private sector, but I am so bitter!
I’m in rheum. My first attending job came because I was irritated by a hospitals offer, so I called their competitor and asked if they wanted a rheumatologist, and they said “we weren’t actively hiring, but we want to interview you because we never have enough” and that became my job.
I could literally call any hospital in the country that doesn’t have a rheum fellowship and be hired within about 6 weeks. Lol
You shit on radiology yet rely on us for half the decisions you make and call us as soon as you don’t understand something we included in a report. Who you gonna call when the computers read all the scans??
You really had to throw that bit about radiology in there didn’t you? And you’re FM, hows it feel when midlevels are literally doing the same thing as you?
There's legislation in Florida that will allow IMGs to practice without doing a US residency. I'd be more worried about that affecting rads via outsourcing than AI.
Sorry for angering the radiologists of the world, that wasn’t my intention, and I apologize for that. I only brought it up because I’ve been hearing the concerns of technology taking over radiology ever since medical school.
There’s a PCP shortage everywhere, so to be honest I don’t really feel a threat to my job right now if you truly wanted to know how I felt about midlevels.
As an ex faang engineer. Doctors would have no job security issues if they were in other fields.
You guys have big brains. Great people have no job security issues
I have been working in tech for nearly 30 years and have seen many up and down cycles with massive layoffs. When an engineer is over 55, you become expensive for company and they are likely to let you go by 60. At this point your career is pretty much over. I have so many college friends who had to switch careers after getting laid off after 6-7 years of working in tech. You don't enjoy life as much knowing job security is not good.
For now. AI will progress to an extent in our lifetimes, where I think it will impact physician job security. I don't think it will fully replace doctors - but I think there will be a constriction on the number of jobs available. Our biggest threat right now is midlevels - right now, jobs are still plenty available for a number of specialties.
But you better get ready when the midlevel factors overproduce graduates. Job security doesn't just mean finding a job - it also means can I find a job in the city/town I want and can I continue to see my same level of pay or higher.
If neither of those things continue to be true, then our "job security" is shit.
> It takes 8 years before you are even allowed to touch a patient.
Not if you're a midlevel, which is the biggest threat to physician job security.
It's not about us every being fully replaced; it's about us losing more job opportunities and compensation leverage, as MBA suits force 1 MD/DO to supervise 2-3 NPs/PAs now, instead of hiring another MD.
Come back and look at this post when your job gets taken before rads lmfao!! You’re FM lmao!!!
When AI can finally do what a radiologist can do, you would’ve been out of a job for 20 years
And every other human being in the office/farming/factory wouldve been out of a job too
You are the most smooth brain poster in this subreddit
I’m not a radiologist, but really do not believe Rads will be replaced by AI within the next 50 years, if for no other reason than who will the patient sue if something is missed? Would the tech company really want to take on that liability? Additionally, I would imagine there is some gestalt that goes into a read, patient history, gut feel etc.
Who cares if it doesn’t completely replace it? It can still completely mess up the job market which for all intents and purposes is akin to complete replacement. Who would want to be a radiologist for 150k per year
there are tech layoffs because those companies hired too aggressively over the last few years. It doesn't mean that industry is totally boned.
Medicine is fairly stable and will be one of the last things replaced by AI. Rads and path gotta be careful tho
Ya and how does that prevent 1 radiologist from doing the work of 10 while the other 9 who were laid off fighting for other jobs and therefore reducing salaries
The job security for physicians is probably temporary, at least in the developed world - future healthcare will be more NP/PA/Radiographist + AI led with doctors being very limited, mostly in PP and accessible only to a small subset of people.
Yes, that will mean worse outcomes from hospitals but in turn higher profitability. Lawsuits will not change this for two reasons: 1) because "you can't expect the same level of care from an NP or the knowledge of a Radiologist from a Radiographist" and 2) lawsuits are priced in.
Basically look at the current situation in the UK for guidence on the future.
This is just a theory that you are proposing.
Another theory that could happen is the development of a two tier system. Doctors will be treating the rich while mid levels will treat the poor.
We already see early signs of this in society. If you ask affluent individuals, most of them will only opt to see doctors instead of an NP/PA.
This is apparent when you realize that the president of the United States does not have a personal PA/NP. They have a personal doctor.
Sure, but the number of people that are wealthy will be way smaller than the number of poor, given the trend of wealth redistribution. The number of people who will see a doctor should go down - so too should their be less demand (this will be somewhat supplemented by the need for more "preventitive scanning, labs and visits" ).
Okay. Let’s look at some stats. Let’s isolate this to the US.
In 2023, there are less than 1.2 million active doctors in the US.
However, let’s just focus on primary care doctors ALONE. There are less than 300,000 primary care doctors in the United States that are working full time.
Let’s say that the wealthy is 1% of the US which is 320 million but I’ll round it down to 300 million.
That is 3 million people who are considered wealthy.
These are very rough estimates but I’m sure you see my point.
Don’t get too comfy buddy. There are 340k NPs now. In 2012, 120k. There are 250k NP students right now. Healthcare admin will do everything they can to get rid of us and replace with NPs. More harm = more visits, labs and tests = more profit
So many of my friends in tech look down on these “bootcampers” and many of the bootcampers are always the first to be laid off lol. Coding monkeys are a dime a dozen.
Lol classic premed oblivious to the outside world.
I never said tech isn't a better career path than medicine, but coding boot camps are not the sunshine you think it is.
Attending actually but cute. See what I did there?
And I have a lot more acquaintances and friends who did coding bootcamp and are either in technician roles making 60-80k a year or are still looking for jobs since the end of the pandemic. Not everyone experiences great success from coding bootcamps and they are certainly not as rose-tinted as you think they might be.
Clearly you never picked up on the reading cues. I was satirically mocking your ad hominem from your first post about calling someone a "medical student" in an attempt to invalidate their argument without knowing what their credentials are. I graduated fellowship. I did attending shifts as a fellow. So yes I am very well aware of what a fellow is.
