I agree! It's amazing to require the visitor to edit the url to go from blog to main site. For my projects I pay attention to avoid this as I find it so annoying. I want visitor that are interested to have easy access to the website!
LLMs as a technology are neutral and largely act as amplifiers.
Now, there is not an ounce of decency between our SV overlords and I have zero trust they will choose to amplify the right things. On the contrary, their apparent ideal state is a vast swath of technoserfs force fed ever more content and ads and more content, getting by on Uber-for-everything, where you spend what little money you have saved up being a delivery boy on things you don't own. We will stumble about in barren apartments, living a fake life through VR goggles, watering virtual plants with virtual water, all of which we pay for of course. All the while Zuckerberg, Musk, and Thiel are tucked away on the moon, their vile hands clinging to a last hope of immortality, just as hopeless as the people below.
I don't agree with the repeated mantra that technology is neutral because the creation, maintenance and promotion of technology requires lots of resources and a lot of choices. A lot of conscious effort goes into creating things, and to change the thing after someone uses it. Make it better, make it safer, make it easier to use, etc. That doesn't feel neutral to me.
Makes sense. Coal mining can be automated, and that has been partly done. If coal mining still would be done mostly manually, there would be way more coal miners, or, more likely, coal mining would be unprofitable, and be a thing of the past,
Yoga teaching hasn’t been automated yet, and may never (a startup using robots to give yoga classes likely would be a hit on social media, and might initially be successful, but I am not sure that would last)
Wikipedia on Situs Inversus (visceral organs are mirrored, heart on the right, liver on left) [0], mentions mixed results regarding handedness. There would be a load of other confounding factors here and I know nothing about medicine.
Situs inversus ("dextrocardia") is a rare disorder. What I postulated is a (very) small selective advantage leading to a neurological mechanism evolving over generations, not a direct line from the heart to handedness during development. Anyway, the effect would be very slight, and even if it did exist, it could have gone away later, but dexterity would have been baked in at that point (see also the ocular blind spot).
> In regards to the whole ecosystem: TC39 should take a look into adding a better standard library to JS itself, which would reduce the amount of one-liner packages.
I concur, the best part of working with Deno way back was its standard library [0] and overall complete dev environment. It is just so damn obvious that a runtime comes with an integrated test runner and assertion library.
To be fair, Node has `node:test` [0] and `node:assert/strict` [1] modules out of the box for several LTS versions now. `node --test` can easily replace Mocha and `node:assert/strict` is fine, but `chai` is still sometimes nicer (include ergonomics like `expect`). (Deno's @std includes an `expect` style assertion library.)
Of course, the trouble is that there are so many test runners in the Node ecosystem and many of them cannot be as easily replaced as Mocha, so the shift to the out-of-the-box test harness and assertion library will of course be painfully slow. People like the over-complicated nature of both Jest and Vitest for all sorts of reasons. Major companies thought Karma was a good idea. (I still don't understand why more developers didn't cringe at "Yo dog, I heard you like V8 for your unit tests, so we're gonna spin up a second, different copy of V8 from your existing V8 environment.")
Much came after Deno added them. I don't know what will happen to Deno, but I am glad they showed the Node world than life can be a little more pleasant
(Specifically `Temporal.Now.instant().since(somePastInstant)` returns a Temporal.Duration that you can relatively easily determine the highest granularity you want and pass that to an Intl.RelativeTimeFormat instance. Also Intl.DurationFormat which is what a Temporal.Duration's `toLocaleString()` uses may also be good enough in many "x hours ago" type situations, though it is over-precise for them.)
So, back to the GP post - TC39 should make a bigger stdlib.
Lets say timeago.js is warranted (as a polyfill and terser API) AND TC39 is taking action.
On slice.js, TC39 took action AND usage is unwarranted since the functionality is widely available. Maybe a stride.js would be needed.
There are 2 modules where npm's culture of "tiny modules because the stdlib is impoverished" holds - but the issue isn't TC39 really. There are 312 modules that aren't related to npm's culture of "tiny modules because the stdlib is impoverished".
> Lets say timeago.js is warranted (as a polyfill and terser API)
Though it may be useful to point out that timeago.js specifically is not a wrapper for Intl.RelativeTimeFormat. It implements its own unique internationalization beyond/instead of the platform capability. (Similarly, so do Moment, Luxon, and date-fns.)
I would argue that it is unwarranted to use such libraries, because we can do better in Vanilla with platform features now. Though yes, Safari still doesn't implement enough of Temporal today for it to be considered Baseline Widely Available. (There also are direct Temporal polyfills. Surprisingly I've found vanilla polyfilling with Date by hand isn't terrible enough to warrant a Temporal polyfill, but also my most complex Temporal math is usually server-side in Deno.)
But yeah, that's mostly quibbling outside of the point being made.
> There are 2 modules where npm's culture of "tiny modules because the stdlib is impoverished" holds - but the issue isn't TC39 really. There are 312 modules that aren't related to npm's culture of "tiny modules because the stdlib is impoverished".
