Doctors are using AI and why I am ok with that to a degree…

CNN just posted an article and It was pointing out that AI is being used, The title of the article is

5 ways your doctor may be using AI chatbots — and why it matters

Specialized medical AI chatbots have quickly become a go-to source for many doctors and trainees. The CEO of one of these medical chatbot companies recently claimed that more than 100 million Americans were treated by a doctor who used their platform last year.

You know what. If the doctor is using AI to help diagnose an issue i am ok with this, But, if the doctor is using the AI as a replacement of his diagnostic I would be against that, the challenge with AI is using it in a way that is not a replacement of the doctors own agency.

One thing that should be majorly addressed here, is that the doctor should tell you right out how he is using the AI and what data is being used. If you are like me, you want to have a transparent doctor. I’ve explained my conditions to doctor and I see it ever time, Mid explaination his or hand falls down to the pocket level and you see in like martial arts the Sen no Sen its the move that you know he is getting his phone to google what you just told him or her. They will excuse themselves in the moment to go google my condition..

My normal reaction is .. to call the doctor right out, I tell them if you are going to google this do it in front of me and not to be embarrassed, I am the zebra in your career. I do not need the illusion of mastery of you are a doc, I personally want you to accept that you are not the god of your position and every instance as a doctor is a learning experience. I am not going to look down on a doctor that doesn’t know a rare genetic condition. I will look up to a doctor that uses the moment as a “Classroom” moment where he becomes the learner and I am the master. Because as far as doctor/patient this is the higher praise you can give to a doctor and it shows him as the “master” that he is willing to learn.

“ChatGPT is like your crazy uncle,” said Dr. Ida Sim, a professor at the University of California, San Francisco, who studies how to use data and technology to improve health care.

Any AI can be turned into your crazy uncle if you input enough information to them, but if doctors collaborate with the patient and the AI , I think a more diverse diagnosis would be made without the “symptom checker” fatigue that AI’s can load out on any Doctor,patient or third party can come up with.

As for AI’s they are not great doctors, they are the median doctor that is good at anything that slightly drifts from the center, they will be good for health upkeep or catching stuff before it happens. but on major issues the AI’s are so far in left field that they are irrelevant and become crazy unclue(pun intended) bob, That will start diagnosing diabetes before neuropathy in a chemical exposure case if context is done wrong.

The most common use case

Millions of research papers are published every year — and keeping up with them all is impossible.

“You’d need like 18 hours a day to stay up to date,” said Dr. Jared Dashevsky, a resident physician at the Icahn School of Medicine at Mount Sinai.

But doctors are expected to stay current on new research and guidelines to maintain their licenses. Many say they now use medical chatbots as a reference tool to help them stay updated.

Yes, there are millions of papers, but for Dr. Jared Dashevsky he doesn’t need to keep up with all of them. that would be insane. Millions of papers come out a year, by the end of said year 400,000 of those papers are changed or phased out into new research. Cnn and the doctor are wrong here, if you have a patient with a rare condition, AI can be used to contextualize the papers and come up with a mean average of the output to give the doctor a clue, I am not expecting the doctor to read all of the papers because he would rabbithole down so many roads that treatment and diagnostics would be a mess.

Save the papers in rare research for the specialist, your GP doesn’t need to know the ins and outs of 1 million papers that half of the time fail in the real world because lab controls do not equal real world observation. The Doctor that is slightly questioning his diagnosis and inputs some weird statistical drift will get a better answer out of AI and know what specialist to give the information too. But the doctor can use the AI as tool to faster make information available to him. If he tries the google search method it leads to bullshit that starts saying vitamins and sunning your butthole is a cure.

But many doctors use unauthorized chatbots called shadow AIs, according to doctors CNN spoke with. Some of these shadow AIs also advertise HIPAA compliance features.

HIPAA is a federal law that requires certain organizations that maintain identifiable health information — such as hospitals and insurers — to protect it from being disclosed without patient consent.

Here’s where doctors can win, Create a system that strips out all PII and just get to a processor that strips out the information and gets down to the numbers. Otherwise, the companies on the other end use the data as resaleable materials and ignore HIPAA , The healthcare entity should have an end to end chain of ownership to show the patient where there data begins and ends. the second and LLM user that data that is protected by HIPAA the LLM should be charged, if they sell it to insurance companies or walmart to figure out sales trends. I’m not saying AI should not be used , I’m saying accountability should be transparent.