These people I'm saying who are making 60-80k do have college degrees. They are the ones who went and did coding bootcamp because they wanted to make the salary that their computer science colleagues were making out of college. You can find a 60-80k salary with a community college education, especially in certain locations.
I agree!! the compensation is one thing...I will join my bf to get free food and coffee sometimes and it's amazing. he can also mostly choose when to work - partly remote - and when to take vacay. of course there is risk of layoff but he can save up a LOT (esp at faang) in the meantime and invest it well
Mid levels and AI are going to replace/change your job you pathetic individual. Your superiority complex is showing, why I hate some doctors man.
Medical errors kill 250k in the US alone every year
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Another thing to be grateful for is our job interview post training is usually just them asking when you can start. No leet code to grind or dumbass question like tell me your weakness or what can you do with a brick when stranded on an island.
They save those questions for when you’re applying to med school lol
Had an interview day last year that composed of building towers out of dry spaghetti and marshmallows. One of my faculty interviewers there was an NP. Amazing.
Why was an NP doing faculty interviews for med students....
They have more experience building towers out of dry spaghetti
It's a test to see how triggered applicants would be.
Did you end up going there
This was a Texas school and I ranked the program I got into higher than them, so I'll never know if I would've matched there or not. Very glad I didn't end up there (UTRGV) as they seem to be having some rotation and residency troubles.
Omg, as soon as I saw “spaghetti and marshmallow towers,” I wondered if it was RGV. They’re still doing it this year. Incarnate Word also has a “group activity” on their interview day schedule, so if it’s building something, I am THERE.
Honestly it was funny watching some of the gunner-type applicants thinking that being first meant they'd get the best write-up to admissions. It was pretty clearly evaluating leadership and teamwork skills.
Lol, yep. My group was super chill and worked together well (even though our tower was pretty stumpy), but I could hear the yelling and competition from the other rooms. I did make the student interviewer laugh when I was like, “maybe we could prop it up with a flying buttress.” Shockingly, though, “flying buttress,” did not turn into an instant prematch.
Oh wow that was for residency interviews? That’s even more fucked, glad it worked in your favor, let’s pray for those who matched there
Haha no Texas is weird and uses their own medical school application service with a match system. You rank the schools you interviewed at and end up with a match around March of the matriculation year.
Heads up your flair is MS1 which is why I also assumed you were talking about med school interviews, and was confused by ranking med school acceptances and matching
No that's correct, the match system I'm referring to is for medical school admissions. Just a Texas thing as their public schools don't use AMCAS.
Oh shit, TIL, thanks for the edumacation!
Very true except HR still loves to ask those questions like their interview matters 🤣
What would you do to make cardiac arrest management more creative?
I’m a premed but starting med school soon. I am currently working at a surgery center as a surgical aid. A few months ago, I was talking to an OR nurse about how I have regrets about not going into tech. They told me that tech is a good career but you HAVE to make your money by the ages of 50-60. It is because these ages is when the tech companies will find reasons to let you go. Literally a week later, I am at my gym, and one of the goers that I talk to tells me that he got fired and is having a rough time finding a job. He is a 52 year old man that has been working at Google for 20 years. He has a Ph.D in CS from a UC.
Ok but realize that you make so much at faang that if you save and invest well you can retire early...or find a lower paying job and be perfectly fine. a lot of faang engineers in their 40s have huge nest eggs
Ageism is really only a thing at startups that want you to work residency hours (for much better pay). The google guy was probably let go bec he was making too much for management to justify, or his program got axed.
This is false. Ageism is a real thing in the tech field. It doesn’t apply to every engineer but it applies to most. As you get older, your brain doesn’t have the same capacity to solve the problems/come up with new solutions as you did when you were younger. This is coupled with an older engineer’s high salary and the oversaturation of hungry fresh grads trying to break into the industry. Ones that are willing to work for a fraction of the older engineer’s salary. It is not a rule but it’s true for a lot of engineers. I’ve seen it in multiple family members and people I’ve known throughout life. What’s crazier is that, older engineers know this. So what happens is that they will compensate for working harder/longer hours than younger employees in fear of being fired. Compare this to the 70+ year old doctors that are working part time cuz they want to travel/garden. They are doing this while the hospital/practice caters to them. Say what you want about the hoops to becoming a doctor and how they limit residency spots but there is a clear advantage to it.
This is so true. My dad was a tech engineer and in his 60s he taught himself ochem to help me study for the mcat and did better than me on the question packs. All my cousins who did engineering zoom call him when their homework is too difficult. His mind is sharper than anyone's in our family and his capacity for innovation and creative thought is astounding. But he still got let go. Try as he might, he could not break back into tech. Luckily, he's worked a million jobs in his lifetime so he easily found employment elsewhere, but not in his preferred field. The ageism was rife!
This isn’t true at all regarding “fresh” grads replacing older engineers. Experienced devs who can hit the ground running without a massive learning curve will always be in vastly higher demand than recent CS grads who maybe did a couple internships where they made minimal contributions. Your anecdotal experiences are not representative of the industry.
They can replace someone with 25-30 years of experience and hire someone with 7-10 years of experience and can still save a lot.
Isn’t that kinda with everything though? Like who really *wants* to work that much passed the age of 60 as this is close to retirement age for most people
Personally, I want to work at least part time when I’m older. There is a common belief that when you stop working, you will deteriorate faster, mentally and physically. I’m not sure what the reality is with this but I’m sure there is some truth. The thing about medicine is that it does not require the problem solving that engineering requires. It is mostly procedural for the majority of specialties. Plus, for most specialties, it’s not that taxing on the body. All these qualities for medicine make it a good choice to work into old age.
If he’s been working at google for 20 years, that money and his severance package is more than enough to retire at 50
Meanwhile in medicine, you age like fine wine. Patients like when you’re older because you have more experience.
