Yes, we have moved far afield and I agree the changes I think are coming will not be easy, quick, nor may they all come to pass. My thought on the computer replacing the specialist as being harder is that the specialist is often looking for the cause of a problem and how to treat it beyond just looking a test results. The computer may be very good at pointing out anomalies and suggesting courses of action but not that good and drawing inferences and conclusions from them and other information that may not be readily quantified by a test result. they're real good at the routine and predictable but not very good when unfamiliar or complicating factors occur. As for an easier job, given most problems seen by GPs respond to treating the symptoms without determining the underlying cause; i.e. you have an infection, infections generally respond to X so i will prescribe X and the problem will go away even if I do not know what the case is you will be cured, so a computer could easily be designed to provide common treatment based on symptoms, IMHO.
I see your points but I guess we will just have to disagree on which areas of medicine may be most impacted by computers in terms of replacing a doctor.
I'm saddened by the misapplication of "computer science" as a term. When I took computer classes, they were not called "computer science" until one was actually supposed to program the computer. Like, open an IDE, write code, and compile it.
I don't think that it's appropriate to use computers to teach basic skills to children, but regardless of that perspective, it is wholly inappropriate to call an introduction to computers "computer science".
I'd go a step further and say learning a computer language isn't studying computer science any more than learning a foreign language is studying linguistics. There is a difference between acquiring a specific skill and understanding the concepts and theory behind how the skill is employed.
With sufficient resolution (as TFA points out) and the ability to finely control the drones this could be a good thing since you could hover near and area and get a closer look; and then do a normal inspection if you still have questions.
Maybe the U.S. could fund degree attempts at state unis. The problem there is that states have been pulling money out of higher ed. then turning around and claiming their state schools are still state schools. The some of the increase in tuition at state schools is directly the result of the state legislatures pulling money out. The legislators then turn around and claim there is a crisis in higher education with ever higher costs for the average person.
Some statesdo. Georgia has the Hope Scholarship which pays tuition at state schools if students maintain a certain GPA.
I would disagree with "Which means: find out what kind of important work your developers dislike the most, and do it for them." I would say:
"Find out what non-essential stuff is interfering with real work and protect them from it."
There often is work that is important that must be done but is not exactly fun, such as documenting code, helping tech writers prepare user manuals, listening to users and getting feedback on the UI, etc. Developers may dislike that work but they are the ones that need to be involved with it or do it. Sometimes it's the manager's job to point out stuff that needs to be done and find a way to get it done; even if it isn't what they want to do.
convincing banks to create securities of sub-prime mortgages he could bet against
The article does not say that he did that. Instead, the article says that the banks bought insurance against mortgage defaults (credit default swaps), and that prices of such insurance was very low. John Paulson decided the price was too low compared to the risk, so he bought a lot of the same insurance.
Good summary of what happened. he bet against stupidity, and won. Now he gets to do what he wants with his money.
I agree no insurer, unless they are an HMO, has the ability to dictate weather you see an MD or NP. They can, however, adjust reimbursement rates and/or co-pys to make a NP a more cost effective solution. If they reduce reimbursements a GP may find they do not make enough to maintain a viable practice. It's not that the patient isn't getting to chose a GP over an NP, it's that they both get the same payment for the service. The GP, who has higher costs than an nP, will be squeezed.
Yes, the healthcare reimbursement system is a mess; and the main point seems to be for insurers to deny payment for any reason and hope the clock runs out before the provider fixes the errors. It will be interesting to see what happens as fee for service is replaced by an outcome based reimbursement system.
If the number of specialists increases than they may see their revenue drop simply because more people are sharing the pie; but as GP reimbursement drops anyone who spends all the time and money to become a doctor would want to be a specialist simply because that is where the money will be.
As more states allow NP to practice on their own they will have no reason to share a practice with an GP, they will more likely work closer with specialists when they see a patient that's problem is beyond their license. They will become the entry point into the health care system because they will be cheaper than doctors. Ultimately, the economics of healthcare will drive the model.
To affect change the insurers don't need to be monopolists, they just need enough covered bodies to represent a significant percent of an area's inserted population so health care providers can't afford not to accept them, and their rates, because they would be left fighting over a much smaller pool of patients who can pay for services.
I also agree the change will take time but I think it is inevitable; given the need to control health care costs.
"If nobody's going to buy the database, in one month I'm releasing the keys, and victims will have their files automatically unlocked.â
Oh , how heart warmingly magnanimous of you! I can see how contrite and sorry you are about what you've done... well apart from still wanting some money for the DB.