We’ve been through this bullshit with the human genome with everyone attempting the copyrighting of the DNA of the human body, Now we are at the precipice with code of the human condition itself. We have Named Entity Recognition (NER) system to strip names and Privacy to ensure that even if the AI “learns” from your data, it cannot be reverse-engineered to identify you. We need this institutionalized across the system.

Otherwise we are creating a dangerous system that the human credit score will make it where insurance will have a value on a child before its born and create ways that have been used in the past to make people uninsurable.

GIve or take, Google Classroom makes Google a school admin, but also if you look in to common-core most people don’t realise its a job app to corporations across america. We do not need this to happen again. Common core in itself can feed LLM’s and Hippa issues since the IEP, typically the most powerful force for education can be identified later in life by LLM who are technical admins and further if the information from Common core and human condition meet you have an identifiable plot to unmasking the user. It could be connected the child who had suicidal ideations in school over low stress can be weighted and for a temporary issue , cause a person insurance to go through the roof.

Dr. Carolyn Kaufman — a resident physician at Stanford Medicine — and other doctors say that patient information is making its way into unauthorized chatbots, potentially opening the door to new ways of commodifying patient data.

“Data is money,” Kaufman said, noting that she has never uploaded HIPAA-protected information onto an unapproved chatbot. “If we’re just freely uploading those data into certain websites, then that’s obviously a risk for the individual patient and for the institution, as well.”

This statement here is a perfect reflection of above.. In the end, IEPS , common core assessments and more need to be Air gapped and when you leave school an agreement should be made between the student(or parents) on who can assess the information.

AI chatbots have also stepped in to help doctors draft summaries of patient visits and long hospital stays. These notes are viewable on online patient portals and help doctors track a patient’s course and communicate plans across the care team.

I am not worried here, If anything AI could be useful in suggestions to add to the file and give a treatment idea to the doctor, But no doctor should take this as gospel.

“From a med student perspective … you’re seeing a lot of things for the first time,” said Evan Patel, a fourth-year medical student at Rush University Medical College. “AI chatbots sort of help orient me to what possibilities it could be.”

Just No, First, fourth, or fortieth , Should never go in with AI , If you end with AI as a counterpoint or a co-researcher in the end is ok, but the doctor should not cognitively offload to the AI to help with diagnosis. Because if that becomes standard the cognitive process of diagnostics goes out the window and dies.

Med Students out of the gate should be regulated that AI is a non-negotiable in any point of the process before, during and any time patient contact is being made. At any time after if a Student uses AI after for a confirmation or a research Node, that can be agreed to but using the AI as attending physician is career suicide.

This preserves the Agency of the Physician and Occam’s razor.. The problem with AI is humans with 8.3 billion variations that AI tends to only use the mean average. It leaves many doctors with zebras that AI will hallucinate to high hell about and be dangerous.

The Final Word here. AI is Ok, but used correctly, not shoehorned into the medical spectrum..

Acknowledgements: Article from CNN.com 5 ways your doctor may be using AI chatbots — and why it matters

The problem with chronic Pain and Pain scales.

As a pain scale , they are amazing things. they measure the amount of pain you are in the given moment. The problem is the pain scale is great if you fall off a house and go yes this pain is at a 9. But as a chronic pain sufferer, What does a 9 mean ? is that 3 more than your baseline? is it 9 more than your baseline. When you ask a doctor about it you get , Just tell me what it feels like. but when you live at a 6 in pain, and can tolerate a 10 what do you tell your doctor?

More times than not if I have injured myself my pain tolerance is epic, I have taken 24 needles to the legs while holding a conversation with a medical student. My figure is i have a rare condition this is the guys one chance to see a zebra for once and give him any knowledge i have. I even tell the student, My tolerances are higher than you can imagine. While i watch people wait for a nurse and scream their head off as a nurse goes by i find it a waste of time. I internalize my pain, I use every bit of concentration not to scream, and at times it does not work in my favor. You get a doctor that thinks he’s god, he will every time send you away with two Tylenol and a note in the system as “poss seeker”

Although … I’ve had my moments. Told the doctor my pain was at 9.5 , he said you don’t seem to have anything wrong . 4 hours later and the ER tried to wait me out , I forced my hand and asked for an x-ray. the funny part was getting the X-ray tech running off and than coming back with the doc and him going . shit it is broken!