Ah, yeah, I think that is a fair call and I mostly agree with it. "The stdlib is impoverished" argument has changed a lot since the "leftpad" days. So much so it has started to feel more like "the stdlib was impoverished for too long" (and/or "Node was too slow to adopt Browser platform stdlib features and accidentally forked the stdlib for too long"). Most of the damage happened in the past, but a lot of those libraries remain in the ecosystem as developers are slow to adopt new platform features or switch away from old "comfortable" libraries (timeago.js or slice.js versus more vanilla approaches; the quibbling above wasn't entirely tangential, I suppose).
But also the proliferation of modules in npm goes far beyond that. Of course there are a lot of blockchain libraries that will never be stdlib. Of course there are client modules to proprietary APIs that will never be stdlib. The giant size of the npm ecosystem includes a lot more than just "stdlib" style libraries.
I even think the "leftpad" debacle itself did a lot to accelerate npm out of the "tiny modules" approach in general. It also may have itself been a sign that that attitude was already dying. (It was caused by one of the earliest and most prolific "tiny modules" authors leaving the ecosystem in a huff because the ecosystem was changing.)
The effort required to set this up far outweighs the price to pay someone to do it for me.
I pay a cleaner, I have a dishwasher, I pay someone to do my taxes, I pay for companies to host software.
Then again, I never order food and almost never get takeaway, as cooking is nice and I value my food enough to care what goes in it. Cheaper too, easily offsetting what I pay for my password manager.
Tailscale for your laptop, phone, etc. to be able to talk to the other computers when away from your home WiFi. (Optional, but makes syncing easier).
Syncthing, talking to your Tailscale IP addresses if you use it, or your private WiFi network addresses if you don't use Tailscale.
One folder synced, containing keyfile2.kdbx.
30 minutes to set up and then you almost never need to think about it again. If you don't trust Tailscale, you can run a Headscale server or just not use it. And the syncing is entirely run on your machines; your data never ends up written to someone else's SSD.
I mean does it? I have set it up before but I just set it up for my new small office team. I already had an internal server and WireGuard vpn in our office and it took 2 minutes to create a quadlet to run vaultwarden and a few more to configure it. The “hardest” part was training the team on how to use collections.
The carousel also had a political component: you can have every exec's pet project above the fold on the start page. Users develop banner blindness and scroll past without noticing. In an odd way everybody wins.
> The real irony is that building something genuinely simple, something that loads instantly and says exactly what it needs to say and nothing more, is often harder than bolting on a chatbot. But that's invisible work. Nobody sees the restraint.
Band and severely punish systematic violations of privacy.
Regulate the poison first, not the access to it. All this age verification nonsense is an admission that some platforms knowingly harm their users. And instead of fixing the issue by cracking down on the proverbial crack, governments make everybody's life worse.
I remain hopeful that one day, humans will regard the online advertising companies with the same scorn we do the tobacco industry and may they be ashamed and disgusted at our inaction.
Medicine is so much more than "knowledge, experience, and pattern matching", as any patient ever can attest to. Why is it so hard for some people to understand that humans need other humans and human problems can't be solved with technology?
So much of what I know from women in my life is that the human element of medicine is almost a strict negative for them. As a guy it hasn't been much better, but at least doctors listen to me when I say something.
One of, if not THE biggest challenge in getting treatment is getting past insurance rules designed to deny treatment. This is much, much easier when you're able to convince a doctor (and/or trained medical staff) to argue on your behalf. If you can't get those folks to listen to you, that's probably not gonna happen. You might have to go through several different practices before you find a sympathetic ear.
Now replace some / all of those humans with... A machine whose function also needs insurance approval.
Sounds like we need to dismantle and replace this broadly dysfunctional system at multiple points. It's not like the US insurance landscape is anywhere close to the best way of handling healthcare if you look at many places in the world.
This is because "dismantle and replace" (or perhaps in other words, "defunding") is not a serious, viable solution to many of the societal issues we face.
Things were ruined slowly. They unfortunately will need to be fixed very slowly too.
I don't think that's going to work. We need broad political change and then that has to work rapidly to legislate this. I don't think slow and steady has done anything but lead to the decay our institutions over the last 70 years.
I think that both this and GP are misguided. The pace of societal change in a given direction is neither inherently proportional to the pace of change in a different direction (GP) nor is the pace part of the direction (you).
You have to engage with the specific historical events/factors that led to the direction and the pace in order to change either. Broad statements like "society is big so change has to be slow" are just as unwarranted as "slow change results in decline".
There's a correct answer to "how quickly can change in a new direction be achieved". It will probably only become known after the fact. It will certainly not be model-able as a function with variables for "progressive or not" and "speed of change".
My argument is more along the lines of "slow change has resulted in decline observably for the time period I have observed it and we should try catalyzing something else"
I grant that whether that winds up being fast or slow even if the attempt is intended to be fast is out of my or anyone's hands for the most part as the system dampens that barring total collapse and chaos :P
> They unfortunately will need to be fixed very slowly too.
this can work until you hit a crisis point; i think one issue is we are sliding faster in the wrong direction (increasing bureaucracy, increasing fees, wait times, overwork etc) so "slowly" can work but only if its "fast enough" if you get what i mean (people are really suffering out there)
Of course they do. Most of their platform is built on [appearing] to repudiate coastal elitism and left wing dogma in higher education + globalism with a healthy dose of fuck you because you're you.
