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title: Why a Puppy Might Do More for My Patients Than I Can
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og:title: As a Doctor I Ask Myself If a Puppy Would Do More for Patients Than I Can
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![](https://static.time.com/v3/assets/bltea6093859af6183b/bltf44afb870625a51a/698a3b2c09208f3fd441a2d3/GettyImages-1311303672.jpg?branch=production&width=1200&quality=75&auto=webp&crop=16:9)


# Every Day as a Doctor I Ask Myself If a Puppy Would Do More for Patients Than I Can

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<!-- video src="https://cdn.jwplayer.com/manifests/UIDfUltg.m3u8" -->
## Video: How AI Is Changing Medical Imaging

[Watch (HLS stream): How AI Is Changing Medical Imaging](https://cdn.jwplayer.com/manifests/UIDfUltg.m3u8) (2:33)

![How AI Is Changing Medical Imaging](https://cdn.jwplayer.com/v2/media/UIDfUltg/poster.jpg?width=720)

_Published 2022-11-03. Medical imaging in radiology has come a long way, and the latest artificial intelligence (AI)-driven techniques are going much further. If the first few decades of radiology were about refining the resolution of the pictures taken of the body, then the next decades will be dedicated to interpreting that data to ensure nothing is overlooked._


by 

[Farzon A. Nahvi](https://time.com/author/farzon-a-nahvi/)


## Farzon A. Nahvi


Mar 16, 2023 10:00 AM UTC

![Funny white dog laying on the bed](https://static.time.com/v3/assets/bltea6093859af6183b/bltf44afb870625a51a/698a3b2c09208f3fd441a2d3/GettyImages-1311303672.jpg?branch=production&width=1200&quality=75&auto=webp&crop=3:2)

A cute dog can do more for many of my patients to comfort and care for them.

A cute dog can do more for many of my patients to comfort and care for them. Victor Dyomin

by 

[Farzon A. Nahvi](https://time.com/author/farzon-a-nahvi/)


## Farzon A. Nahvi


Mar 16, 2023 10:00 AM UTC

I became a doctor because I wanted to help people. Like “supporting the community” and “doing what’s right,” the idea of “helping people” can be so vague that it borders on meaningless. And so, having entered medicine with good intentions but without specifics about whom I wanted to help or how I would go about doing it, I would soon learn just how hard it was to truly help anyone at all.

The truth is that the idea of a sick person coming to see a doctor, being diagnosed and treated, and later leaving cured and satisfied is somewhat quaint. These days, patients often arrive with chronic problems that we might be able to patch up, but we cannot cure. We can make sure our patients suffering from dementia take their medications on time, for example, but there is little we can do to treat their underlying brain disease. We can lower our diabetic patients’ blood sugars when they get too high, but we have nothing to actually cure their diabetes itself. And when our patients with end-stage cancer arrive seeking relief from their cancer pain, we know that even our best treatments will do nothing to stop the progression of their real problem.

And so, early on in my career—frustrated by our collective inability to help our patients to the degree that I wished we could—I began playing a game I call “Medical Degree versus Puppy Dog.”

After each patient I saw, I would ask myself: Would this patient’s problem be better handled by myself, with a decade of rigorous medical training and board certification in emergency medicine, or by a yellow Labrador with a wagging tail?

I kept a written tally. “Medical Degree” would mostly win—but that was little reassurance. That it was a close competition at all was somewhat disturbing. Furthermore, that I would occasionally wrap up a shift and realize that “Medical Degree” had lost to “Cute Puppy” was a more profound statement of modern American medicine than anything I have ever read in any newspaper’s op-ed page.

---

### More from TIME


---

The game is effectively this: Many of our patients are already well aware of the limits of modern medicine. The majority of those suffering from chronic illness have lived with their problem for years and know their situation better than their doctors do. They appreciate our treatments, of course, but ultimately what they are really looking for is to simply feel better. These people want comfort and reassurance. They want to feel cared for.

Dogs are excellent at this. They lie on our laps and express their affection. They are deeply concerned with what we are feeling. They allow us to tell our stories and are never in a rush to leave our side. So while they provide no breakthroughs and certainly administer no pharmaceuticals, they nevertheless provide a terrific comfort.

What dogs offer so readily, of course, is precisely what modern American physicians do not. Every year, our system equips us with more medicines to prescribe our patients yet less opportunity to sit down beside them and explain how they should be used. Each new administrative initiative brings us more tasks to complete and less time with which to complete them. Staffing cuts and bureaucratic demands resulting from corporate control of medicine force us to sprint through our days to accomplish the bare minimum of keeping our patients healthy, often leaving us unable to perform the critical task of simply slowing down to listen to them. As a result, we can find ourselves in the curious position of having saved our patients’ lives, only to realize that they remain generally frustrated with their experience. More curiously, we understand that they are not necessarily wrong to feel this way.


And so, having found myself on the losing side of an end-of-shift tally to a puppy, I have come to appreciate that if I was ever going to make good on my original intention to “help people,” it would not be by simply applying the skills I learned in medical school. Providing the correct medical treatments— even diligently saving lives—is not enough.

We need to do much more. We need to wrestle back control of our healthcare system from the corporate control that has led to so many of our runaway problems. We need to institute safe staffing mandates so that our hospitals have more doctors and nurses, allowing us to slow down and sit at our patients’ bedsides once again. We need an end to for-profit medicine that treats patients like bureaucratic boxes waiting to be checked off, and we need universal healthcare that simply puts patients first once more. If we are going to truly find a way to “help people,” we’re going to make our healthcare system a bit less like the sterile bureaucratic machine that it has become, and a bit more like my dog.


## Transcript

Artificial intelligence is being used to expand the power of radiology and Medical Imaging Healthcare was it was going to be a Panacea. Maybe it was going to replace humans in this process or that generally, I, I was going to be able to look at massive records and make. Massive decision was saying that that isn't going to happen someday, but the product is priced a really around that triage finding things. Early finding things in large quantity. So it might take a few days to be able to find a diagnosis, or, as computers can run without sleep, continuously and find those those patients that need triage care right away.

The US Food and Drug Administration has approved around 420 algorithms involving aai and imaging for various diseases. Most of them in cancer at Mass General. Brigham doctors have about fifty such algorithms to help them with patient care about half have been approved by the FDA and the remaining ones are still being tested there, a certain conditions that if you don't treat quickly, add the patient worsens or could actually pass away. And so examples of that would be like pulmonary embolism in the ER setting. A patient comes in with shortness of breath. That could be one of the things they have, but it might not be the thing that they have, that have congestive heart failure, which is treated differently.

So now, there are algorithms, that can detect pulmonary embolism on a CAT scan of the chest and tell when a cat's detected, it doesn't make the diagnosis. That it's important to know that it's not saying, this is definitely what it is saying that. The probability of this patient, having it is much higher than this patient. And so you should look at this patient first. When you have a series of patients that you need to care for, it does help to get that bump up in the list to be able to say I should look your first cousin. Higher likelihood that this patient as that in diesel treatment. All of these at different levels of AI, all today, require human intervention to come in and say I agree or disagree.

So, depending upon today, the sophistication of a, i, it just makes it easier for that human to focus on the one area and to focus on the right patient to say, how do we get care faster.

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