The Robot Doctor Will See You Very Soon

by Dr Vernon Coleman MB ChB DSc FRSA

Like them or not there is no doubt that the robots are coming. And there is one area of the world where they are going to be very successful: health care.

Back in 1980, I wrote a book called Aspirin or Ambulance. It consisted exclusively of flow charts designed to enable readers to decide whether their symptoms required them to take an aspirin or call an ambulance. (It was a little more complicated than that. But the title was catchy and you get the idea.) A short while after publication, a chap who had seen a copy of the book wrote and asked me if he could turn it into a computer program. Since everything in the book was based on simple ‘yes’ and ‘no’ answers (‘Do you have a headache?’ ‘Is the headache at the front of your head?’ ‘Have you vomited?’ and so on) the text was eminently suitable for conversion to a computer program. The resultant software, available on a cassette tape, did quite well (it was promoted as the Home Doctor, written about in The Times (where it was described as the first computerised medical program in the world), described in every computer magazine imaginable and sold in 26 countries. But the problem was that the market was extremely limited since the only home computer capable of running the program was something called a Sinclair.

It was an idea well before its time.

However, there is no doubt that computerised medicine is now about to hit the big time.

There are several reasons why medicine is well suited to computers and why the idea I had in 1980 is now ready to reach fruition.

First, the technology is ready, available and capable.

Second, the market is massive. The incidence of serious disease is rising rapidly. Disorders such as diabetes are increasing rapidly. (Type 1 diabetes is inherited and Type 2 diabetes is increasing because too many people eat too much.) Heart disease is rocketing because millions take very little exercise and eat far too much fatty, processed food. The demand for medical care is rising rapidly.

Third, it has become clear that doctors make lots of mistakes. One in six people in hospital is there because he or she has been made ill by doctors. Iatrogenesis (doctor induced disease) is now one of the top three killers (up there with cancer and circulatory disorders such as heart disease and stroke). A computer program is far less likely to make mistakes.

Fourth, in Britain (and many other ‘developed’ countries) the availability of medical care is worse than it was half a century ago. In Britain, there is no effective medical cover outside working hours. GPs have been allowed to opt out of the traditional 24 hour a day medical cover which they used to provide. It is often impossible to persuade a GP to visit a patient at home, and patients frequently report that even when they are ill, they frequently have to wait two or three weeks for an appointment with a doctor. (‘You’re either better or dead by then,’ quipped one.) EU working regulations mean that hospitals are struggling to provide medical care at night time and at weekends. The General Medical Council’s regulations have forced doctors who choose to retire to retire completely. Retired doctors are no longer allowed to help out in emergencies.

Fifth, young doctors do not have the sense of service, responsibility and duty which characterised their predecessors. Today, young doctors in the Entitlement Generation will happily go on strike for more money and improved working conditions. The unreliability of already wafer thin medical services makes computerised medicine an inevitability.

Sixth, it is relatively easy to prepare a medical robot which can check your pulse, take your blood pressure, examine your eyes and check out rashes and other skin abnormalities. I designed such a system over 30 years ago, so it is definitely possible and practical now.

The bottom line is that medical robots (in whatever form they might appear – probably an internet program or an App suitable for smart phones) will be cheaper, more reliable and less likely to make mistakes than human doctors.

Computerised doctors are far less likely to misdiagnose, far less likely to miss serious conditions and far less likely to prescribe inappropriate or dangerous remedies. And courier services mean that it is perfectly possible for patients to be given their prescriptions within hours.

But it is important that when medical robots become widely available, they are independent and not controlled by drug companies or others with products to promote.

If medical robots are truly independent then I think we can all welcome computerised medicine with open arms.

But if they aren’t independent they will kill even more people than human doctors.

This is one area of the internet where regulation is urgently needed.

Copyright Vernon Coleman 2016