'A true AI revolution feels out of reach': Why this physician is wary

The rise of artificial intelligence systems such as ChatGPT have many speculating about its use in medicine, and Benjamin Mazer, MD, an assistant professor of pathology at Baltimore-based Johns Hopkins University, sees a future where AI becomes a new way to bill patients.

A large portion of a physician's work involves analyzing symptoms and lab results, producing a diagnosis and selecting treatment. AI could effectively replicate these tasks once the medical field embraces it, Dr. Mazer wrote in a March 16 opinion piece for The Boston Globe. He sees a world where physicians embrace AI and the money it could generate.

"Your AI doctor isn't going to be free and efficient; it's likely to be a costly generator of unnecessary care," he said of this scenario.

He paints a world where AI could perform routine checkups, order labs based on a patient's medical history and symptoms and prompt a physician when a specialist may be needed. "You'll leave the doctor's office utterly impressed. Your physician finally had time to talk to you, and your medical workup was more thorough than ever," Dr. Mazer wrote, before pointing out the potential downside: The bill arrives and patients begin to wonder if their health insurance covers everything.

"American medicine plays by different rules than other industries. Innovation doesn't drive down prices; new healthcare technologies typically lead to greater expense," he wrote. "This is because our insurance system is still largely based on 'fee for service,' which means that physicians and hospitals make more money when they perform more tests and procedures. The latest techniques tend to pay a lot better than the tried-and-true tools they replace, and one service naturally leads to another."

Already, artificial intelligence is becoming more ingrained in medicine, and Current Procedural Terminology codes are expanding to include AI. The American Medical Association convened a digital medical payment advisory group to develop CPT codes for AI devices. The preliminary guidelines went into effect in January, Dr. Mazer said.

"I'm keen to see how new technologies might improve the lives of my patients," Dr. Mazer wrote. "But until we reform the way American medicine is financed and practiced — until we prioritize affordability and discourage excessive care — a true AI revolution seems out of reach."

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