And I graciously waited and allowed them to do things that will take decades if not more to repair before deciding they were irredeemable. I had hoped a middle ground and bipartisan ship would be reached, but it's clear to me it won't be. We do not inhabit the same universe at this point, the disdain is mutual.
You’re acting like I’ve always thought about them like this or like I haven't spent years observing and thinking about this to come to my conclusion. You'd do well to listen to your own words about theory of mind. I was raised conservative I voted for Romney. I'm a fan of many of the political platforms they run on now (minus originalism, removing bodily rights, religion), but in practice they do not walk their own talk. The wars, the spending, abandoning neo-liberalism except in word the blatant corruption and disdain for the positions they hold and how they appear on the world stage.
No, I’ve watched their actions for 15 years and moved ever closer to the position that I have nothing in common with them even being ideologically close to a version of their party from 20-30 years ago and they do so blatantly want to destroy the middle class, health, and wealth for anyone outside a small oligarchic class.
I'm pissed because they wear a lot of my ideology as cheap dress to fuck someone.
You are describing a set of dynamics that lead nowhere other than violence and total and complete breakdown of the polity. If you are correct, then nothing matters, everything is fucked. You won't get what you want, but neither will anyone else.
My preferences, while possibly futile, are least an attempt to not just accomplish short term goals but to fix the broken dynamics of the system. That is, in my opinion, far more important than literally any particular policy goal. Policy progress is pointless in a broken system, so fix the system first.
It's possible that my view of focusing on fixing the system, restoring institutions, erecting new guide-rails in places we have observed that the old ones don't work, etc. won't work. But at least it has a chance of producing a good outcome. A good outcome literally can't come from the kind of political behavior you describe. You want your side to seize as much power as it possibly can when it wins, enact as much "good" as it possibly can in however long it can maintain it's grip before the political tides inevitably swing and you lose power again. You don't seem to realize that this is what we have been doing for at least several cycles now. And what we have seen is that the next administration just tears up the progress, does the same thing except in the opposite direction and even harder, and does what they view as "the good thing" and which your side views as nothing but unmitigated evil (the same way they viewed you and yours when you were in power), and so the both sides have accomplished nothing but pushing the pendulum a little bit further, giving it a little more momentum, and shredding up the social fabric a little bit more.
I'm not so naive as to believe that it is possible for just one side to say "no we won't do that, we will unilaterally disarm". But I am of the belief that, if one wants to pretend that one is "on the side of good", that the only rational action is to, when granted power, to spend as much political capital as is possible to slow down the pendulum, tear back power from the bloated executive and the federal branch more broadly. Stop trying to enact your political project and instead make your political project nothing other than the restoration of the norms and principles of the constitution.
This is not something that has been tried and failed. it's the opposite of the past 50 years of federal political dynamics. What has been tried is your plan of "fuck the other side, they are evil, just do what our base wants and ignore consensus and norms".
It doesn't work, it won't work, and it can't work. It's destroying the country.
From my perspective, you are no better than the side you hate. You may want different policy goals, but both you and your polar opposites are collaborating on a shared project: the destruction of the country.
I want my party back and I want to cut out all the garbage that has infested it. Sometimes that requires taking an actual stand and staying firm to it. Middle road nonsense like what you're suggesting is impotent when one side has so clearly decided to be against it.
Edit: And coming back to this later I need to be clear the left also needs to be swept out. I think our institutions in general need to be reworked. Not replaced entirely, but it's clear they don't survive contact with people who would abuse them for their own ends nearly as well as we had hoped.
It's easy to destroy but hard to create. If your goal is to further destroy then I suppose that's achievable, but I have a hard time picturing what positive change is going to come from it.
No offense, but this comes off as passive indifference and while I've heard people say things like this all my life it has broadly resulted in watching 30 years of societal decay. I can't help but think this is wrong.
We should have stacked the courts ourselves, brandished executive orders etc, had some spine.
Edit: I think I need to make clear my thinking that the right has selectively destroyed institutions and levied them in other areas where it makes sense for their agenda. It's not been wanton. So when I say leverage the playbook it's not a one sided act of destruction.
"Stacking courts" would require a Senate that actually votes those judges in. "Brandishing Executive orders" requires a congress that won't be able to countermand you and a Supreme Court that won't "nuh uh" you.
You are yet another person upset that Democrats cannot overcome the purposeful design of our government that you need a lot of power to build, and little power to destroy.
People who want to fix things need dramatically more power than people who want to stymie and break things. Democrats only rarely get that power, and usually only by one or two votes from people who strictly do not care about fixing things. You want this country to fix things? You need to vote significantly more for a party who will push to fix things.
The minority party in congress has no power by design.
Im an independent who would prefer a version of republicanism that died and the closest thing I have is a deeply ineffective party. While the right is currently building things I don't like to put in place institutions and laws I dont like.
All of you talking about the right destroying things are wrong they’re just building things and enshrining things you wont like.
Let's say, hypothetically, you had two political parties — a "destroy the current institutions" party, and the "preserve the current institutions" party.
The latter might notice the former having an easier time, but "hey, it works for them" is the wrong takeaway. Commit to the hard work of building resilient institutions; don't join in the destruction because it's easier.