Tell you what you sorry little turd, how about you release them anyway and give these poor people their data back? @rsehole.
In addition, he's said "I am part of a criminal conspiracy and am will to sell the tools I used as part of this conspiracy. Oh, BTW, I also probably violated money laundering and income tax laws as well. That part where I deleted files related to the conspiracy? That's not obstruction of justice is it? Also, please believe me I never infected any computers while testing it so I didn't violate and computer crime laws." When he sells it he'll probably ask the buyer to verify he or she is not in law enforcement beacsue a cop would never go undercover and lie about being a cop; or use an informant to get evidence.
They also tend to be more durable than a smartphone. You can carry it in a pocket or drop it with much less chance of damaging it. If you lose it you're out $20 rather than several hundred. I know contracters that use them for that reason as well as give them to employees for use on site for similar reasons.
are some advantages. If all someone wants is the ability to make calls dumb phones are a great choice. Many of my friends have them for elderly parents so the always have a phone handy. Using a smart phone touch screen can be overwhelming as the have to unlock it, touch the phone app, then dial using a non tactile screen. OTOH a dumb phone keys mimic the landline they have been using so it's simply a matter of making sure they know how to charge the phone and use green button to dial and red to hangup.
Cables companies will primarily become internet providers and satellite companies will provide programming to the peeps in the boonies.
Personally, I say "freaking awesome". Both industries treated their customers like crap for decades. Reap what you've sown you jackasses.
If you hated the old regime what till you see the new one. The new battle ground will be usage caps. Cable companies will start offering tiers of data. Want to stream video 24x7. No problem, just buy our gazzilion GB package at $200 per month. Oh, you want fast speeds? Upgrade to Speed plus for a $20 more. They will simply change the pricing to make money off of the pipe, not the content.
Content companies need to buy into the new model as well. The really small channels very few people watch such as SciFi or F/X will see their revenue drop significantly and some will simply go under. The big guys, such as ESPN that gets something like $6 per subscriber will not want to have to try to get their current revenue from the people who actually watch the channel(s). More than likely, when all is said in done you'll see a variety of companies that bundle packages of channels and sell them as a bundle, such as SlingTV. Apple seems to be getting into the business as well and for premium content sellers such as HBO selling al la carte may be more viable because that is what they already do so it's more of a way to get more revenue by tapping into cord cutter stain changing a business model. As for the bundlers, that sound a a lot like, wait., a Cable Company. Except now they will compete with companies like SlingTV while still controlling the pipe and its pricing.
Until Google or someone else offers an alternative pipe they have you where they want you and the hearts, minds, wallets will soon follow.
You spend too much time around Doctors. They're very smart, and very good at figuring out how the human body works as a system; but their cluelessness as to how the health system pays them is frankly astonishing to anyone who has to deal with them for more then 10 minutes. These are people who will, with a straight face, tell that one reason they deserve more respect then other PhDs (average salary: not $55k) is that they spent four years in pecuniary earning only $55k for their residencies
True, you are worth what people are willing to pay not what it cost to get the education to do the job. Quite frankly, the pay for activity model is broken.
In this case, no GPs are never going to be fired en masse. Arguments saying Nurse Practitioners are better, or a computer would be better are simply irrelevant in light of the fact that consumers want to go to see a Doctor.
Also true, which is why educating the consumer will be part of the shift to lower cost treatment venues. This is not something that happens overnight; but the growth of the minute clinics staffed by NP's is a step in that direction. Consumers may want to see an MD but will trade that off for seeing an NP today vs an MD next week.
Since the co-pay is the same either way NPs can only gain market-share in places where there are not enough GPs. Which means that no, no hospital is going to actually fire a GP and replace him. It would be stupid business, so an MD-run hospital might try it, and if you tried you'd lose market-share to the newly opened GP partnership of three guys you fired.
Moreover, Specialists willing to work in places far from the costs make princely salaries. $500k is not unrealistic. $200k is not unusual for people whose entire job is to read test results and not talk to patients.
Here's the problem. As insurers switch to pay for results and MDs can no longer make more money by running a test the ability to generate enough revenue to make a desired income will decrease. GP's will be competing with NPs and salaries will reflect that. This isn't about firing GPs but the impact computers and a changing way of reimbursing will impact the practice of medicine. A specialty will be even attractive because that is where the money will be.