But the scale that is on the wall is horseshit. 1 to 9 . with no arbitrary idea of where to start and end. I think there should be two scales. One scale for the mean pain , your chronic pain, your menstrual pain, your general pain. THan the scale on the wall

because if you are having a 6 day on your mean scale and on the other pain scale you are having an 8 . than put your end number at 14. so , 6 1 2 3 4 5 8 vs, Just 6 . So on a day where you are already at 9 , even a 4 on current charges is overwhelming. if my tolerance can go to 10 it does not mean i am functional at 10 , the Pain debt past 10 gets overwhelming quick. Can i function past 10 yes. Can i function at 20 .. no . but at a collective 15 it’s like walking around with a dead weight the size of yourself.

Both Scales should be there. that way a doctor gets a better baseline. If you are at a 2 mean and add a 7 for the wall scale , you can likely get away with a large dose of Motrin. but if you are at 5 and stack a 7 on it Motrin is like trying to put out a fire with pocket sand.

To a person with chronic pain life is like a flywheel that keeps us going. it may be a little out of balance, but the more out of balance it is when we have a critical failure like a fall . That flywheel might be putting us so far out of bounds that adding new weight to it (pain) we are in the worst state possible from a small weight (pain) .

So when I am in the hospital looking normal, sometime i have that coffee to my lips to keep me from screaming. I’d rather use that energy to divert to enjoying the coffee rather than throwing it in angry because I feel like something is killing me.

So on a day you see me sitting more than normal with a coffee and I’m not saying much . It’s not because I have a little to say , It’s because I am trying to keep centered and not trying to scream.

Decaf Dissenting: Why Social Media is Gaslighting Your Soul at large.

Ever go on a website like Reddit or youtube and down vote something? Than notice that you can not see it or fuzzy math doesn’t count your vote? You are not seeing things when it would seem to be that you dissent into madness over something you disagree with.

It made me start thinking, Kids saddle a lot of emotions these days and the fact that when most of their lives is online, you have to consider there environment. Disassociation is on the rise with kids and I think social media contributes to this by making them feel powerless in the world we live in.

If you consider this for a moment. You go on reddit and you see a post that has a socially disagreeable thing on there.

Here is an example: the post is already at 0 .

Show that you do not like the post and downvote it.

You see the vote is clearly at -1 , feeling like you have made a opinion but, when you see next when you click on the page to comment .

Now look, Your vote is gone, your opinion is meaningless. For a kid trying to find their footing and meaning in life, that’s not just a glitch it’s a rejection of their validation and existence. It’s stupid. its likely damaging to a kids psyche.

This is a Digital Erasure of the soul, You strike out at something disagreeable and the corporate overlords come out and say “now now, you should be seen and not heard.” like any kid who grew up in the past would hear.

This is the space where the digital ego and soul goes to die and gets dangerous. We tell our children they are the masters over their domain and we try to give them the agency to do so. This is where the corporate overlords say “NO” and seriously hurt this mindset. The very tools they give adults and children come back with negative reinforcement by changing that vote back to zero. By faking the thumbs down and the downvote you are destroying the person sense of morality and ethics. Because when they see the vote reset they say “I guess i mean nothing” . it creates a specific kind of psychological rot that adults may not feel but to a child this has a profound effect.

But by not allowing the consensus of anger the very soul of the person is put up for wholesale click farming. Math should not equal 0- 1 = -1 to -1+1 =1 . This shit needs to be stopped and we need to value opinions even if we do not like the opinion. Otherwise, this is why we are seeing more and more people disassociating, they feel like they do not count and they just freeze because why does it matter anyways?

This needs to stop . This is like giving decaf coffee to the world at large. It taste like coffee acts like coffee and you fall asleep and than get angry. We like our regular coffee, you take that away there would be riots..

Adding AI to Vaers will not make it better…

The Vaers Database is getting an upgrade it seems. The Vaers database tracks reactions to Vaccines. This database has been long used by the AntiVax crowd to point out non-causal links in vaccines.