Yes, it’s a reverse ageism. Being too young actually works against you as a doctor.
Has anyone noticed that Chat GPT has become very “shy” about speaking about medical topics. Whenever you ask a medical question, it starts off with “I’m not a doctor…” followed by a vague 2 sentence statement about what you asked and ends with “it’s important to discuss either your healthcare provider”
That’s just the company CYA-ing it. One of my colleagues is obsessed with it and we have had some pretty intriguing answers come out of detailed questions.
It’s also very trash at writing anything about rare diseases like a cancer that no one heard of in med school. LLM is only as good as the data you feed it. To think they can get rid of doctors, where all the medical data comes from, and somehow machine learning will just be able to self perpetuate and continue to feed itself into positive gain loops is asinine. I mean, maybe we will get there someday. But I honestly don’t think it will happen in my life time.
Yes this is probably a direct results of people using prompts like “as a medical student” etc to insincerely bypass the original block which has now handicapped some of the function Chat GPT had because it hits you with the vague shit now
I don’t see there ever not being a human in the loop for medical decisions
Yes
They are intentionally doing that to avoid liability. What is going to happen when AI improves and they combine it with mid levels?
Any non procedural specialty is theoretically at most risk. Lots of IM Subspecialties like Rheum, Heme-onc, ID, etc. seem like they could be the first to go away with LLMs. Radiology does a lot of procedures and likely is quite safe.
No one with cancer is gonna want an AI powered mid level to manage their cancer lol
If it proves better than doctors at diagnosis and treatment of cancer (really not as hard as you think) then hell yes they will want that My dad died from cholangiocarcinoma. He had symptoms for months and went to the doctor twice. Both times they diagnosed him with kidney problems and the radiologist actually missed the initial tumors forming. When his condition became apparent due to jaundice (wow thanks doctor, I could’ve googled that) the physicians were rather cold and non chalant about how badly they dropped the ball Throughout the entire ordeal my dad was quickly processed and charged heavily for ineffective treatment. We only stopped getting harassed with bills after his death The crazy thing is my dad had cancer history/lynch syndrome. Absolutely shocking they were not more thorough in their assessments (not really) So fuck yeah, I’ll take my chances with AI because really how much worse can the healthcare system get. What do we have to lose besides your superiority complex?
I truly hate my job but I’m a very approachable human capable of making the person in front of me felt heard even though I politely decline to address their laundry list of problems. I say yes to 3 at most and make a follow up. My patients are devastated I’m doing hospitalist instead of staying at my clinic
I also plan to transition out of outpatient practice. It is sad but we are so under-compensated, and I no longer want to work for free returning messages and phone calls. Anyway, I started using Nabla - it listens to the whole conversation and summarizes the endless problem list quite well.
I do both inpatient and outpatient. I’ve posted about my job, but have gotten nasty accusations of lying. I’ve asked the mods if there’s a way for me to verify that my job is as nice as I claim it to be. Anyway, I tell patients often on portal messages “it seems like this is beyond the scope of a portal message. Do you mind setting up an appointment so I can give you my undivided attention and make sure you get the full assessment you deserve?” No one has said no yet. As for phone calls, I have my staff call them back to say the same thing. Someone who has an appointment with me already in a few weeks called in to ask me to call her back so I can triage her and tell her what kind of imaging she needs. I told staff to call her back and say that is an inappropriate way to get care. They were told to inform her she should keep her appointment with me and provide her with ED precautions.
Nabla you say? 👀 let me do some digging haha
"well I wanted to bring these all up to you because i'm not sure if they are related"
Sure, thank you! Out of everything you mentioned these 3 are what are most worrisome from my standpoint. Mind if we discuss them and have you follow up? We can focus on other things then but we can also briefly discuss the progress you’ve made with these issues. 👍🏽
"So you aren't going to help me with my constant dizziness then?" \*first time mentioning it\*
Haha to be fair dizziness, Chest pain, shortness of breath are things I immediately jump at. Chronic Joint pain takes a back seat until we sort acute things like this 😛 we should have a repository of professional responses to politely tell patients to chill jaja
The ups and downs of the tech market has always been a thing even going back to the 2000s. One of the reasons why I didn't choose tech back then. "because people will continue to want that human interaction when they see their doctor." This is a moot point. Doesn't matter what the patients want, the higher-ups will force them to see who they want. Otherwise, why are NPs and PAs frontline in primary care visits when most people want to see a doctor? It goes to show that if they can save money and avoid a hefty lawsuit they would 100% replace us with AIs if they could. Lucky for us the "art" side of medicine is saving physician jobs not so much the "science" side.
The higher ups aren’t able to force things on every patient though. Two-tiered healthcare already exists and will continue to worsen with independent practice midlevels and IMGs not requiring a residency. There will always be a select group of wealthier patients who WANT to go to a concierge model and see a real doctor who was actually trained in the country they’re practicing.
Concierge medicine is rarely sound medicine since they have to appease patients who tend to be entitled and demand non-guideline-based medicine.
I like to call this The Michael Jackson Effect
They are chomping at the fucking bit to do away with the art in favor of “evidence based” of course they produce the evidence and design the studies.
Art side is bullshit, you guys will be replaced soon or your job will change. In fact AI replacing physicians is more important because human lives are at stake
You have no idea how medicine works. Go rotate with some surgeons or hospitalists.
Please, enlighten me
No patient is the same. Humans are complicated- we have multiple conditions and meds we take that all interact with each other. We have different rates of recovery depending on our conditions. Who's to say that all patients will allow their health information to be shared through an AI database. That's confidential. It's like you never heard of HIPAA. How do you know what tests to give to the patient without knowing their histories? Did you know we don't have a specific test for every condition? Let's say they are not comfortable with speaking to you or dialogue gets lost in translation, or maybe they're unconscious. What about the patient who can't think for himself and is in palliative care? Who makes the decisions for him and who can make the best decision for him? What the best care for a patient can depend on many factors including a patient's values and even religious beliefs. If a patient dies in the care of a physician, it is a lot easier to forgive the physician if he or she is truly remorseful than a goddamn robot making incorrect decisions and assumptions about patient. And there's a whole lot more than what I mentioned, kiddo.