Let me put it to you this way, which Hospital do you think is will do better:
A) Hospital A's business model is to fire three guys making $150k, replacing them with 3 NPs making $40k. This gives them $330k to buy a computer system that has to understand the entire human body.
B) Hospital B reduces is Surgical staff by two because it can out-source all data analysis in their specialties to a computer it will buy. It has saved $1 million. It can hire all 3 GPs A) just fired and it's computer budget is $550k. Which means not only does it have a better computer, that does less (remember: instead of understanding everything as a GP does it only has to understand a couple of specialties well enough that their specialists can cut analysis a few hours a week), it also poaches most of the patients those 3 GPs saw, and it's got a great marketing angle ("see a real Doctor").
First of all, the computer doesn't have to understand the whole body; rathe it needs to be able to treat symptoms not determine the underlying cause. When the symptom goes away you are cured, and the MD or NP's job is to determine what is the most likely course of treatment based on the symptoms, using the horses not zebras analogy. yes, they determine what you are most likely to have and act base don that, but it is very much a symptom -> action treatment based on pattern recognition; something computer can help with while relying on the MD or NP to recognize anomalies as well as validate the results.
The problem with your poaching model is your assuming insurers will continue to pay enough to cover a GP salary and make money. A more likely model is a number of NPs in practice with
I cannot comprehend this entitled attitude. on cable tv you see ads. in a magazine or newspaper you see ads. before movies you see ads. during movies you see ad placements. so it's not like Netflix is proposing a crazy new concept, to show you an ad even though you pay a subscription. why so angry bro?
Perhaps, but I subscribe because I get ad free programing. if they want to show ads thats fine, I'll just move on to something else. I'm not angry, just voting with the wallet.
Most CS professors are paid market value. You can look up salaries at public schools. You'll find that at the ones that compete with CMU, the salaries are all in the range of what the researchers would make at a company ($100-250k). Bonuses are a little harder to compete with. But, in CS at least, grants cover a ton of travel. To publish in CS, you have to go to the conferences you're publishing in, unlike the rest of science which just has journals. That more than makes up for the lack of bonuses as far as fringe benefits go.
Quite true. There is a big difference in the market value of a researcher who is doing cutting edge research in a field that is relatively new vs the value of a research in a field that is mature enough for companies to see practical applications for the research. The former attracts researchers because they can explore new ideas and develop thing that don't exist, but they will be paid by academia standards since that is where much of that research is done. Once they can apply their research then they become much more attractive to private companies who are willing to pay much more for their expertise because they plan to develop commercial applications to make money. Universities can't afford, nor do they need, to pay equivalent salaries.
Now, the one benefit you get from industry is that you don't have to write grants. But, you also have more job security in academia. What worries me most about this is that when this bubble bursts, Uber will be one of the first companies to go (at least, research at Uber will go quickly). These researchers will now be stuck without jobs in a market that will be very hostile towards PhDs. For their sake, I hope they all vest quickly enough to get a nest egg before things go south. (it's going to happen, it always does)
-Chris
While I agree they need to get while the getting is good, if they were good enough for C-M they can probably return or find a similar gig if they want to if Uber crashes and burns, although Uber says they have a million dollar liability policy so even if that happens they met be OK for a while.
That way it can't be overwritten by software. Or at least require an internal jumper to be set before any writes can happen. Any user updating their BIOS would be fairly experienced so taking the lid off an setting a jumper wouldn't be a problem for them and people who arn't technical could just take it to a store.
Or, ship each Mac with an encrypted dongle that must be unlocked to do a firmware upgrade. You could even print the key on the dongle so you wouldn't worry about losing the key; if yo lose the dongle then still allow an authorized service center to do firmware upgrades. Of course, this my be a solution in search of a problem.
GPs will be fine. People really like having a human Doctor. Particularly an American-accented human Doctor. Unless the Hospital can bill the insurance company extra for using the human GP they will continue to use the human GP. And the insurers aren't likely to pay extra so the hospital can replace a GP earning low six figures with a computer. Moreover computers would make really shitty GPs, as they are unable to figure out whether you have high blood pressure because you're about to die, or because you're nervous that a robot has just grabbed your fucking arm.
While I agree with much of what you said, I don't think it will be a robot grabbing your arms much as a PA or NP who sees you and the computer does more of the analysis and the PA or NP does the final analysis and diagnosis; and the NP licenses will allow independent practice in all states and not just some as it is in the US today. It's not so much that the computer replaces the human as changes the role and training of the human, and thus the costs. In addition, a broader move to NP's and connected, computer assisted practice, could make primary care more available as well.
