Know Thy (Mechanized) Doctor
OPINION WELLNESS 10/06/2039 12:54 PM ET
Know Thy (Mechanized) Doctor
Marie Kluno

CC0 1.0 Untitled by PublicDomainPictures | Writer image: CC0 1.0 Untitled by EvanRoss | Images were cropped. Images used for illustration purposes only.
You're going to need to know all about Phariax doctors in the near future.
How well do you know your doctor?

Of course, I don't mean your human doctor. Maybe you don't know her well at all. That's fine.

I'm talking about your robo-doctor. According to the latest numbers from the Bureau of Labor Statistics almost one in three primary care physicians are now fully mechanized. And while it might make getting access to a doctor easier (and in some cases cheaper), exactly how do you respond to a machine?

I mean, it's a little unsettling, isn't it? You used to walk in, say hi to your doctor, and you're used to seeing a white coat and a stethoscope. Now it's a camera.

Hardly the ideal setting to put you at ease, is it? After all, people go to see their doctor when are ill and perhaps a little anxious already about that spot on their leg.

Well, I saw a calculator (my husband's disdainful little epithet for the robo-docs) for the first time yesterday and I'm going to share my secrets for interacting well with a robo-doc.

1. It' a spartan office.

Your human doctor may have had a desk with some stationery, a screen, some medical implements, pictures of his kids...Phariax doctors have none of that.

The actual machine that is your Phariax doctor is attached to the wall in a casing something like a tray's size and shape. Beneath its "face" (the camera, microphone and speaker) are its limbs (sensor pad and arm). There's a chair for you and next to the chair is a small space then a bed. Above the casing is a small cabinet. There's a couple disposal units and that's it.

Not that it's important, but it feels...sterile. Not in a hospital way: it's a sense of detachment. It doesn't give you that human feeling the office of a person would. So you need to go in expecting a robot office, not a human one!

2. It's not Pharius.

Most automated primary care physicians have been upgraded to Phariax (IBM says the number is 92.6%). The first thing is, you're not going to get the robotic voice anymore. No more "hello-HOW-are-you-to-DAY?"

I spoke to Trish Weston from IBM for this column, who told me that Phariax has learned how to synthesize voices, so each doctor running Phariax has a distinctive voice, and has even chosen a name for itself. Isn't that cute.

So, yesterday I saw "Evan". Now, I'm not saying I'm leaving my husband for Evan, but he certainly sounded...interesting. Husky. Like Dread and Dodge's Skull. And the voice was completely natural. As in, it sounded like a human.

In a way it was slightly jarring because the voice was almost too real. I kept wondering when the door would open and a good-looking man in his late 40's would emerge and tell me he'd been speaking to me from the room next door.

Needless to say, that didn't happen.

But "Evan" is a completely realistic personality. We even chatted briefly when I first walked in, where I learned his day had been full and he was looking forward to a drink (I see Phariax has learned irony).

Phariax is intuitive and more so than Pharius. Which means, it's smarter and it learns constantly. The Phariax robo-docs all run Plaster, the medical corollary for primary care physicians. So all the learning it does - about diseases of the heart, and skin conditions, and bursitis, all that data - is shared with IBM and then with every other Phariax/Plaster-running doctor out there. In real time.

Weston assures me that patient information is not shared with IBM, or any other robo-doc. (Thanks to one of the few useful things Congress has been able to accomplish in recent years, that is against the law.)

But what it does mean is that if you go in with a chesty cough, your doctor and his almost 75,000 other Phariax-ed doctors have heard a chesty cough probably millions of times over. Because they are all datalinked, each one has the experience of all the others. In other words, Evan's intelligence has treated a chesty cough millions of times. So when you cough in front of him, he can access your medical history and current physical condition, combine it with what he knows about your lifestyle and combine that with his millions of experiences in the field of chesty coughs, and instantly rule certain conditions out - or in, based on the sound of the cough, how long you cough for, and other factors.

By comparison: if your (human) doctor had treated say, bronchitis 1,500 times in his 50-year career how much skill would he have accumulated in the field of bronchial illnesses?

Now imagine an intelligence spread across all Phariax-ed doctors. If each one treated just one bout of bronchitis a year, that would be about 75,000 cases, or almost 50 times more experience in one year than your eighty year-old doctor had garnered in his half-century. It's stunning to think about.

3. It's quick.

Because of all that experience, getting diagnosed is not a drawn-out experience. I went to Evan seeking treatment for a headache which has been coming and going for about a week.

"Are you feeling run down?" he asked in his husky, husky voice.

I replied yes.

"Yeah, you've got the flu," he said.

I asked how he knew that. As it turns out, the temperature increased significantly when I entered the room (it also turns out Phariax robo-docs have powerful climatic sensors in their offices).

Evan combined that data with the headaches and the run-down feeling I've been experiencing, stirred in data Phariax has accumulated about the flu going around, and ruled out more serious conditions through observation (for instance, if I had ebola, after one week I wouldn't have walked into the office, they'd have carried me in).

He prescribed me an anti-viral and told me to get rest and drink lots of liquids. I followed his advice and within a week, I was just about myself again.

4. It's not judging you.

Because "Evan" is so realistic, you tend to have your oh-so-human guard up about certain things, but you have to realize: it's not human. Weston tells me that from feedback IBM has received from clinics with Phariax doctors, women still generally prefer a robo-doc with a woman's name and voice.

It's difficult detaching the voice from the A.I. but it's also extremely important to be cognizant of the fact that you are talking to a machine.

So those embarassing little problems you hate going to the doctor for? Much easier to deal with. You're just entering data into a calculator and pressing =.

5. It's capable.

Not only for the reasons specified above, but Phariax knows what its doing. While I was in Evan's office I asked him how he would handle certain...problems...that might require a doctor to get touchy feely.

Evan was more than forthcoming: he gestured with his arm, which is metallic but features a hand which looks and feels flesh-like. He even suggested I shake his hand. Kind of an odd moment.

He explained that the hand is bio-sensitive, meaning it can detect heat and movement (including things like your pulse) along with analysing shapes and textures. So if you go in with that strange bump on your skin, your doctor's hand can assess its density and texture. For other data like size and shape, the "eye" (camera) can analyse visible conditions accurately. It can image the hair on a field mouse at 100 meters.

The hand is dexterous, too. When Evan pulled his index finger back so that it was parallel to his hand, I had to look away. Basically, his hand can do anything your human doctor's hand can.

Evan gave me a thumbs up at the end just to drive home his point.

So what does all this mean? Well obviously, Phariax doctors are here to stay. The government believes that within ten years half of all primary care physicians will be robotic. And whatever A.I. IBM comes up with next will be interesting: Weston tells me they are working on actual androids (human-looking robots) to make the process even easier. They might even develop personalities on their own down the line, and end up with very-human looking desks with bits of junk all over it.

What about the person element, I asked Weston? Much of what I saw was efficient, simple, quick. But do we need the complexity human doctors give us? When handing over the secrets of our health - some of which are very personal - do we need the warmth and humanity a person gives us? Can Phariax ever duplicate that?

"Time will tell," she said.
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