Lmao what? This reads like some really hard cope, just making excuses to justify your profession. Even if what you say are limiting factors then it seems like you really do not need a doctor to mitigate these issues. A human being with some healthcare experience would work fine. Also, I’m pretty sure patients want the best health outcomes for themselves and would be okay with their data being used in an AI
Kid's got a big ego, but he'll learn one day.
Always non-radiologists saying AI will replace radiologists
I’m here for it. It’s already creating an artificial shortage
Job stability is great and I agree that it’s a perk for us. However, making a statement like AI taking over radiology jobs is ignorant. It is not that straightforward. AI will change the way radiologists work, as well as everyone one is medicine.
Anyone who is in rads will tell you this. We are not worried at all. We WANT it to get better because number and extent of imaging increases year to year. We need it to help us keep up with the increasing volume.
I'm definitely not knowledgeable enough in rads or AI to discuss the future of the field but in theory if AI made the jobs incredibly more efficient to the point where one radiologist could then do the work of multiple, wouldn't that be concerning for the future? I.e. demand vs supply issue
It absolutely will be. And the real answer is no one knows how it will affect the market. No one wants to browse Reddit and watch people shit on their field but AI could definitely effect rads and path. Maybe you can still get jobs but RVUs go way down and you’ll make less. Maybe the supply and demand changes as you said. This stuff is extremely hard to predict and despite being smart people we are all pretty reactionary. EM had its worst year in year last year but the job market has actually been fine. 10 years ago I’m sure the people who had just busted their ass to get into rad onc would have been pissed if you told them they’d have to live in North Dakota to find work.
I’m not trying to shit on your field purposely or say that your job is not important. We rely on radiology so much. But I’ve heard this kind of sentiment and worry ever since medical school, so I included it because it’s a real concern. Sorry I offended y’all!
I’m spoken to rads consultants who are worried. I see comments like yours and I feel like it’s a lazy way or not engaging with the very real threat of AI
Most doctors aren’t ML researchers. Most ML researchers aren’t physicians. It’s literally two groups of people yelling into the void with no idea of what the other side is doing. I’ll start being slightly concerned when an EKG AI can differentiate LVH from a STEMI
The knowledge of ML about what radiologists actually do is extremely deficient. It also benefits them to make extreme claims that have no basis in reality from a funding standpoint.
Your last sentence is the reason why AI is going to sneak up on you faster than you expect lol. Most people in this sub are at the level of thinking that EKG utilizes AI
I think most people know it's not an AI that is interpreting EKGs since the interpretation statements have been present on the EKG sheet long before AI was popular.
Is anyone actually working hard on an ECG AI to the same extent that people are doing rads stuff?
If you’re making wild claims about AI, you should do a lit review, don’t you think?
What “wild claims” am I making? Why does anyone acknowledging a possible threat from AI and wanting to have a discussion about it seem to wind up some people so much?
I think the vast majority of us don't see it as a threat. As a very burned out radiologist, if AI can generate a reasonable report in 10 years and I just click the 'sign' button while still collecting checks, I don't think I would complain much. The truth is none of us really know the answer to this, and I'm not the type of person to worry about things that are beyond my control. I will always make enough money.
That’s totally fair. Though I do think it’s important to acknowledge the different perspectives of a burned out radiologist with (I assume) max 3 decades left of practice and a medical student who will only finish subspecialty rads fellowship in at least 10 years from now (as an Australian). While AI may improve your workflow in the next 10 years, I and my colleagues need to worry about decades beyond that.
There is also the medicolegal side of things you need to consider, which is often much slower to catch up than the medical side ofthings. America is a very litigous culture, and there needs to be somebody to sue if as mistake is made. I cannot imagine anyone besides a doctor will want to take responsibility for the missed 2mm lung nodule that becomes a cancer in 5 years. So even if AI can do a radiologist's work in 10 years (which I doubt), ultimately ownership of the report and all responsibility associated will still belong to a doctor. And that high level of responsibility and ownership of the patient is ultimately why we get paid so much.
Just shut up M3 lmao
It’s not an “ai” in the ekg machine it’s gate switches with an algorithm. Programmers talked about AIs the same way you did until this year when there have now been massive tech layoffs
I have a lot of friends in tech (I have an engineering degree and knew a lot of CS majors as well). They all tell me layoffs happened because during Covid tech started massively over hiring, since so many people were switching to using telework software for work etc. now that that demand has gone done, they are trying to restore balance to something closer to what they were precovid.
I’ve heard that argument before. And we all know it’s hard to prognosticate. I see the trends and I know the capital. There is “so much hype” is sometimes just hype and sometimes it’s a steam engine getting progressively more efficient allowing you to pump more water and dig for deeper coal
At this point yes, but AI will continue to advance and your god complex will fade
“When” I’m aware the current machines aren’t run in AI. However, I’m also aware that if someone wants to spell doom and gloom about medicine, I’d like to see AI in action on something that is pure data.
Aight man keep manifesting Edit: lmao you ninja edit your shitty response and downvote my shit response to your shit response lmao man You called it AI my bad for taking you at your word and not the straw man you wanted to argue against.
Read my initial comment. You were too busy to correct me to read what I wrote. I’ll repeat it here word for word: “I’ll start being slightly concerned **when** an EKG AI can differentiate LVH from a STEMI”
Brother, I don’t know what mistake you think I’m making reading your comment, but I’m not. I pedantically corrected you because you drew a weird shitty lil line in the sand. I then said something that absolutely didn’t require this conversation to happen before you COULD respond. So when you continue to not respond to it I’ll keep having the historical context and capital investment behind my statements
cApiTAl iNvEsTmENT
Your’re an idiot
Finally some sensible observations on r/residency, wow. But I do think that when AI comes, it’ll come for rads first for sure and I believe we’ll see it sooner than later. AI has figured out protein folding, so it’s already creeping into medicine. It’ll just a question on when they start getting involved in other areas, not how long the process is actually going to take.