OTOH, many specialists entire job is reading a chart. The chart's format does not change much. Interpreting data is something computers are great at. Watson was already measurably better at reading certain specialized charts then actual Doctors back in '13. Those guys are gone. They make more then a GP does, while frequently bringing in less revenue, and the patient's aren't going to ding your Medicare quality ratings because a behind-the-scenes Doctor they'd never met got replaced by a computer.
This is just like any other skilled work that can be automated. The textile machines of the early 19th century were demonstrably worse then many weavers, but they were a) cheaper, and b) better then the average. So as of 1840 or so weaver was no longer a career option. Computers are already better then the average specialist in some fields, and they will be cheaper soon enough thanks to Moore's Law.
I'm not so sure here. I've worked with specialists and while they do a lot of chartology the decision making process is more than just what the chart says; especially when it comes to final treatment and decisions on a person's health. I agree a computer can take a lot of the analysis work off of the specialist but for the real skill the have is knowing what questions to a ask and how to followup to solve a problem, not a rote review of a defined operation procedure that can be codified. As one put it, it's as important to know when not to operate as when to operate. Will how they interact with computers change? Certainly, but I think the GP is more likely to see a greater impact than the specialist; at least in the short term.
I suspect quite a few other jobs behind the scenes will be automated. For example, why have a human X-Ray Tech analyze your pictures when computer image analysis is getting so much better? Heck, why have a team of Medical Specialists who make ($500k a year each) when a computer program can read the data and do the work?
Read the data and interpret it are two very different tasks. Sure, a computer can make an very good guess based on the rules it has to but to infer what something means based on patterns and something unusual will take a while longer for machine to do as well as a human. I'd say a machine is more likely to replace a GP first since they are treating symptoms rater than cases and most symptoms will respond to standard, well defined treatments. the machine can run the tests and check the symptoms and provide a diagnosis for review by a clinician. The problem, even with that, is the machine won't notice other thing start a person doesn't mention, that could be symptomatic of a different problem.
Truck drivers, OTOH, are already set for replacement, at least for long haul tucks where a truck with a robot driver can drive, at least in proximity to one real driver; so several tucks may only need 1 driver in the future.
1. They can accurately identify students and staff. Since no one has ever created a fake social media account that shouldn't be hard. Just require everyone to provide a list of all their accounts. No one would object to that, correct?
If you even just read the summary you would see that the school board is buying software which is capable of location based identification, so simple fake accounts should be easy to see through. I suppose a brother or sister in the same household might be able to pretend to be you, but beyond that, I doubt this software is that easy to fool.
I guess the question is how do they determine location? If it simply by where you say you are then the software would depend on people accurately entering their location? Geo staged photos? Not hard to fake. I do not know how you extract location data from Facebook. Maybe Facebook sells the data to the software provider so they get accurate data based on FB ability to ID locations? I know sone services use IP addresses which my VPN easily confuses.
1. They can accurately identify students and staff. Since no one has ever created a fake social media account that shouldn't be hard. Just require everyone to provide a list of all their accounts. No one would object to that, correct?
2. Software can accurately parse potential threat from random uses of keywords and not require excessive reviews of material that is innocuous.
3. No one would create fake accounts to cause #2 to occur.
4. No one will object nor have the cash to hire a lawyer if the school demands account information under threat of punishment.
Amending public records laws to require individuals to grant permission to release personal information prior to releasing records? And go allow charging for material, if the law doesn't already, so fishing expeditions would be to expensive.
Our government is out of control anyway, anything that allows blackmail, removal from office, misery in their lives. etc is a good thing
While we're at it let's extend it to programmers, DBAs, sys admins an designers who cause us so much misery because they are too stupid or lazy to build secure systems.
I came up with the answer by reading books and online content about common questions asked at interviews.
Wrong answer. You see, when I ask that question I am wondering how well you think on your feet, not that you actually have an answer; since I really don't care about the answer you give. I need to know how you might handle an off the wall question from a client in a meeting and if I can trust you not to say something stupid. I really just want to see how you react; because you never know what a client might ask, or say.
Do you want to know my Strengths and Weaknesses next, or just how many basketballs fit in this room?
Nah, I'm more of a "How many golf balls were sold in NYC last year" kinda person.