There's also an element of "Never (...), they will drag you down to their level and beat you with experience."
The republicans are building things not just destroying is the point. It’s just stuff you wont like. This is why Im not a democrat. The left hasn't been able to effect change or be useful ever [my entire life], sure loves to moralize though.
Strongly agree. I think some (not all) of the Trumpian playbook can be wielded very effectively for non-conservative parties, for a few reasons:
- Some executive orders are always flipped as soon as the opposition takes office, but some unilateral changes are much harder for a cyclical/pendulum-swing opposition season to reverse than they are to emplace. We don't know which are which yet. The return-to-office mandate for Federal workers is probably one that'll have a lasting effect--even if un-done in the future, the average prospective Federal worker will consider the job as something that has a significant likelihood of requiring in-person work if the political winds change and that EO is restored.
- Some things really do get permanently addressed within an electoral season, if you have the guts to shotgun through enacting a solution to them. The withdrawal of most U.S. troops from Afghanistan under Biden is a good example of this. So is the "Fork"/RIF/firing wave of Federal employees under Trump. I'm not saying those are both good things, but they aren't "reversible" in the sense that, say, the Global Gag Rule was endlessly reversible.
- Success follows success, as well. Part of the reason that momentum holds such a sacred place in electoral planning is the same reason that Trump's "flood the zone" strategy was effective (again--not good, but undeniably effective): capitalizing on/marketing early unilateral wins of any size results in the public and Congress being more likely to support larger, more durable changes. This is complicated by many factors (media landscape, districting, money), but is broadly true.
You've witnessed a dismantle and replace effort by the right wing that wishes to squeeze everything to make rich people more money. An effort by the left would destroy the private insurance scheme and build up medicare. Completely different and you'd get something functional.
When the wrong targets get destroyed, everyone suffers. When parasitic forces are destroyed, the system functions better. It's the difference between defense and friendly fire.
We already had an effort by the left. You can “no true scotsmen” if you want, but it represents the reality of what will happen when ideals clash a sector that makes up 18% of the GDP.
Are you referring to the ACA here? That was a compromise bill that props up the current system in the US, primarily created by right leaning centrists.
Why is this downvoted? What the (far) right wing has done to american institutions is incredibly destructive and it will take decades to fix it, if that's even possible. People are hurting because of it.
The whole system has basic flaws in how's financing set up.
There is an intermediary between customers and seller and it's allowed to take percentage of the sale. No such entity will ever work in the interest of the consumer. It has every incentive to inflate prices. Intermediary is needed but it should be financed by buyers with flat fee (possibly for additional incentives that reinforce the desired behavior). The tragedy here is that initially it was. But it was deemed too expensive for the buyers and got privatized which made it vastly more expensive in the long run.
Insurance is also wrong. Insurance is gambling and gambling needs restrictions. You are allowed to take people's money without providing any service most of the time, so you shouldn't be allowed to refuse legal service for that privilege.
Hate to break it to you. It’s the same outside of America. Yes, your insurance system is broken. But no just because you live in say Sweden you won’t get all the treatment you want directly. It is a pain to get it and if you get it you will often have to wait a long time (unless it’s a heart attack in progress then they are fast)
Perhaps, but I don't have much optimism for what this ends up looking like if it's an AI you have to convince to listen to you. In the spaces where this is already happening (rescruitment comes to mind), things are not looking good..
Agreed. Last time I was sick I said my fevers were pushing up to 100 and they said it's not a concern until 100.4. felt like an odd number. It's 38 C. Because my dramatic undersampling of my temperature was 0.4 degrees lower than their rounded threshold through some unit conversions, I clearly didn't have a fever. That's not a very human touch
Maybe you had trouble re-reading your own comment but I can tell by how you responded here (a cascade of links/references) and a snarky comment ("I can keep going if you'd like") that I'm sure the doctor was glad to be rid of you.
You didn't say the doctor disputed you had a fever. You said the doctor told you the fever wasn't concern until 100.4. Which I'm guessing is your fault for misinterpreting. If you google around, it's very easy to see the fever thresholds.
Here, I'll even paste a summary for you, and I can keep going if you like:
Key Temperature Thresholds
- 100.4°F : The standard definition of a fever.
- 103°F : Contact a healthcare provider
- 104°F : Seek medical attention, particularly if it does not come down with - treatment.
- 105°F : Emergency; seek immediate care.
In one of your own links (clevelandclinic.org), here's an excerpt for you:
When should a fever be treated by a healthcare provider?
In adults, fevers less than 103 degrees F (39.4 degrees C) typically aren’t dangerous and aren’t a cause for concern. If your fever rises above that level, make a call to your healthcare provider for treatment.
A fever is 38c, great. What the parents said was that you may have misheard because a fever isn't serious until 104. Which is line's up with the language you used.
> and they said it's not a concern until...
Parent is not suggesting that a fever isn't at 100F, they're suggesting that it's not "a concern" until 104F, a number strangely similar to 100.4 that you claim you heard, presumably, while you had a fever.