The Food and Drug Administration (FDA) rolled out a new system using AI, that uses  publicly accessible reporting of negative or unexpected health effects linked to medicines, vaccines, cosmetics, animal food and other consumer products. -Source: [Fox News]

While the addition of Cosmetics, Animal food and other stuff seems like a boon to this it is not. it will cause doctors to chase ghosts in the system. If a baby eats dog food after a vaccine and has a reaction it will be logged, When the actually reaction may have been the dog food. This will cloud the new database where Causal reaction will cloud issues casual relation.

This will make it impossible to find out what is the actual problem.

The FDA claims it will have a single, platform that researchers will have access to key data -Source: [Fox News]

Also by publishing monthly there is going to be a much harder time vetting the information. While throwing large amounts of Information To an AI it is likely going to hallucinate if the database is not perfectly formatted.

If you throw millions of variables (Dog Food+ Flu Shot + Rash) into a monthly processing cycle, the probability of a “false positive” signal approaches 100%. The AI isn’t finding truth; it’s finding bullshit correlations.

While this new system claims to be cheaper I feel like the numbers maybe cooked. the Old system you could download the entirety and manually search. If AEMS only allows search through an “intuitive” AI interface, it effectively creates a Black Box. You won’t be able audit what you can’t see. This new device takes the data out of the users hands and may present a fever dream of an answer. It could spit out the entire plot of the 1989 batman movie when the joker poisons products.

In the end, as a researcher, I’d rather have the data in my hands than given what an AI thinks because in the end AI does not have intuition. End all it will flood the research market with uninspired noise that will confuse time tested research methods. Under the new system, a Fart could be diagnosed as a vaccine reaction when it did not take to fact the person ate a 3 bean burrito at taco bell.

Anyways Im out, to have a coffee that will be misdiagnosed as cocaine use in this new system….Stay Caffeinated, Stay vigilant of bullshit…

ps: the amount per search via AI is going to cost an astronomical amount of power vs the several cents worth of electricity of using a CSV.

When did HHS become HHD

Health and Human Services has become lost in the last year. We’ve turned from trying to keep people from getting sick to keep people from fringe things that statistically don’t matter. Targeting things like Red , spending a year on it than going never mind as long as red is not made from oil?! While that is going on the US has had a measles that is threatening the US. This measles outbreak is threatening the US from being nearly free after 30 years. HHS is ignoring measles, Its barely in the news. But back to RED , saying that red has increased autism is a failed statistic. the correlation could confirm autism with anything. The Price of socks has caused autism to rise in the last 30 years. The Consumption of pizza has caused autism to rise. the amount of warmer water in the use of bottled water caused autism to rise. What i mean is HHS is focusing on a bottle of water and wondering why the neck is warmer than the rest. While missing the point that the water has gone green .I have a secret, I know why autism rose… It is crazy. F84.0, F84.1, F84.5, F84.9 . if your a doctor you smiled. if not you have not figured out the big secret here. the magic in this case is diagnostic criteria here. Using diagnostic criteria there were condition that were close to autism and the diagnostic criteria got rolled in with it. Meaning conditions that were orphaned were matched with autism. so was there an explosion of autism, Not really. It just looks that way when otherwise condition with no known cause were that looked like autism. here is the thing, if it looks like autism acts like autism call it autism. Parents had a unneeded shame factor in the 80s and earlier. Your kids weren’t broke, they just marched to a different drum.

Now, Measles Is something that we had nearly gotten rid of , yet now measles is running wild in states. States are dangerously getting close to the bottom of herd immunity. Stop looking at the fucking red and get to the issue of measles. Measles if let to run, will cause long term medical issues to skyrocket. Measles can cause your body to forget to what it is immune to , Imagine having chicken pox again at 25 or 35? Have Asthma .. good luck, severe pneumonia. Acute encephalitis (brain swelling) during the infection can cause permanent intellectual disabilities, seizures, and hearing loss (deafness). Subacute Sclerosing Panencephalitis. This is all very very bad to all of us. The US medical system is already under strain. Doctors need to stop having to worrying about our leaders saying weird shit. and not have worry about red when this measles will cause a crash.

So in the end I restate: STOP LOOKING AT THE FUCKING RED AND GET TO THE ISSUE OF MEASLES.!