Slashdot Mirror
Yes, we have moved far afield and I agree the changes I think are coming will not be easy, quick, nor may they all come to pass. My thought on the computer replacing the specialist as being harder is that the specialist is often looking for the cause of a problem and how to treat it beyond just looking a test results. The computer may be very good at pointing out anomalies and suggesting courses of action but not that good and drawing inferences and conclusions from them and other information that may not be readily quantified by a test result. they're real good at the routine and predictable but not very good when unfamiliar or complicating factors occur. As for an easier job, given most problems seen by GPs respond to treating the symptoms without determining the underlying cause; i.e. you have an infection, infections generally respond to X so i will prescribe X and the problem will go away even if I do not know what the case is you will be cured, so a computer could easily be designed to provide common treatment based on symptoms, IMHO.
I see your points but I guess we will just have to disagree on which areas of medicine may be most impacted by computers in terms of replacing a doctor.
I'm saddened by the misapplication of "computer science" as a term. When I took computer classes, they were not called "computer science" until one was actually supposed to program the computer. Like, open an IDE, write code, and compile it. I don't think that it's appropriate to use computers to teach basic skills to children, but regardless of that perspective, it is wholly inappropriate to call an introduction to computers "computer science".
I'd go a step further and say learning a computer language isn't studying computer science any more than learning a foreign language is studying linguistics. There is a difference between acquiring a specific skill and understanding the concepts and theory behind how the skill is employed.
With sufficient resolution (as TFA points out) and the ability to finely control the drones this could be a good thing since you could hover near and area and get a closer look; and then do a normal inspection if you still have questions.
Maybe the U.S. could fund degree attempts at state unis. The problem there is that states have been pulling money out of higher ed. then turning around and claiming their state schools are still state schools. The some of the increase in tuition at state schools is directly the result of the state legislatures pulling money out. The legislators then turn around and claim there is a crisis in higher education with ever higher costs for the average person.
Some statesdo. Georgia has the Hope Scholarship which pays tuition at state schools if students maintain a certain GPA.
I would disagree with "Which means: find out what kind of important work your developers dislike the most, and do it for them." I would say:
"Find out what non-essential stuff is interfering with real work and protect them from it."
There often is work that is important that must be done but is not exactly fun, such as documenting code, helping tech writers prepare user manuals, listening to users and getting feedback on the UI, etc. Developers may dislike that work but they are the ones that need to be involved with it or do it. Sometimes it's the manager's job to point out stuff that needs to be done and find a way to get it done; even if it isn't what they want to do.
convincing banks to create securities of sub-prime mortgages he could bet against
The article does not say that he did that. Instead, the article says that the banks bought insurance against mortgage defaults (credit default swaps), and that prices of such insurance was very low. John Paulson decided the price was too low compared to the risk, so he bought a lot of the same insurance.
Good summary of what happened. he bet against stupidity, and won. Now he gets to do what he wants with his money.
A few comments:
I agree no insurer, unless they are an HMO, has the ability to dictate weather you see an MD or NP. They can, however, adjust reimbursement rates and /or co-pys to make a NP a more cost effective solution. If they reduce reimbursements a GP may find they do not make enough to maintain a viable practice. It's not that the patient isn't getting to chose a GP over an NP, it's that they both get the same payment for the service. The GP, who has higher costs than an nP, will be squeezed.
Yes, the healthcare reimbursement system is a mess; and the main point seems to be for insurers to deny payment for any reason and hope the clock runs out before the provider fixes the errors. It will be interesting to see what happens as fee for service is replaced by an outcome based reimbursement system.
If the number of specialists increases than they may see their revenue drop simply because more people are sharing the pie; but as GP reimbursement drops anyone who spends all the time and money to become a doctor would want to be a specialist simply because that is where the money will be.
As more states allow NP to practice on their own they will have no reason to share a practice with an GP, they will more likely work closer with specialists when they see a patient that's problem is beyond their license. They will become the entry point into the health care system because they will be cheaper than doctors. Ultimately, the economics of healthcare will drive the model.
To affect change the insurers don't need to be monopolists, they just need enough covered bodies to represent a significant percent of an area's inserted population so health care providers can't afford not to accept them, and their rates, because they would be left fighting over a much smaller pool of patients who can pay for services.
I also agree the change will take time but I think it is inevitable; given the need to control health care costs.
No, and does it even fucking matter? Guns aren't illegal..
I see your 2cd and raise you with they are in some areas like schools.
"If nobody's going to buy the database, in one month I'm releasing the keys, and victims will have their files automatically unlocked.â
Oh , how heart warmingly magnanimous of you! I can see how contrite and sorry you are about what you've done... well apart from still wanting some money for the DB.
