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Interesting Enemies For a Diagnostic Database
dlh writes: "Boston.com is carrying an article about Dr. Lawrence L. Weed's Problem Knowledge Coupler software. Apparently the medical profession is not exactly thrilled at the idea." Seems access to information is a positive thing, but certain doctors seem to feel threatened by this sort of database.
The article already mentioned this. But an obvious answer, for cases that aren't situations where the patient will die in 10 seconds, is to have intelligent non-doctors input information beforehand, in the waiting room. (There IS time there for this.) Then the doctor can make a diagnosis and take a glance at the expert system's diagnosis. If the two jibe, and there is little likelihood of weird possibilities, then little time wasted. If complications happen, the doctor can check the expert system's results, and even choose to manually answer the questions again.
I don't think this is a technological problem as much as a usability issue.
I'm not surprised that your friend made an off the cuff remark like this which portrays physicians simplistically as a walking database. But I think it would be closer to the truth to call them walking neural networks which are constantly learning and which use databases (reference books) to affirm their suspicions, and also who are cerified by a board and licensed by the state to be responsible, ethical, and competent.
Doctors must also take into account that the person describing the symptoms may have more than one condition simultaneously, that the patient may be exagerating something common or normal as a symptom because he believes it is related to the other actual symptoms. As others have pointed out in this discussion people can unconsciously pick up symptoms based on information they have read. It is rare to have a doctor these days that knows you for very long and who has treated you and your family for many years but that would give the doctor more insight into what the problem could be.
The article starts off with an example where Dr. Cross had an unusual case for which he did not recognize the symptoms and which turned out to be a condition he hadn't even heard of before. This is a situation where using this program makes sense; it merely computerizes the literature search. But I disagree with you that doctor's could easily be replaced. This program can only be a helpful tool used in conjunction with all the physicians other tools.
The doctor must be the one who diagnoses. He can not become just a technician asking the patient questions and entering the response into a computer form. Physicians are licensed for the same reason that Professional Engineers are licensed. When human life hangs in the balance, someone must be accountable to make sure things are done right.