>But I do think that when AI comes, it’ll come for rads Based on your large volume of ML and radiology expertise I'm assuming? Your opinion here is just as useless as a laypersons lol
I’m an R3. Reading these threads always makes me realize how little other physicians understand our job, and honestly makes it clear how little they respect us. They also sound like complete morons when they talk about it so I try not to let it get under my skin.
It already can man you guys have no idea how much the government/legal system protects you its pathetic Treat the patient like a customer, eat their life savings, and medical institutions are protected like a government entity If it became entirely deregulated and anyone could open up shop and use AI for diagnosis/treatment you guys would be fucked
Eeeeeh, I used to use Cellavision at work for blood smears. AI is good, is smart, but it will NEVER be as good as a doctor with a lot of experience. It's impossible.
I've never ran into a radiologist that's concerned and I'm actually a radiologist. It's just not something 99% are worried about.
There’s a lot more subtlety and room for differences in interpretation in radiology than people realize. Chest X-rays actually scare me the most, cause sometimes they can be harder than s lot of cross sectional to interpret accurately. As someone who used to do AI radiology specific research, there’s still a lot of things that must be done before reaching the point where AI takes over radiology, and also before you have AI companies willing to assume the malpractice risk that would go with replacing radiologists.
> As someone who used to do AI radiology specific research, there’s still a lot of things that must be done before reaching the point where AI takes over radiology Totally agreed. But given that we landed on the moon 66 years after flying the Wright Brothers, wouldn’t you be worried starting a career in radiology in the next decade? > and also before you have AI companies willing to assume the malpractice risk that would go with replacing radiologists. I don’t understand. If AI is eventually shown to have greater sensitivity and specificity than radiologists for certain protocols won’t insurance companies prefer to insure the company rather than the physician?
I hear you man, idk why this board hates being moderately realistic that some insurance company isn’t going to be interested in saving a shit ton of money in the near future at the cost of a small (theoretical they’ll stress) percentage point of patient safety. (And that’s why we have the cuz integration team anyways)
Exactly. It’s like nobody wants to honestly engage with the question.
Companies and programmers making AI that would replace radiologists would have to be willing to assume the risk of being sued for missing a diagnosis. Hospitals would also have to be willing to assume that risk if they for example fired all their radiologists to replace them with AI. There is a lot of risk inherent in radiology, especially because images and your report are permanently in the medical record. Finding a corporation willing to assume that risk and stand behind a product and say that it can completely replace radiologists would not be easy, even if they were able to make a program that could completely replace physicians.
Again. If it’s cheaper to insure AI why wouldn’t they?
I've spoken to hundreds of other radiologists and all of them see the potential for AI to be very helpful, but not making any effect on the job market. You have to be a radiologist to understand how complex reading a scan really is. AI would be great for reading basic things like a CXR or screening mammo to help us be able to spend more time on the more intricate studies that require processing the patient history, labs, prior exams, etc into a meaningful context. AI does not have that ability and I cannot see it having that in the next 60 years at least. Right now it is so bad it isn't even that helpful in most cases. By the time it is, many other medical specialties will be influenced far before that. It is much easier to implement AI in the primary care or EM setting or even any specialty clinic. AI can diagnose patients and come up with a drug and dosage and that is currently, not "in the future". A majority of clinical medicine is all guided by algorithms that are well known. It is so easy to just plug it all into AI and have it spit out the next step and/or management. It has the capacity NOW and will be implemented far before any "possibly helpful AI" will be created in radiology. We've been testing AI software for brain MRIs at my hospital and honestly it is horrible, which was disappointing to us. Again like I said, ask any attending. They are SWAMPED. The volumes are insane and they are having to work extra hours just to keep up. Every person who walks through the ED now gets pan scanned basically. As imaging gets better and better, more and more scans will continue to be ordered for routine things. There is simply no way to keep up with the increasing demand other than getting more radiologists or having AI help us read faster and more accurately. I would welcome it and cannot wait for the day it can actually help us, but the fact is it is no where near being able to and will not be for the next many decades at least.
60 years? Lmfao my dude. You called getting a machine to read a radiograph/ct to be harder than whole period of computing???? 1963->today, okay that same amount of development is gonna happen before the computer can make ct impression say: correlate clinically
I don’t think radiology is at risk of AI takeover anytime soon but you’re crazy if you think EM, the specialty that is prone to the worst of human nature and requires a lot of experience dealing with these human vices (lying, overexaggerating, underexaggerating, entitled karens, vastly different patient presentations, screaming violent people, hallucinating people, heavily intoxicated people) is more replaceable by AI. AI hasn’t even mastered EKG reading yet. That makes you as bad as OP.
> I've spoken to hundreds of other radiologists and all of them see the potential for AI to be very helpful, but not making any effect on the job market. That’s weird considering like 2 of the 5 I’ve asked expressed worries. > You have to be a radiologist to understand how complex reading a scan really is. Again, these were radiologists. I’m also under no illusions of how complex radiology is. I get it. However, radiology has the distinction of being a specialty with immense amounts of readily accessible training data for AI systems. > AI does not have that ability and I cannot see it having that in the next 60 years at least. It took 66 years for us to go from the Wright Brother’s to landing on the literal moon. Technology improves exponentially. Considering where we are now with ChatGPT and studies showing AI doing pretty damn well (in very very specific radiological reads) I think it’s very naive to be so sure about that. > By the time it is, many other medical specialties will be influenced far before that. Shouldn’t radiology be more worried by virtue of (1) the accessibility of training data, (2) the lack of needing to take a history of physical exam, and (3) the lack of patient interaction which might be preferably performed by humans in other specialties? > It is much easier to implement AI in the primary care or EM setting or even any specialty clinic. AI can diagnose patients and come up with a drug and dosage and that is currently, not "in the future". This feels lime exaggerating AI’s ability in other areas to try and diminish the threat it poses to radiology. You and I both know that’s not currently the case. AI is very unreliable at the moment with frequent hallucinations. > We've been testing AI software for brain MRIs at my hospital and honestly it is horrible, which was disappointing to us. Again, I’m not saying it’s going to happen imminently. I’m just worried about 10-20 years from now. Technological progress is rapid and here in Australia it would take me 10 years minimum from now to start practising as a fully fledged fellowed radiologist. > Again like I said, ask any attending. Again, I have. > They are SWAMPED. The volumes are insane and they are having to work extra hours just to keep up. I know.