They aren’t objectively incorrect. You are conflating two things:
- You aren’t considered to have a fever until you get to 100.4. Anything less than that isn’t considered a fever, let alone a concerning one
- A fever isn’t considered concerning (ie dangerous) until it reaches about 104. Anything between 100.4 and 104 is just a regular fever and isn’t considered concerning.
At which point I'd ask: how much of that is baked into the AI now?
It doesn't have opinions, research, direction of its own. Is this a path of codifying the worst elements of human society as we've known it, permanently?
This even translates to the pediatric space. I took all of my kids to the pediatrician because either they don't make comments to me like they do to my wife, or I don't take shit from them. I'm not sure which. Here's an example:
My wife and daughter were there and the doctor asked what kind of milk my daughter was drinking. She said "whole milk" and the doctor made a comment along the lines of "Wow, mom, you really need to switch to 2%". To understand this, though, you need to understand that my daughter was _small_. Like they had to staple a 2nd sheet of paper to the weight chart because she was below the available graph space. It wasn't from lack of food or anything like that, she's just small and didn't have much of an appetite.
So I became the one to take the kids there. Instead of chastising me, they literally prescribed cheeseburgers and fettuccine alfredo.
My daughter is in her 20s now and is still small -- it's just the way she is. When she goes to see her primary, do you know what their first question is? "When was your last period."
> My daughter is in her 20s now and is still small -- it's just the way she is. When she goes to see her primary, do you know what their first question is? "When was your last period."
Is that supposed to be a problem? How does it connect to the story in your comment?
The question seems to be warranted to me, since being underweight can stop you from menstruating. So if you find someone thin and her last period was off in the distant past, you can conclude that there's a problem and something should be done about it; if it was a couple of weeks ago, you can conclude that she's fine.
(It could also just be something that is automatically assessed as a potential indicator of all kinds of different things. Notably pregnancy. For me, it bothered me that whenever you have an appointment at Kaiser for any reason, part of their checkin procedure is asking you how tall you are. I'd answer, but eventually I started pointing out to them that I wasn't ever measuring my height and they were just getting the same answer from my memory over and over again. [By contrast, they also take your weight every time, but they do that by putting you on a scale and reading it off.] The fact that my height wasn't being remeasured didn't bother them; I'm not sure what that question is for.)
I’m a normal weight, and get asked the same question. More importantly, I can tell them, “I have a regular cycle” and they WILL NOT take that as an answer. I HAVE to give them a date, and they will ask me to make one up if I can’t remember or want to decline giving them that information.
Particularly given the alarming stories of people being prosecuted for having miscarriages, it feels ridiculous.
If anything I hope more automated diagnostics and triage could help women and POC get better care, but only if there’s safeguards against prejudice. There’s studies showing different rates of pain management across races and sexes, for example. A broken bone is a broken bone, regardless of sex or race.
The system doesn't know that you're a smart person who will only say "I have a regular cycle" when you've had something that could reasonably be called a regular cycle. A lot of patients are stupid, and requiring a quantitative answer eliminates one source of stupidity. Yeah, this particular doctor knows you're smart, but I hope you can see what disasters might result if the procedure said "the doctor may skip this step if the patient is smart".
It's the same reason why the doctor will take your temperature, instead of accepting your word that you took your own temperature and it is normal.
> Particularly given the alarming stories of people being prosecuted for having miscarriages
You need to delete your social media accounts and change where you're getting your news from. Nobody is "being prosecuted for having miscarriages". A few people have been investigated for drug abuse during pregnancy which led to the baby's death, which sensationalist news stories twisted into attention-grabbing headlines.
A doctor asking about cycle is just a core piece of diagnostic data like taking blood pressure and temperature, not some conspiracy to harm you.
Perhaps I wasn't as clear as I could have been. My point was that doctors treat women differently than men, even when they're the parents. I don't think that it's inherently malicious, but there is absolutely a bias.
You are asking how it connects, and it absolutely doesn't. But they keep asking and won't accept "it's regular" as an answer.
She's in her 20s and is seeing her primary for routine things, not because of her weight -- that part of the story was about how they chastised my wife for giving her whole milk but said absolutely nothing to me about it later on.
However, your argument focuses on the routine intake instead of any listening part. The fact that the doctor measures height, weight, temperature, and blood pressure on intake and then asks about LMP doesn’t surprise me… that’s the part of the script where you just provide the data before you bring up concerns.
Not to say the doctor was not a jerk, just that your argument doesn’t do much for me.
Yes? That's a very important piece of information, and I hope would be a thing a doctor asks, especially if there are concerns about weight or nutrition.
She's not there about her weight, though. I highly encourage you to talk to women about their experiences here.
The weight thing was not the key aspect of my original comment. They chastised my wife for continuing to give my daughter whole milk while being underweight, but did not make similar comments to me. That was the point.
For women, their pains and problems are far too often whisked away by hand waving and "it's hormones and periods" and serious issues are often overlooked. Very little has changed in that area over the last twenty years.
Yes, let's pretend that the bias does not exist, that is helpful. It certainly doesn't have to do with the fact that it's currently a 60/40 split in active male vs female physicians. Or that women are more likely to be taken seriously by doctors:
I have it so strong, that after I was preparing myself, my work desc, my books everything, i was starring into the books i wanted to learn for 15-30 minutes unable to just start or do anything.