Tell you what you sorry little turd, how about you release them anyway and give these poor people their data back? @rsehole.
In addition, he's said "I am part of a criminal conspiracy and am will to sell the tools I used as part of this conspiracy. Oh, BTW, I also probably violated money laundering and income tax laws as well. That part where I deleted files related to the conspiracy? That's not obstruction of justice is it? Also, please believe me I never infected any computers while testing it so I didn't violate and computer crime laws." When he sells it he'll probably ask the buyer to verify he or she is not in law enforcement beacsue a cop would never go undercover and lie about being a cop; or use an informant to get evidence.
They also tend to be more durable than a smartphone. You can carry it in a pocket or drop it with much less chance of damaging it. If you lose it you're out $20 rather than several hundred. I know contracters that use them for that reason as well as give them to employees for use on site for similar reasons.
are some advantages. If all someone wants is the ability to make calls dumb phones are a great choice. Many of my friends have them for elderly parents so the always have a phone handy. Using a smart phone touch screen can be overwhelming as the have to unlock it, touch the phone app, then dial using a non tactile screen. OTOH a dumb phone keys mimic the landline they have been using so it's simply a matter of making sure they know how to charge the phone and use green button to dial and red to hangup.
1. Create new gmail account
2. Create Google Voice number and give to PayPal
3.?
4. No profit
Cables companies will primarily become internet providers and satellite companies will provide programming to the peeps in the boonies. Personally, I say "freaking awesome". Both industries treated their customers like crap for decades. Reap what you've sown you jackasses.
If you hated the old regime what till you see the new one. The new battle ground will be usage caps. Cable companies will start offering tiers of data. Want to stream video 24x7. No problem, just buy our gazzilion GB package at $200 per month. Oh, you want fast speeds? Upgrade to Speed plus for a $20 more. They will simply change the pricing to make money off of the pipe, not the content.
Content companies need to buy into the new model as well. The really small channels very few people watch such as SciFi or F/X will see their revenue drop significantly and some will simply go under. The big guys, such as ESPN that gets something like $6 per subscriber will not want to have to try to get their current revenue from the people who actually watch the channel(s). More than likely, when all is said in done you'll see a variety of companies that bundle packages of channels and sell them as a bundle, such as SlingTV. Apple seems to be getting into the business as well and for premium content sellers such as HBO selling al la carte may be more viable because that is what they already do so it's more of a way to get more revenue by tapping into cord cutter stain changing a business model. As for the bundlers, that sound a a lot like, wait., a Cable Company. Except now they will compete with companies like SlingTV while still controlling the pipe and its pricing.
Until Google or someone else offers an alternative pipe they have you where they want you and the hearts, minds, wallets will soon follow.
You spend too much time around Doctors. They're very smart, and very good at figuring out how the human body works as a system; but their cluelessness as to how the health system pays them is frankly astonishing to anyone who has to deal with them for more then 10 minutes. These are people who will, with a straight face, tell that one reason they deserve more respect then other PhDs (average salary: not $55k) is that they spent four years in pecuniary earning only $55k for their residencies
True, you are worth what people are willing to pay not what it cost to get the education to do the job. Quite frankly, the pay for activity model is broken.
In this case, no GPs are never going to be fired en masse. Arguments saying Nurse Practitioners are better, or a computer would be better are simply irrelevant in light of the fact that consumers want to go to see a Doctor.
Also true, which is why educating the consumer will be part of the shift to lower cost treatment venues. This is not something that happens overnight; but the growth of the minute clinics staffed by NP's is a step in that direction. Consumers may want to see an MD but will trade that off for seeing an NP today vs an MD next week.
Since the co-pay is the same either way NPs can only gain market-share in places where there are not enough GPs. Which means that no, no hospital is going to actually fire a GP and replace him. It would be stupid business, so an MD-run hospital might try it, and if you tried you'd lose market-share to the newly opened GP partnership of three guys you fired.
Moreover, Specialists willing to work in places far from the costs make princely salaries. $500k is not unrealistic. $200k is not unusual for people whose entire job is to read test results and not talk to patients.
Here's the problem. As insurers switch to pay for results and MDs can no longer make more money by running a test the ability to generate enough revenue to make a desired income will decrease. GP's will be competing with NPs and salaries will reflect that. This isn't about firing GPs but the impact computers and a changing way of reimbursing will impact the practice of medicine. A specialty will be even attractive because that is where the money will be.
