In his new book, Deep Medicine, the cardiologist argues that artificial intelligence can bring humanity back to medicine.
You tweet several times a day about the latest medical studies. Do you really read all of those articles?
Every one of the 18,000 tweets come from me. People think I have an army of people to help me–no. I’m an information junkie. Ever since I was a kid I’ve been an incessant reader. I apportion time every day–a couple of hours in the morning and the evening.
What is the biggest problem you see in medicine today?
What’s happened is an erosion of the relationship, due to the lack of time doctors have with patients. We use keyboards and screens, and it’s led to depersonalization of the doctor-patient relationship.
How do we re-establish that relationship?
The answer came when I started a deep dive into artificial intelligence. It dawned on me that using technology to enhance humanity is the ultimate objective here. It’s counterintuitive. But for doctors, what this means is the ability to have all of the data about a person assimilated and analyzed, to have scans and slides read. That liberates doctors from keyboards so they can look patients in the eye.
People can track their health now with their smartphones. Is that a good thing?
Some of that data will be enlightening, and really helpful. But some of it is going to be terrible noise and even lead to unnecessary testing and anxiety. It’s a mixed bag. But we’ve seen citizen empowerment across all other sectors, and while health care is trailing, it is going to continue to get a lot of momentum.
What are the best examples of how AI can work in medicine?
We’re seeing rapid uptake of algorithms that make radiologists more accurate. The other group already deriving benefit is ophthalmologists. Diabetic retinopathy, which is a terribly underdiagnosed cause of blindness and a complication of diabetes, is now diagnosed by a machine with an algorithm that is approved by the Food and Drug Administration. And we’re seeing it hit at the consumer level with a smart-watch app with a deep learning algorithm to detect atrial fibrillation.
Is that really artificial intelligence, in the sense that the machine has learned about medicine like doctors?
Artificial intelligence is different from human intelligence. It’s really about using machines with software and algorithms to ingest data and come up with the answer, whether that data is what someone says in speech, or reading patterns and classifying or triaging things.
What worries you the most about AI in medicine?
I have lots of worries. First, there’s the issue of privacy and security of the data. And I’m worried about whether the AI algorithms are always proved out with real patients. Finally, I’m worried about how AI might worsen some inequities. Algorithms are not biased, but the data we put into those algorithms, because they are chosen by humans, often are. But I don’t think these are insoluble problems.
Will we ever have an AI doctor to take care of all of our medical needs?
The pinnacle of AI is being fully autonomous. But I don’t think that will happen in medicine; AI will always need human backup. A machine could handle certain things autonomously–diagnosing a skin rash, for example. Doctors shouldn’t be dealing with things that machines will do better than them. But serious conditions, like getting a cancer diagnosis, are what doctors should be working on. I think once patients understand that there are things they don’t need doctors to do, they would love it–once they get used to it.
Correction, March 14 The original version of this story misstated the title of Dr. Eric Topol’s book. It is Deep Medicine, not Deep Learning.
This appears in the March 25, 2019 issue of TIME.
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