With ritalin, i might have this mental block to, but its overcome in a few seconds.
I went from a 'nearly/borderline failing grade' to the nearly the best grade in just one year.
Because people believe that they know everything about humans and how they work (or they hedge it). This is the exact same reason I don't trust supposed "experts" claiming AI will replace all these jobs: those same experts have no idea what these jobs actually entail and just look at the job title (and maybe the description) but have not once actually worked those jobs. And there is a huge chasm between "You read the job description" and "you actually know what it is like to be in this position and you fully understand everything that goes into it".
Ok fellas put your money where your mouth is. It’s easy to talk until you put your money behind it (or lack of by getting rid of spending on it) if you are so confident in doctor as a service by llm.
I would use one for sure. Much of medicine is getting tests / labs booked fighting to get certain medicines. Doctors will barely give you 5 minutes only deal with one issue per visit, rarely are available and going into an office can make you sicker. An llm with Doctor powers could offer more. I don't think we are at the surgery point but we are past getting notes and medicine's refilled.
So why not order your own labs? I'm sure you can think of ways to get your own medications if you are sufficiently convinced that this is the best course of action for your health.
Arterial blood gas. Calcium score (may not count as a lab). Skin biopsy for cancer (does it count as a lab?). I'm unaware how to order my own troponin if I think I've had a heart attack (not that that's one I should DIY diagnosis). Prostate specific antigen.
Several of those are more procedures than labs. Of course you can't get someone to do a procedure on you for free. Arterial sticks and biopsies may have nontrivial risks (and commensurate liability risk for the performing provider).
PSA and troponin seem trivial to get. Did you look?
It seems likely to me that doctors whose job is almost or entirely about making diagnoses and prescribing treatments won't be able to keep up in the long run, where those who are more patient facing will still be around even after AI is better than us at just about everything.
If I were picking a specialty now, I'd go with pediatrics or psychiatry over something like oncology.
You are confusing the job with a subset of tasks. Some tasks can be automated, some won't. That doesn't mean LLMs, which cannot tell how many r's are in strawberry, will replace anyone.
I'm not. I understand the difference and also that through improvements to the core models as well as harnesses, LLMs are able to handle an increasing share of tasks. I also understand that these things will continue to improve until AI can automate entire jobs.
You, on the other hand, are confusing LLMs from the past with current SOTA LLMs, which can tell how many rs are in strawberry.
It's tech bros like you that are to blame for the shortage of radiologists supporting statements since 2016 which state that radiologists will disappear. Your great SOTA LLMs will tell you to walk 5 mins to the car wash instead of taking the car.
> That doesn't mean LLMs, which cannot tell how many r's are in strawberry, will replace anyone.
But most of us live in America in 2026. There are a lot of interests that don't give a shit about you who would love if you to got your medical care from a machine that "cannot tell how many r's are in strawberry". And there a lot of useful idiots with no real medical issues who will loudly claim the machine is great.
How are you defining technology? How are you defining human problems? Inventions are created to solve human problems, not theoretical problems of fictional universe. Do X-rays, refrigerators, phones and even looms solve problems for nonhumans?
Claiming something that sounds deep doesn’t make it an axiom.
A) nice chatty friendly and cool doctor and can diagnose correctly 50% of the times.
B) robotic ai that diagnoses 60% correctly.
What you chose? If you have a disease than can kill your, the ai is 20% more likely to help you and probably prevent. I can’t see too many people choosing human doctor. Anyway I’m sure there will be people that will chose doctor with 10% correctness vs a 100% ai no matter what.
If you read the study, the whole conclusion is much less spectacular than the article. What the article really pushes happened:
patients -> AI -> diagnosis (you know, with a camera, or perhaps a telephone I guess)
What REALLY happened
patients -> nurse/MD -> text description of symptoms -> MD -> question (as in MD asked a relevant diagnostic question, such as "is this the result of a lung infection?", or "what lab test should I do to check if this is a heart condition or an infection?") -> AI -> answer -> 2 MDs (to verify/score)
vs
patients -> nurse/MD -> text description of symptoms -> MD -> question -> (same or other) MD -> answer -> 2 MDs verify/score the answer
Even with that enormous caveat, there's major issues:
1) The AI was NOT attempting to "diagnose" in the doctor House sense. The AI was attempting to follow published diagnostic guidelines as perfectly as possible. A right answer by the AI was the AI following MDs advice, a published process, NOT the AI reasoning it's way to what was wrong with the patient.
2) The MD with AI support was NOT more accurate (better score but NOT statistically significant, hence not) than just the MD by himself. However it was very much a nurse or MD taking the symptoms and an MD pre-digesting the data for to the AI.
3) Diagnoses were correct in the sense that it followed diagnostic standards, as judged afterwards by other MDs. NOT in the sense that it was tested on a patient and actually helped a live patient (in fact there were no patients directly involved in the study at all)
If you think about it in most patients even treating MDs don't know the correct conclusion. They saw the patient come in, they took a course of action (probably wrote at best half of it down), and the situation of the patient changed. And we repeat this cycle until patient goes back out, either vertically or horizontally. Hopefully vertically.