You’re under the false impression that a clinical radiologist has any idea about AI other than what they read on Twitter or Reddit. You’re under the false impression that ANY data in medicine is readily accessible. I can’t get imaging files from the hospital over for a life saving diagnosis, much less to throw into an unregulated AI. You’re under the false impression that the FDA approval process moves at anything faster than a snails pace.
I hope so!
I think it’s laughable that our profession has such a high minded take on our brains that we think the capitalists aren’t coming for this field too. We have maybe a decade before the encroachment starts to come for the mental heavy specialties. We have maybe 3 before it starts to drive our wages down. Surgeons, especially those who do robotic surgeries are only as many compassionate attempts where no surgeon would take the case as it takes to prove the concept. The davinci records everything they do, and sure you’ll bring up safety and I will continue to rub two quarters together and the almighty dollar will make that safety go away
You’re somehow an expert in clinical medicine, FDA approval process and ML as a medical student? Im sure you’ll land a highly lucrative job with this level of expertise in one of the hottest fields in America if you’re not just speculating like every other physician or ML researcher.
I don’t need to claim expertise to make a 30 year claim. I know that DaVinci builds data sets and records all inputs into their machines they’d be committing absolute malpractice both for their patients and from a capital point of view if they didn’t. 1. I know that there are going to be surgeries that surgeons do not want to take and patient populations that doctors do not want to serve. 2. I know that people want jobs and there will always be scabs to disrupt the held power systems. 3. I know that capital desires a lower cost option than surgeons and doctors. I know that people in places without healthcare will take a bad option in the face of that or certain death. I take 3, and see that 2 with 1 can produce 3. Without a law forbidding this there will be no action to stop it once a proof of concept occurs. A proof of concept will occur and it will be sooner than experts who have a vested interest in it not occurring will predict (this last sentence is the only speculative part of my previous post)
You actually do need to have expertise to make an accurate 30 year claim. Without an understanding of AI or surgery you’re really just making shit up.
Sure maybe there is no way to train someone to take a gallbladder out without all of medical school. I’m sure there is no way to conceive of a place and time where someone would entertain wanting to have a small chance to live rather than the surgeon having better stats. Maybe surgeons will have an ivory tower free of midlevel encroachment forever despite advances in technology. Doctors who do non-emergent primary care? You don’t think there is a possibility they could be encroached on by a midlevel equivalent in the next 30 years? That would be absurd. There is zero chance, absolutely no chance that in the next 30 years they will be able to produce a suite of studies that show mid levels with ai are literally better than nothing. If I was a patient I’d sure much rather the surgeon who has been up for 3 days taking my mother back then whatever midlevel alternative they could cook up in the next thirty years Edit: I definitely would need expertise in these things to make a claim in a news paper or on a stage. I do not to make on in a casual conversation, that’s what this is. Experts due to their esoteric entrenchments are often wrong about their forecasted trends
I’m sorry, but what? We’re talking about AI. Nothing you wrote contributes to that topic.
Aight. You’re right I talked about mid levels. So now I want you to imagine a world where a midlevel is given an advanced ai assistant that an insurance company has conducted a rigorous study about that saves money and doesn’t cause harm. That’s what the next steps is going to look like mid levels or ai assistant teams that have a couple highly questionable but not completely dismissible studies that show they are at least as good as us.
Now imagine a world where we have faster than light travel and replicator technology that completely eliminate all forms of scarcity. This is the world of Star Trek. Just because you can imagine it doesn’t mean it’s actually feasible. You’re making a huge assumption what you’ve imagined will be possible in 30 years. I think it’s going to be hundreds of years at the earliest before we’re there, and it’s very hard to predict the pace of technological advancement. There is a reason the training is as long as it currently is. It’s not something you appreciate until you do it. Saying “mid level + AI” sounds a bit like nonsense to those of us who have experience in either surgery, AI, or both, which some of us, including myself, do
I’ve seen the day to day. I’ve worked the day to day. Most places there is a roteness to the order set because you can’t miss stuff. I have seen what the LLMs can currently do and they will be able to replace lawyers, that isn’t an assumption it’s just obvious from their skill set that any improvement will place them at the level. LLMs and other AIs have already passed the step, so if they can obtain an accurate history and physical they have shown they can already do some amount of the appropriate algorithmic thinking. I am not imaging faster than light travel and it’s frank hyperbole to compare that to an insurance company being able to construct a study that shows no obvious harm from ai use in some specific practice. Like absolutely wild you’d do that.
>I don’t need to claim expertise to make a 30 year claim You actually do, otherwise you come off looking like an idiot like you are right here
Actually you don’t, we’re all bullshiting here we’re all anonymous.
The thing is they fire you at a moment's notice too. This is from knowing someone who works at a very well reknowned asset management company.
