could we replace doctors with a search engine?

January 24th, 2008

Think about the last time you went to see a doctor. What happened? You spoke, right? Explained your symptoms? You were examined? And then? Got a prescription, did you? Or just advice on how to better your situation? Well, this is what most visits are like, most of mine anyway have been like this. In most cases it was only a conversation and in many cases there wasn't even an examination involved.

Doctors have an odd profession. In the course of their education they have to learn an extraordinary number of facts about diseases and ailments. Alright, so everyone has to learn a lot of stuff. But when they get out of school, they're not using their knowledge to build bridges, or write tv commercials, or fix vacuum cleaners. They just sort of give out parts of that knowledge bit by bit to patients. You come in, you explain your problem, the doctor digs deep into his vast database of knowledge and pulls out the bit of information that is relevant to your situation.

- Doc, I'm having trouble with my foot.
- You might have a swollen ankle. Do this, don't do that. Eat this, don't eat that. Good luck!

Their whole business is based on disseminating personalized information in little portions, at the appropriate time. It's like a temporary storage for information. Hold on to this and remind me at the appropriate time. They are walking encyclopedias, essentially. And, in fact, seeing a doctor is often called "a consultation". So they are consultants. You come to them if you want to know something about their field of expertise.

Can you think of anything else that works this way? Yes, a search engine. The symptoms is the index (think of the alphabetical index in the library), it tells you where the information is. You follow that and you get to the information you're looking for.

Of course, it isn't only what you say. A doctor will use all information about you to make a diagnosis, not just what you tell him in words. He'll also determine whether you look well, whether your pupils are dilated, whether your voice is changed, whether your breathing is normal etc. And he has your medical history available to him, as well as basic facts like age and weight, all of which goes into a deliberation of the most likely thing to be wrong with you.

But if you could actually articulate all of this information, then the role of a doctor could just as well be succeeded by a search engine that would give you the same information. In fact, it could actually be a much better doctor too. Just think of all the knowledge that a doctor has, based on all the experience and all the patients he's seen. When you come to him, that is everything he has available to him to understand your situation. In fact, I have the impression that a doctor who is just out of school isn't very good, because he has no experience. After working a couple of years, having seen hundreds of patients, he's building a database of knowledge that is invaluable to judge what the most likely problem is, given how many possible ailments exhibit similar symptoms. So it's a statistics game, the more experience you have, the more skilled you are.

But just imagine pooling *all* the knowledge that *all* doctors have all in one place and making it searchable. That would be the most knowledgeable doctor of all time. You could present any set of symptoms and if there's one doctor on the planet who has seen this before, you would get a good answer. (Think Google.)

It would also decrease the demand for doctors considerably. If there is now one doctor for 100 people, there could be one to 1000 if the other 9 were replaced. Of course, sometimes you need instruments to do an examination, so you couldn't do this at home, you'd still have to go to the clinic, but it would be a more do-it-yourself kind of place.

One upshot of not having a human doctor would actually be that you wouldn't have to lie about embarrassing problems. This is a real issue for doctors today. Patients don't want to tell the truth when it's humiliating, so they lie and the doctor has to see through this (and of course you *do* eventually want your doctor to know the truth to get the right diagnosis, you just don't want to have to say it) and use his judgment and a little diplomacy to help you despite yourself.

So what about those 9 doctors that aren't needed? Well, they could be working to enrich the database of information. In our current model, educating doctors means giving the same information to everyone (ie. massive duplication) and sending every guy to a different place to see patients. And there is an obvious limit to how much a person can learn in 4-5 years, so every doctor has the same limitation. Instead, what we could have is put those 9 people to work on different things (experimental drugs, studies of diseases and so on) and the huge database of information would be ever richer and more useful.

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5 Responses to "could we replace doctors with a search engine?"

  1. erik says:

    Interesting hypothesis, I'd say we're definitely moving in that direction but we're far from there yet.

    Strangely enough there was an item on this in the Dutch news on NOS a few days ago. Basically people are getting in trouble because they think googling their symptoms equals a doctor's consult. Naturally a lot of them get it all wrong, draw the wrong conclusions, make the wrong 'diagnoses' or just generally look for their information in untrustworthy sources. So their condition gets worse and there have even been a considerable number of deaths because of this private DIY doctoring.

  2. numerodix says:

    Well, is that really different from people who read books or magazines or even leaflets and follow the advice in them? I'd say only that Google is much quicker access to a lot more content, but as always you have to be careful with information you're planning to use... on yourself, in particular.

  3. Paul Matusiak says:

    Great idea, Martin! Kinda like the case with musicians now, and movies and so on.. you don't have to go to a concert or buy an album, it's all on Youtube

  4. Boyo says:

    I don't go to the doctor all that often, but when I do I notice they are looking things up on the computer. They type in keywords of the symptoms as you describe them and their software program lists several possible conditions. Which is exactly the same as how a layperson would use an internet search engine or one on a medical encyclopedia site. So in that regard there is little difference. Of course the doctor actually has a medical education and will be able to pinpoint a condition more accurately, so he would still have the advantage. But there are certainly possibilities for the average person to identify a (developing) disease early on and then seek professional medical attention.

  5. Dan Hinkley says:

    I agree with this blog. Everytime I visit the doctor, it is the same thing. I already know what is wrong with me before I go in. Every time.

    Now, when things go REALLY bad, and lots of tests have to be done, that is when it gets complicated, not to mention surgery.

    For basic stuff like infections, rashes and etc. it makes no sense to spend $100 to see a doctor unless you need a prescription. Have the time I get that online from somewhere and bypass the doctor.