And before you say "let's solve that" keep in mind that a healthy human is only healthy in the sense that their body has the situation under control. Your immune system is fighting 1000 kinds of bacteria, and 10 or so viruses right now, when you're very healthy. There are also problems that developed during your life (scars, ripped and not-perfectly fixed blood vessels, muscle damage, bone cracks, parts of your circulatory system having way too much pressure, wounds, things that you managed to insert through your skin leaking stuff into your body (splinters, insects, parasites, ...), 20 cancers attempting to spread (depends on age, but even a 5 year old will have some of that), food that you really shouldn't have eaten, etc, etc, etc). If you go to the emergency room, the point is not to fix all problems. The point is to get your body out of the worsening cycle.
This immediately calls up the concern that this is from doctor reports. In practice, of course, maybe the AI only performs "better" because a real doctor walked up to the patient and checked something for himself, then didn't write it down.
What you can perhaps claim this study says is that in the right circumstances AIs can perform better at following a MD's instructions under time and other pressure than an actual MD can.
100% of the cases where some headline makes big claims about "AI" based on some study, you take a good hard look at the study and none of the big claims stand on their own.
It's all heavily spinned, taken out of context, editorialized... It's become almost a hobby of mine lately. And I am glad for have read so many papers and reasoned critically about methods and statistics. But it is also scary to realize just how much people take at face value of bombastic interpretations of datasets that support no such claim or much weaker versions only.
Chasing down sources is something that I often do and I've learned that people take a lot of liberty when divulging opinions about sources they don't think will be checked. Even in high trust environments. I have first hand received work by post-doctoral fellows where some articles in the bibliography didn't even exist.
"Human problems can't be solved with technology" is just wrong, unless you have narrower definitions of a "human problem" or "technology".
For instance, transportation is a "human problem". It's being successfully solved with such technologies as cars, trains, planes, etc. Growing food at scale is a "human problem" that's being successfully solved by automation. Computing... stuff could be a "human problem" too. It's being successfully solved by computers. If "human problems" are more psychological, then again, you can use the Internet to keep in touch with people, so again technology trying to solve a human problem.
I think you may be misunderstanding the concept of 'human problem'. A human problem is caused by humans, it isn't something like transportation. That is a physics problem. An example of a human problem is cheating; you can't solve cheating with technology. Just add [incentive] after human and it should make more sense.
IMO "human problem" isn't a well-defined concept, so it's not really possible to misunderstand it. I think a "human problem" is a problem that _humans have_: how to move around? (transportation) what to eat? (agriculture, etc) how to prevent cheating? (some kind of surveillance) how to communicate over long distances? (radio, the internet, etc)
Sure, some kinds of such "human problems" can be reduced to physics and technology, that's the point. This also doesn't necessarily mean that solutions produced by such reductions are effective: is surveillance good at preventing cheating during exams? Kind of. Does it often fail to catch cheating students? Absolutely.
However, indeed, there can be many different (perhaps equally correct) definitions of what a "human problem" is.
> In psychotherapy patients tend to prefer talking to AI than a human therapist and rank the interaction higher.
Even if your statement is true, it's questionable. People also tend to prefer hearing what they want to hear to hearing what they need to hear, and rank the former interaction higher.
Basically, tech's favorite feedback mechanism, customer reviews, cannot actually be relied upon to tell you how good something is.
I know. I know. Part of it is that talking to patients on average is useless but still this can’t be really used for an argument against AI.
Still doctors can have a more broad picture of the situation since they can look at the patient as a whole; something the LLM can’t really synthesize in its context.
I think you'd be incredibly surprised how often charts are super, super incomplete or wrong. Like "pt has no pancreas and presented with pain and weeping from a 6yo pancreatectomy scar" but the chart doesn't mention the surgery or the entire missing organ wrong. Like "pt is a twin whose sibling died traumatically of cancer in front of them a year ago and presents with probable hypochondria about cancer" but the chart doesn't mention any family history wrong. Like "lifelong history of severe cognitive impairment substantiated by a psych eval; attended annual physical before being sent to imaging for head trauma because of observed impairment" but the chart doesn't mention cognition (someone was too polite to note it) nor the psych eval (records sharing wasn't allowed) wrong.
Those are a very few examples off the top of my head. I worked in EMR. I don't know shit about medicine, but man, do I know a lot about the complaints physicians and their staff send when they think it's the records system's fault that the chart was wrong or missing info.
In a big chunk of cases, the MD/NP/whatever's in-person role is determining what's not on the chart so that they can then ask appropriate follow-up questions. Given the massive range of possible dx for a given issue, and how much of getting the right dx doesn't have to do with probabilities/numbers of similar patients with the same symptom:dx data that'd be in the training set, I have major doubt that an LLM can appropriately intuit or appropriately question in order to diagnose.
Yeah... No. I can't possibly disagree with this view more.
I don't need to "talk to a human", I need a problem with my meatbag resolved.
> humans need other humans and human problems can't be solved with technology
WTF are you talking about? Is this bait? You can't possibly mean this. Yes humans are social creatures, but what does that have to do with medicine? Are you talking about a priest, a witch doctor, a therapist? Because if you're not, that sentence is utter BS.