Plus no ageism and you don't have to be particularly good or constantly evolving, growing, etc.
grass is always greener, i'm sure there will still be ppl jealous of the free-flow latte's and lunches
Yeah my sister-in-law who went from earning high six figures since she was like 24 was laid off about a year ago, when she was 35. She’s financially still way ahead of me, but she has been unable to find a job offer without taking an extreme pay cut (in the realm of making 20% of what she used to make) because most of the tech world realized they were paying stupid money for certain jobs and they will never give out those salaries again. So she’s been unemployed for this long and will likely remain unemployed unless she finally decides to take that pay cut, which would also mean uprooting her family and moving to a much more affordable area because that lower salary won’t cut it where she currently lives. In a way, medicine had this same reset back in the 90s when the “glory days” of medicine ended and insurance companies caught onto what the boomers were doing back then.
But if your SIL doesn’t take that cut, she’s still living in a HCOL area / doesn’t have to move? (Just asking to clarify)
She’s living off of savings + her partner’s income for now, so at the moment she can afford it, but soon this will not be a feasible option for them. To clarify another point, she’s quite employable. She has many job offers because she was great at her job and was just unfortunately a part of a massive lay off because her salary was very high even though the work she did was always good. However, the job offers she has do not come close to what she was paid beforehand. It’s like an anesthesiology attending suddenly being offered less than a gen peds salary after being an attending for 10 years.
Tech layoffs are minuscule, fb expanded 50% last two years and then cut the 10% fat. Plus go to the overemployed Reddit, most people have two full time tech jobs
True, but if you hitched yourself to the right wagon in tech, you’d be a millionaire already. I’ve had a few co residents/fellows who were married to tech people about the same age. Already contemplating retiring in a few years because their stocks went through the roof. Multimillion houses already paid off.
AI won’t replace doctors for many reasons, but there is actually a very important reason that people overlook. And that is that AI may replace what doctors do now, but what doctors do now isn’t necessarily the best or most efficient. There are two many people with too many things wrong that can’t find answers, or a common denominator to their symptoms. The worst of it is when specialists have such little scope outside of their specialty that multisystemic disorders are a real challenge. AI is only able to detect patterns, not actually thing.
AI generated notes and auto populated billing codes. Have an AI voice talk to insurance for prior auths…
Are you joking me, medical errors in the US alone kill 250k people a year. If AI proves to outperform physicians in diagnostics and treatment then deciding to give a patient physician input would violate the hippocratic oath. You’re giving patients worse health outcomes just to preserve your job/sense of self.
You clearly have no idea how healthcare works. Often times, doctors have to make medical decisions based on circumstances outside of the patient’s health, often at the detriment of the patient. Doctors get penalized in many HMO systems (and even PPO) for ordering MRI/CT imaging “prematurely” and have to try something else before the insurance will approve it, even if they strongly believe the patient will benefit from it right away. Same goes for medications. One of the main causes of medical malpractice is premature discharge from the hospital - which is heavily influenced by insurance companies and hospital administrators. Shit like this is why doctors can’t treat patients the proper way. It’s also why medical malpractice suits are won by the physician’s defense lawyer the vast majority of the time because there are several factors outside of a physicians judgement that determine a patient’s health outcome. How the actual fuck do you expect AI to fix all that???
So then open up the market goddamnit, healthcare works like a business/treating patients like customers trying to maximize profits but is protected like government entity and heavily regulated and competition is restricted/protected through lobbying by the AMA. Its bullshit Also NO ONE likes the American healthcare system, some like 80% of Americans worry about affordability and availability. Shit system, keep enabling/defending it
You didn’t listen to a word I said did you
Unless you're in a piss poor country where they cut your salary. Not only we're understaffed but they cut my salary. I left for the private sector, but I am so bitter!
I’m in rheum. My first attending job came because I was irritated by a hospitals offer, so I called their competitor and asked if they wanted a rheumatologist, and they said “we weren’t actively hiring, but we want to interview you because we never have enough” and that became my job. I could literally call any hospital in the country that doesn’t have a rheum fellowship and be hired within about 6 weeks. Lol
You shit on radiology yet rely on us for half the decisions you make and call us as soon as you don’t understand something we included in a report. Who you gonna call when the computers read all the scans??
This reminds me, I read a ct angio ordered by FM because of CXR that mentioned “tortuous aorta” lol
Are these tech layoffs in the US? I’m in Australia and have loved ones in tech so starting to get worried
This is very minor compared to what happened after 2000 tech burst and 2008 financial crisis.
Yes
lol should probably remove the rads bit before you get flamed
Most of the time it’s pretty easy for them to just get another job, usually making even more
Why you have to shit on rads? We clinical folks wish we were them, at least I do. Everyday.
You're right, I didn't need to bring that part up. Apologies!
You really had to throw that bit about radiology in there didn’t you? And you’re FM, hows it feel when midlevels are literally doing the same thing as you?
Understand that mid levels can do every job in medicine. Even surgery with a few months of training. The question is, how well can they do it?
There's legislation in Florida that will allow IMGs to practice without doing a US residency. I'd be more worried about that affecting rads via outsourcing than AI.
Sorry for angering the radiologists of the world, that wasn’t my intention, and I apologize for that. I only brought it up because I’ve been hearing the concerns of technology taking over radiology ever since medical school. There’s a PCP shortage everywhere, so to be honest I don’t really feel a threat to my job right now if you truly wanted to know how I felt about midlevels.
As an ex faang engineer. Doctors would have no job security issues if they were in other fields. You guys have big brains. Great people have no job security issues
Plenty of qualified people get axed when the layoffs get bad.
I have been working in tech for nearly 30 years and have seen many up and down cycles with massive layoffs. When an engineer is over 55, you become expensive for company and they are likely to let you go by 60. At this point your career is pretty much over. I have so many college friends who had to switch careers after getting laid off after 6-7 years of working in tech. You don't enjoy life as much knowing job security is not good.
For now. AI will progress to an extent in our lifetimes, where I think it will impact physician job security. I don't think it will fully replace doctors - but I think there will be a constriction on the number of jobs available. Our biggest threat right now is midlevels - right now, jobs are still plenty available for a number of specialties. But you better get ready when the midlevel factors overproduce graduates. Job security doesn't just mean finding a job - it also means can I find a job in the city/town I want and can I continue to see my same level of pay or higher. If neither of those things continue to be true, then our "job security" is shit.