Let me put it to you this way, which Hospital do you think is will do better: A) Hospital A's business model is to fire three guys making $150k, replacing them with 3 NPs making $40k. This gives them $330k to buy a computer system that has to understand the entire human body.
B) Hospital B reduces is Surgical staff by two because it can out-source all data analysis in their specialties to a computer it will buy. It has saved $1 million. It can hire all 3 GPs A) just fired and it's computer budget is $550k. Which means not only does it have a better computer, that does less (remember: instead of understanding everything as a GP does it only has to understand a couple of specialties well enough that their specialists can cut analysis a few hours a week), it also poaches most of the patients those 3 GPs saw, and it's got a great marketing angle ("see a real Doctor").
First of all, the computer doesn't have to understand the whole body; rathe it needs to be able to treat symptoms not determine the underlying cause. When the symptom goes away you are cured, and the MD or NP's job is to determine what is the most likely course of treatment based on the symptoms, using the horses not zebras analogy. yes, they determine what you are most likely to have and act base don that, but it is very much a symptom -> action treatment based on pattern recognition; something computer can help with while relying on the MD or NP to recognize anomalies as well as validate the results.
The problem with your poaching model is your assuming insurers will continue to pay enough to cover a GP salary and make money. A more likely model is a number of NPs in practice with
Advertising always worms its way into everything.
AC
A pox on both Netflix and the advertiser's houses, they have made worms meat of us.
I cannot comprehend this entitled attitude. on cable tv you see ads. in a magazine or newspaper you see ads. before movies you see ads. during movies you see ad placements. so it's not like Netflix is proposing a crazy new concept, to show you an ad even though you pay a subscription. why so angry bro?
Perhaps, but I subscribe because I get ad free programing. if they want to show ads thats fine, I'll just move on to something else. I'm not angry, just voting with the wallet.
Most CS professors are paid market value. You can look up salaries at public schools. You'll find that at the ones that compete with CMU, the salaries are all in the range of what the researchers would make at a company ($100-250k). Bonuses are a little harder to compete with. But, in CS at least, grants cover a ton of travel. To publish in CS, you have to go to the conferences you're publishing in, unlike the rest of science which just has journals. That more than makes up for the lack of bonuses as far as fringe benefits go.
Quite true. There is a big difference in the market value of a researcher who is doing cutting edge research in a field that is relatively new vs the value of a research in a field that is mature enough for companies to see practical applications for the research. The former attracts researchers because they can explore new ideas and develop thing that don't exist, but they will be paid by academia standards since that is where much of that research is done. Once they can apply their research then they become much more attractive to private companies who are willing to pay much more for their expertise because they plan to develop commercial applications to make money. Universities can't afford, nor do they need, to pay equivalent salaries.
Now, the one benefit you get from industry is that you don't have to write grants. But, you also have more job security in academia. What worries me most about this is that when this bubble bursts, Uber will be one of the first companies to go (at least, research at Uber will go quickly). These researchers will now be stuck without jobs in a market that will be very hostile towards PhDs. For their sake, I hope they all vest quickly enough to get a nest egg before things go south. (it's going to happen, it always does)
-Chris
While I agree they need to get while the getting is good, if they were good enough for C-M they can probably return or find a similar gig if they want to if Uber crashes and burns, although Uber says they have a million dollar liability policy so even if that happens they met be OK for a while.
That way it can't be overwritten by software. Or at least require an internal jumper to be set before any writes can happen. Any user updating their BIOS would be fairly experienced so taking the lid off an setting a jumper wouldn't be a problem for them and people who arn't technical could just take it to a store.
Or, ship each Mac with an encrypted dongle that must be unlocked to do a firmware upgrade. You could even print the key on the dongle so you wouldn't worry about losing the key; if yo lose the dongle then still allow an authorized service center to do firmware upgrades. Of course, this my be a solution in search of a problem.
GPs will be fine. People really like having a human Doctor. Particularly an American-accented human Doctor. Unless the Hospital can bill the insurance company extra for using the human GP they will continue to use the human GP. And the insurers aren't likely to pay extra so the hospital can replace a GP earning low six figures with a computer. Moreover computers would make really shitty GPs, as they are unable to figure out whether you have high blood pressure because you're about to die, or because you're nervous that a robot has just grabbed your fucking arm.
