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It’ s Not Even R2-D2
by Mary Barry, MD
On January 6( not an auspicious date), the state of Utah went live with a new AI-powered software system from Doctronic.
Doctronic’ s ad says,“ Hi, I’ m Doctronic. Tell me your symptoms and get a diagnosis and treatment plan in minutes. Trained on peer-reviewed medical research. Board-certified clinicians agree with my treatment plans over 99 % of the time. Need a prescription, lab test or doctor’ s note? See a licensed doctor online in under 30 minutes for $ 39 if treatment is needed. Completely free. Anonymous. No email or credit card is required.”
It continues,“ I can help you understand health issues, refill medications, answer health and lifestyle questions and much more. I give you expert medical insights at your fingertips, whenever you need them. Appointments available instantly 24 / 7. I only share data with your doctor if you want me to.”
Users have noted they paid and yet sometimes were connected to a nurse practitioner, not a doctor. Payment can come from a health savings account card or a credit card. Major health insurance companies are partnered. The AI tracks wait times for connecting to a person, not a robot, for a video visit. Users have noted per online reviews that wait times for a human can be up to an hour; that refills are typically for only 30 days but one can negotiate for longer; that filling out all the data the robot wants is easiest on a computer and very tedious on a phone, since can take up to an hour to answer all the robot’ s queries.
Actual doctors in Utah were both surprised and very concerned about this new online venture that promises treatment through the airwaves, and not ever in person. The Utah Medical Licensing Board
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in April called for the immediate suspension of this program, which was approved by the Utah AI Office, not the Medical Board.
The whole time I am reading about this I am screaming internally,“ What about the PHYSICAL EXAM?!”
Does the patient look sick? Do they look worried, scared, exhausted, limp? Diaphoretic? Are they curled into a ball on your exam table? How does the pulse feel? Is there a gallop or a new murmur? Is there a rash? Do I shudder when I look at that throat? Do I think that just one more question will make them burst into tears?( For you youngsters, patients who burst into tears when you ask the first question either have the flu, or something quite bad has happened to them.)
Back when COVID-19 was new and I was working part-time in Dr. Mike Needleman’ s office, we did either video visits for people who had acute respiratory symptoms, or else we donned isolation gear and saw them in the parking lot. I required all those with respiratory complaints to pass a physical exertion test. If you could not walk really fast or climb steps without any degree of gasping, I sent you instantly to the ER. So far as I knew then, those Covid people survived; the ones who stayed home“ because they were afraid of the hospital” ended up there anyway, generally having gotten rapidly worse.
Experienced office clinicians develop a gestalt with a mental rating scale for sick people, progressing from“ will be fine” to“ viral misery” to“ crummy but ok” to“ I don’ t like the look of this” to“ hurtin’ cowboy” to“ Get EMS here now.”
If it takes some people an hour to fill out the online forms, pay, then wait, one could imagine that those in the last two categories above might decline at frightening speed.
OPINION