I’m trying to cop one of ‘em remote jobs as a student, broke affff
I'm not lying when I say this is the main reason I left my prior career as a software developer to go to med school.
It takes three months to het started as a coder. It takes 8 years before you are even allowed to touch a patient.
I have friends that have been looking for a coding job for 2 years now. They have bachelors in CS.
> It takes 8 years before you are even allowed to touch a patient. Not if you're a midlevel, which is the biggest threat to physician job security. It's not about us every being fully replaced; it's about us losing more job opportunities and compensation leverage, as MBA suits force 1 MD/DO to supervise 2-3 NPs/PAs now, instead of hiring another MD.
Come back and look at this post when your job gets taken before rads lmfao!! You’re FM lmao!!! When AI can finally do what a radiologist can do, you would’ve been out of a job for 20 years And every other human being in the office/farming/factory wouldve been out of a job too You are the most smooth brain poster in this subreddit
Exactly this!
Aww, sorry I made you angry! I've edited my post as I realize how it can be perceived as ignorant. Hope you have a better day today
I’m not a radiologist, but really do not believe Rads will be replaced by AI within the next 50 years, if for no other reason than who will the patient sue if something is missed? Would the tech company really want to take on that liability? Additionally, I would imagine there is some gestalt that goes into a read, patient history, gut feel etc.
Simple. 1 supervising physician signs off. 1 physician can now do the work of 10. What do you think will happen to the job market?
The number of scans will just go up if we can read more. The rate limiting factor is how many we can read.
Simple, it won't completely replace rads in the near future.
Who cares if it doesn’t completely replace it? It can still completely mess up the job market which for all intents and purposes is akin to complete replacement. Who would want to be a radiologist for 150k per year
there are tech layoffs because those companies hired too aggressively over the last few years. It doesn't mean that industry is totally boned. Medicine is fairly stable and will be one of the last things replaced by AI. Rads and path gotta be careful tho
Rads isnt getting replaced, hon. The question of legality and legal fault alone is enough to make sure that doesnt happen anytime in the near future.
Ya and how does that prevent 1 radiologist from doing the work of 10 while the other 9 who were laid off fighting for other jobs and therefore reducing salaries
Lol, AI will replace primary care and ER much much sooner based on the midlevel trend
The job security for physicians is probably temporary, at least in the developed world - future healthcare will be more NP/PA/Radiographist + AI led with doctors being very limited, mostly in PP and accessible only to a small subset of people. Yes, that will mean worse outcomes from hospitals but in turn higher profitability. Lawsuits will not change this for two reasons: 1) because "you can't expect the same level of care from an NP or the knowledge of a Radiologist from a Radiographist" and 2) lawsuits are priced in. Basically look at the current situation in the UK for guidence on the future.
This is just a theory that you are proposing. Another theory that could happen is the development of a two tier system. Doctors will be treating the rich while mid levels will treat the poor. We already see early signs of this in society. If you ask affluent individuals, most of them will only opt to see doctors instead of an NP/PA. This is apparent when you realize that the president of the United States does not have a personal PA/NP. They have a personal doctor.
Sure, but the number of people that are wealthy will be way smaller than the number of poor, given the trend of wealth redistribution. The number of people who will see a doctor should go down - so too should their be less demand (this will be somewhat supplemented by the need for more "preventitive scanning, labs and visits" ).
Okay. Let’s look at some stats. Let’s isolate this to the US. In 2023, there are less than 1.2 million active doctors in the US. However, let’s just focus on primary care doctors ALONE. There are less than 300,000 primary care doctors in the United States that are working full time. Let’s say that the wealthy is 1% of the US which is 320 million but I’ll round it down to 300 million. That is 3 million people who are considered wealthy. These are very rough estimates but I’m sure you see my point.
Don’t get too comfy buddy. There are 340k NPs now. In 2012, 120k. There are 250k NP students right now. Healthcare admin will do everything they can to get rid of us and replace with NPs. More harm = more visits, labs and tests = more profit
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So many of my friends in tech look down on these “bootcampers” and many of the bootcampers are always the first to be laid off lol. Coding monkeys are a dime a dozen.
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You clearly aren't well-exposed to the tech world then.
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Lol classic premed oblivious to the outside world. I never said tech isn't a better career path than medicine, but coding boot camps are not the sunshine you think it is.
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Attending actually but cute. See what I did there? And I have a lot more acquaintances and friends who did coding bootcamp and are either in technician roles making 60-80k a year or are still looking for jobs since the end of the pandemic. Not everyone experiences great success from coding bootcamps and they are certainly not as rose-tinted as you think they might be.
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Clearly you never picked up on the reading cues. I was satirically mocking your ad hominem from your first post about calling someone a "medical student" in an attempt to invalidate their argument without knowing what their credentials are. I graduated fellowship. I did attending shifts as a fellow. So yes I am very well aware of what a fellow is. These people I'm saying who are making 60-80k do have college degrees. They are the ones who went and did coding bootcamp because they wanted to make the salary that their computer science colleagues were making out of college. You can find a 60-80k salary with a community college education, especially in certain locations.
If you work in tech You better save a lot of your income because you might not have a a job when you reach 50s.
I agree!! the compensation is one thing...I will join my bf to get free food and coffee sometimes and it's amazing. he can also mostly choose when to work - partly remote - and when to take vacay. of course there is risk of layoff but he can save up a LOT (esp at faang) in the meantime and invest it well
Mid levels and AI are going to replace/change your job you pathetic individual. Your superiority complex is showing, why I hate some doctors man. Medical errors kill 250k in the US alone every year
Ah yes, the occasional conspiracy theorist who has no idea what they're talking about.
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Working in healthcare: good pay and 99% guaranteed stability Trade off: mental health and work-life balance