Artificial Intelligence (AI): Friend or Foe to Concierge Medicine?

Whether you are an enthusiastic adopter of virtual assistants like Alexa and Siri, and apps to monitor everything from glucose to sleep patterns— or consider them error-prone and intrusive—it’s impossible to ignore the growing influence of Artificial Intelligence (AI) and ChatGPT in medicine. At a recent healthcare conference, Specialdocs CEO Terry Bauer shared an informed perspective on this hot-button topic, ultimately defining AI as a valuable addition to the concierge physician’s growing toolbox:

Terry Bauer, CEO Specialdocs Consultants presents “Artificial Intelligence (AI): Friend or Foe to Concierge Medicine?” – 2023 Concierge Medicine Forum; Atlanta, GA

AI, the capability of a computer system to mimic human cognitive functions such as learning and problem solving, has been sweepingly called by Google CEO Sundar Pichai “probably the most important thing humanity has ever worked on.” Fei-Fei Li, Co-Director of Stanford University’s Human-Centered AI Institute, further described its impact, saying “there’s nothing artificial about AI…it’s made by humans, intended to behave by humans, and, ultimately, to impact human lives and human society.”

While AI’s potential is compelling, Bauer cautioned that it is still a nascent technology, with numerous developments and improvements ahead. “The physician’s oath to ‘first, do no harm’ will continue to guide medicine’s measured approach to implementing technological advances,” he said.

Echoing that concern is American Medical Association President Jesse Ehrenfeld, MD, MPH: “OpenAI’s ChatGPT and other generative AI products currently have known issues, including fabrications, errors, and inaccuracies. For AI-enabled tools to truly live up to their promise, they must first earn—and then retain—the trust of patients and physicians. Just as we demand proof that new medicines and biologics are safe and effective, so must we insist on clinical evidence of the safety and efficacy of new AI- enabled healthcare applications.”

In the near term, Bauer noted AI’s effectiveness in serving as a particularly able administrative assistant, helping streamline routine tasks, improve scheduling, book appointments, and manage insurance documentation. “AI is already being used in physician offices to save staff a great deal of time by managing claims submissions, denials, and prior authorizations,” he said.

As AI evolves, Bauer believes its effect on medicine will become increasingly profound. “AI is likely to not only identify harmful drug interactions more precisely than current systems, but to also predict the most effective medications based on an individual’s genetics. Drug and other medical discoveries may also be accelerated using AI, significantly cutting the 17 years now required to disperse life-saving treatments to the market,” he said.

“The ability to expedite diagnoses with AI’s rapid analysis of all available data will ultimately help minimize unnecessary testing,” he continued. “And the promise of real time monitoring with analytics that can accurately predict the risk of a heart attack or stroke and enable early intervention is truly exciting…imagine how many lives can be saved with this kind of tool.”

Acknowledging the unease felt by many regarding the potential for AI to upend the way medicine is practiced today, Bauer concluded: “I’m convinced AI is going to help those who are practicing concierge medicine or exploring its possibilities be even more successful, more efficient and better diagnosticians. That said, AI’s most important contribution may be the role it plays in facilitating more quality time with patients. I cannot envision AI ever matching the judgment, experience or compassion of dedicated concierge physicians who know and care for their patients like treasured members of the family.”

Defining AI

A large language model (LLM) is a type of AI that uses deep learning techniques and large data sets to understand, summarize, generate and predict new content. ChatGPT, powered by LLM, is a generative AI model designed to understand and produce human-like text responses based on input provided. Released at the end of 2022, Chat GPT now has 180.5 million users worldwide; alternatives include Google’s Bard, used by 1 billion people globally, and Microsoft Office 365’s Copilot AI, with 400 million subscribers.

AI in Action

From early disease detection to accelerated drug discovery to 24/7 virtual health assistants, the applications for AI abound. Below are just a few examples of AI being utilized in healthcare:

✚ At Google Health, AI research led to the development of an automated tool that uses an AI camera to detect diabetic retinopathy in less than two minutes.

✚ At Cedars Sinai, investigators are leveraging AI’s algorithms to identify early signs of pancreatic cancer, and to predict the likelihood of coronary heart disease and sudden cardiac arrest.

✚ At Mayo Clinic, the cardiology team uses AI-guided electrocardiograms to detect faulty heart rhythms before symptoms appear, and to identify the presence of a weak heart pump, preventing future heart failure.

✚ At the AI & Tech Collaboratory for Aging Research at Johns Hopkins, the team is exploring robots that can help patients with cognitive impairments, dementia or Alzheimer’s navigate daily living tasks; using Alexa to administer cognitive tests at home; and configuring Apple Watches to provide alerts of possible falls or wandering.


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