Yes talking to a human is good and necessary. But for diagnostics humans are not good at it. I'm happy for to human to use a tricorder and then tell me the answer.
>Medicine is so much more than "knowledge, experience, and pattern matching", as any patient ever can attest to.
Humans (doctors/nurses) can still be there to make you feel the warmth of humanity in your darkest times, but if a machine is going to perform better at diagnosing (or perhaps someday performing surgery), then I want the machine.
Even now, I'll take a surgeon that's a complete jerk over a nice surgeon any day, because if they've got that job even as a jerk they've got to be good at their jobs. I want results. I'll handle hurt feelings some other time.
I'd be a little bit careful here - being a jerk is quite different to non-conformity / red sneaker effect in surgery and it is not a quality you should look for.
The truly compassionate surgeons will want to improve their skills because they care about their patients. They care if they develop complications and may feel terrible if they do, the jerk may not. Being a jerk may mean that the surgeon can rise to the top, but it may not be due to surgical skill at all, they may be better at navigating politics etc.
> Even now, I'll take a surgeon that's a complete jerk over a nice surgeon any day, because if they've got that job even as a jerk they've got to be good at their jobs.
This seems like an incredibly poor line of reasoning.
Hospitals are often desperate for surgeons. The poorly mannered ones are often deeply unsatisfied, angry at the grueling lives they've opted into, and the hospitals can't replace them. The market is not exactly at work here.
I haven't known doctors or nurses to be very warm and fuzzy. I have known them to have real world experience in seeing the outcomes of their actions instead of...
Dude you removed my right thumb I was in for an appendectomy!?
You are so right! I ignored everything you asked for. I am so sorry. I am administering general anesthesia now, then I will prepare you for your next surgery.
I think there's a real space there, and a lot of what e.g. nurses and doctors do is talking to humans, and that won't go away.
But two facts are also true: a) diagnosis itself can be automated. A lot of what goes on between you having an achy belly and you getting diagnosed with x y or z is happening outside of a direct interaction with you - all of that can be augmented with AI. And b), the human interaction part is lacking a great deal in most societies. Homeopathy and a lot of alternative medicine from what I can see has its footing in society simply because they're better at talking to people. AI could also help with that, both in direct communication with humans, but also in simply making a lot of processes a lot cheaper, and maybe e.g. making the required education to become a human facing medicinal professional less of a hurdle. Diagnosis becomes cheaper & easier -> more time to actually talk to patients, and more diagnosises made with higher accuracy.
I would personally vastly, vastly prefer to go to a robot doctor, who diagnoses, treats and nurses me. What exactly do I need from a human here? Except of course being the one making the system.
Emotional support. Some human doctors absolutely radiate confidence and a kind of "you're gonna be okay" attitude. For me, this helps a lot. I'm not sure a machine can do this.
But I hate if the human doctor "radiates confidence" when I know he is not doing the proper scan, because I have to get back with worse symptoms first for him to take it serious. I don't need emotional support from a human doctor. I need the adequate scans and a proper analysis. I am pretty sure that a competent human will be still way better than AI, but AI even now will likely be better than a doctor not really paying attention.
>Why is it so hard for some people to understand that humans need other humans and human problems can't be solved with technology?
Perhaps because they have been persistently failed by other humans, but not by technology; and/or because they believe they don't have the right and/or capability to improve other humans, but may be able to improve the technology?
For complex human reasons, I am effectively deprived of healthcare, in a country where healthcare is socialized. Other services provided by the state are also gatekept by my nominal healthcare provider, making certain "normal" things, indeed things that are required of me in order to participate in society, technically impossible.
(I will not go into concrete detail, because when I request help from anyone with my situation, the "help" consists of implorations to comply with painful nonsense, combined with a random helping of rudeness and idiocy. Yes, we exist.)
If I had "open source" access to just the "knowledge, experience, and pattern matching" that is presumably still involved in medical practice besides this nebulous "talking to a human" (which the other human usually actively works to make impossible, having been fundamentally socialized into language use by means of violence - and thus, the more intelligent my interlocutor, the more quickly they begin to feel threatened by understanding what I'm talking about), I would be able to maintain my body to a better standard than the standard of care that the institutional medical establishment has kindly deigned to make available to me.
Meanwhile, I don't even have "open source" access to the designs of the motor vehicle which hauls said body around. Being a car mechanic is so much more than "knowledge, experience, and pattern matching", too - it's being a part of a web of trust and tacit collusion; a.k.a. a guild.
Come to think of it, I don't even have "open source" access to the internals of the device I'm writing this from. Though at least in the domain of computing there are valiant attempts to produce libre software and hardware.
I'm happy that "talking to a human" has helped you. In my case, requesting help has a >10% likelihood to endanger my life, >25% to imperil my health, and >50% to degrade my sanity. Rough ballpark, eh?
A fully "open source" OS, device, vehicle, body, and mind, would presumably allow me to solve my immediate problems without needing other humans to perform the inexpicably painful sacrifice of comprehending my communications. Without access to these basics, consent to "healthcare" is impossible; we just put our lives in the hands of the medical technopriesthood and hope they don't leave us with permanently crossed fingers.
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