The healthcare AI work making Dr. Giovanni Piedimonte think of Oppenheimer

Healthcare's artificial intelligence advent is something that worries Giovanni Piedimonte, MD.

Dr. Piedimonte, vice president for research at Tulane University in New Orleans, spoke with Becker's about his concerns for AI and the healthcare workforce, along with the opportunities he sees in the technology.

Question: What are you most looking forward to this year?

Dr. Giovanni Piedimonte: Leading the Artificial Intelligence Taskforce at Tulane is a lot of work, but also a great opportunity because it's been pushing me to look at all the facets and angles of the incredible opportunities and dangers that are associated with generative AI. In a way, it feels like when J. Robert Oppenheimer was confronted with the supernatural power and unfathomable risks of nuclear energy and began understanding that the new technology could create a brand new world or destroy it. It's been a very interesting experience, but it's just the beginning, so it's impossible to predict where this journey will take us. I hope our team will be able to master the more productive aspects of this incredible technology while trying to avoid some of the problems.

Q: When you think about some of the potential problems that AI could have in healthcare, what are you doing to address those?

GP: I think the potential dangers are enormous. And the most frightening experiences actually come from my attendance at several healthcare and higher education meetings. I'm dismayed when I hear people who are unconditionally gung ho about how wonderful these opportunities are, but completely forget the other side of the equation. There is obviously unprecedented opportunity, but the chances that our current system is completely going to melt down are a clear and present danger. 

One of the problems that I'm looking into is the fact AI is going to lead to a very substantial loss of traditional jobs. The entire front and back offices of every healthcare system are going to be depleted within five to 10 years. Millions of jobs are going to disappear and be replaced by AI-based technology. Before we do that, we need to find alternative solutions to provide these workers with jobs and incomes. When in history, very large swaths of the population end up without satisfying and remunerative work, it always has very drastic repercussions on the social system. It's great that we're going to have robots doing the work currently done by humans more accurately and efficiently, but at the same time, we cannot think only about the bottom line. 

Q: What kind of pivot do you see for administrative workers with AI? 

GP: One thing that is already happening in Europe, particularly in France is they are cutting the working week to four days. That is something that has to be done. At the same time, we have to make sure there are resources to pay people who work only three or four days a week. Those arrangements have to be made in time, and we cannot wait. Requalification of the workforce is going to be very difficult, in my opinion. It's not going to be easy at all because it's not that easy to convince people who have been working in a line of business for most of their lives to completely reorganize their lives and become experts in AI applications. Plus, there is not going to be a need for a lot of those positions. People may say we figured things out when the previous Industrial Revolutions happened, but in the original Industrial Revolution, there were machines that could replace 10, 20 or maybe 100 workers. Now we have the capability of replacing thousands with a single robot. I think it's going to be a completely never-before-seen revolution in the structure of society, which comes in a perfect storm together with other seismic accelerations, such as the progressive aging of the population and the increasing social and economic inequalities. 

Q: On the flip side, what areas of healthcare AI make you excited and optimistic?

GP: We're going to be able to dramatically reduce medical errors. Humans make mistakes. Machines don't. There still will be a need for some humans to operate the machines, but not that many. Machines are probably going to perform most tasks, such as administering drugs, generating diagnoses, and creating algorithms for medical and surgical management, dramatically faster and more accurately. It's going to be machines that are going to be able to remove an enormous amount of bureaucratic load on physicians, but even there, there are going to be significant risks, especially concerning the protection of [protected health information].

I am of a generation that used to make mathematical calculations by hand or in my head. Today, I don't know if I can because there are calculators everywhere, and a lot of people are completely losing the ability to do that. And exactly the same thing is going to happen on a larger scale when we rely on machines for most of our creative functions. We're going to have AI dominate the world of scientific writing, for example, with consequences for peer reviewing and intellectual property that are difficult to predict. 

No doubt there are incredible and unprecedented opportunities within our reach, but it's going to be also a massive risk because detecting fake data and plagiarism is going to become progressively more difficult, if not impossible. I am afraid AI will have on [intellectual property] the same impact social media have had on privacy: It will be a relic of the past. So the opportunities are inextricably intertwined with the risks, but it's a journey through perilous waters that we have to navigate while learning as fast as possible how to survive and thrive. 

Q: What other trends in healthcare are you following the closest?

GP: Precision medicine is becoming more and more a reality rather than just an idea. I think it is the way of the future. There's no doubt that now people understand that you need to tailor medicine to the individual rather than the other way around. I think there is going to be a Copernican revolution for medical therapy and will be driven by the same AI algorithms. 

The importance of double-blind, placebo-controlled trials is likely to stay, but it will only tell the way the majority of subjects respond to therapy. Some people in the same sample are going to be intoxicated by the same therapies, and others are not going to respond at all. So the process of tailoring therapies based on increasingly more sophisticated biomarkers and sensors is going to radically change the way we diagnose and treat diseases. 


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