Finding me. part II

After the events of december, I still find myself looking into a black void trying to remember something, anything that would be part of my life before the events of my suicide and I have been given information by others and nothing that I can find in myself as for my confidence is at a low I can’t explain, when someone tells me something that I can not draw upon it drives me mad with trying to remember. I know with some people It seems like remembering an emotion,, but the details elude me. I feel bad saying that I have to meet a person for the first time again. When I was released from the hospital I did not realize that there was a gap in my memories , Even before I got home i did not even recognize the apartment, the furniture the floors the layout, I found myself dependent on others for location and places of the recent, the more I delved into what i could remember the more i realized that there was a huge hole in my memories in the last 6 years, I feel bad i can not recognize something and it hurts worse that I know that this profound loss of memory hurts others…..

Well now…..

Well after posting for 15 years on my former site I’ve decided that i am going to give this a try again! This site is always dedicated to coffee and the world around me.  So topics will be widely ranged.  I feel now is a good time to restart things and I have mirrored all my old post which I admit was a pain in the ass to move.  So with little fanfare I will say this site is open and the coffee is brewing!

It’s June ..

I’ve been updating a little more , its been missed but the atomic bullshit of the world pretty much made the last 3 years a blank spot.  In a way I am glad I did not post and in another way I know i should of. Sometimes the clarity of the world is a bit brighter in pixels when you can weed out the bullshit. Cut-the-Nuclear-grade-Bullshit-will-ya-buddy-Life-is-hard-enough-without-the-smell-of-what-you39re-dishing-out-meme-14752

Bullshit is everywhere , Everyone trying to forward there own agendas just to do something what they want to do without care for others , and when its brought up its brought up in a way that they bring the person staying out into the bullshit. With all of the bullshit thought I remain happy in way , Happier than I’ve been in ages. I wake up knowing the bullshit is outside when I wake up and in parts of my body but none the less the mornings start bullshit freeish*.

funny-bullshit-calling-meme

The annoyance of where the bullshit starts is me, my bullshit body more specifically … I was given a bad hand in the genetics department and if I wrote everything down here that was known about my genetics you’d all go that’s bullshit. I live in pain day to day , and its really bullshit, to the point that I do not feel like bullshiting with people because my pain is to the degree of bullshit.  The degree of things I do to keep myself going is pretty maddening to say the least, though I always say things could be worse.  I spent the last year trying to get down on my medications in order not to feel like another bullshit situation that has darkened the last few years.

I’ve got to the point where therapy actually has done more harm than good and its really one of those moments that makes you reflect on what kind of bullshit I have to deal with.  It is sad when  the thing that is supposed to help me heal is actually diametrically opposed to what it actually did, The bullshit meter is off the charts on that one.  acowIts getting to tough times , I am not sure where the future will lead and I know it will be tough but, I know this. I will wake up in the morning and  I will say bullshit to the pain I know that will eventually curtail my days actions.  I do what I can and I will continue to do what i can.  I wake up in pain I goto sleep in pain. There was an episode of House that actually made an expression of how I feel .  Here’s a quote.6b8944438f56d004d8a72ef1cc9ad07c

 

For all the times I wake up in the morning thinking today will be good I am proven wrong with my body going bullshit and having the feeling of having a hot piece of glass shoved through my arm while having it frozen than hot water splashed liberally over it.  It pisses me off , It punishes those around me since I cant do anything. I feel like I have no worth. Worse is when I try to hide my condition because I don’t compassion , I want to be normal and sometimes people just take advantage of It.  I hide my pain for other peoples comfort and sometimes its a bit much and I withdraw.  Sometimes keeping the “nice” face on is more of a pain than the pain it self.  When I show myself its because I am comfortable and I know that who i show myself to cares.  but otherwise If your going to walk over me or say something contrary to the position when you have no knowledge of , please keep your bullshit to yourself you’re contributing to global warming from the bullshit that’s spraying from your lips and all the hot air.

 

To which end.. the people who I let into my world and I let them see under my shell. I am glad they are there. They understand me and have kept me sane enough to wake up every morning and face the bullshit with a smile* (or whatever face i can muster that’s marginally better than agonized.) . Maybe they will never see this post but know this I love them very much for putting up with my bullshit.

 

Anyhow… Till next post.

 

PS: the word of the day is bullshit! (22)