While I agree with much of what you said, I don't think it will be a robot grabbing your arms much as a PA or NP who sees you and the computer does more of the analysis and the PA or NP does the final analysis and diagnosis; and the NP licenses will allow independent practice in all states and not just some as it is in the US today. It's not so much that the computer replaces the human as changes the role and training of the human, and thus the costs. In addition, a broader move to NP's and connected, computer assisted practice, could make primary care more available as well.
OTOH, many specialists entire job is reading a chart. The chart's format does not change much. Interpreting data is something computers are great at. Watson was already measurably better at reading certain specialized charts then actual Doctors back in '13. Those guys are gone. They make more then a GP does, while frequently bringing in less revenue, and the patient's aren't going to ding your Medicare quality ratings because a behind-the-scenes Doctor they'd never met got replaced by a computer.
This is just like any other skilled work that can be automated. The textile machines of the early 19th century were demonstrably worse then many weavers, but they were a) cheaper, and b) better then the average. So as of 1840 or so weaver was no longer a career option. Computers are already better then the average specialist in some fields, and they will be cheaper soon enough thanks to Moore's Law.
I'm not so sure here. I've worked with specialists and while they do a lot of chartology the decision making process is more than just what the chart says; especially when it comes to final treatment and decisions on a person's health. I agree a computer can take a lot of the analysis work off of the specialist but for the real skill the have is knowing what questions to a ask and how to followup to solve a problem, not a rote review of a defined operation procedure that can be codified. As one put it, it's as important to know when not to operate as when to operate. Will how they interact with computers change? Certainly, but I think the GP is more likely to see a greater impact than the specialist; at least in the short term.
I suspect quite a few other jobs behind the scenes will be automated. For example, why have a human X-Ray Tech analyze your pictures when computer image analysis is getting so much better? Heck, why have a team of Medical Specialists who make ($500k a year each) when a computer program can read the data and do the work?
Read the data and interpret it are two very different tasks. Sure, a computer can make an very good guess based on the rules it has to but to infer what something means based on patterns and something unusual will take a while longer for machine to do as well as a human. I'd say a machine is more likely to replace a GP first since they are treating symptoms rater than cases and most symptoms will respond to standard, well defined treatments. the machine can run the tests and check the symptoms and provide a diagnosis for review by a clinician. The problem, even with that, is the machine won't notice other thing start a person doesn't mention, that could be symptomatic of a different problem.
Truck drivers, OTOH, are already set for replacement, at least for long haul tucks where a truck with a robot driver can drive, at least in proximity to one real driver; so several tucks may only need 1 driver in the future.
1. They can accurately identify students and staff. Since no one has ever created a fake social media account that shouldn't be hard. Just require everyone to provide a list of all their accounts. No one would object to that, correct?
If you even just read the summary you would see that the school board is buying software which is capable of location based identification, so simple fake accounts should be easy to see through. I suppose a brother or sister in the same household might be able to pretend to be you, but beyond that, I doubt this software is that easy to fool.
I guess the question is how do they determine location? If it simply by where you say you are then the software would depend on people accurately entering their location? Geo staged photos? Not hard to fake. I do not know how you extract location data from Facebook. Maybe Facebook sells the data to the software provider so they get accurate data based on FB ability to ID locations? I know sone services use IP addresses which my VPN easily confuses.
1. They can accurately identify students and staff. Since no one has ever created a fake social media account that shouldn't be hard. Just require everyone to provide a list of all their accounts. No one would object to that, correct?
2. Software can accurately parse potential threat from random uses of keywords and not require excessive reviews of material that is innocuous.
3. No one would create fake accounts to cause #2 to occur.
4. No one will object nor have the cash to hire a lawyer if the school demands account information under threat of punishment.
Amending public records laws to require individuals to grant permission to release personal information prior to releasing records? And go allow charging for material, if the law doesn't already, so fishing expeditions would be to expensive.
Our government is out of control anyway, anything that allows blackmail, removal from office, misery in their lives. etc is a good thing
While we're at it let's extend it to programmers, DBAs, sys admins an designers who cause us so much misery because they are too stupid or lazy to build secure systems.
I came up with the answer by reading books and online content about common questions asked at interviews.
Wrong answer. You see, when I ask that question I am wondering how well you think on your feet, not that you actually have an answer; since I really don't care about the answer you give. I need to know how you might handle an off the wall question from a client in a meeting and if I can trust you not to say something stupid. I really just want to see how you react; because you never know what a client might ask, or say.
Do you want to know my Strengths and Weaknesses next, or just how many basketballs fit in this room?
Nah, I'm more of a "How many golf balls were sold in NYC last year" kinda person.