Over the last few years, the question of whether “Will AI Replace Surgeons?” has often been asked at a conference or in the media and indeed sometimes stated in its other format “The Robot Will See You Now”. It has always seemed like science fiction and a problem for future generations of surgeons to solve or deal with, at least until now. The explosion of AI in the last few months with the launch of Chat Generative Pre-training Transformer more commonly known as Chat GPT and other powerful software has changed the timelines and debates significantly.
Chat GPT was launched in November 2022. It attracted 5 million users within 5 days and reaching 100 million monthly active users within just two months after launch, making it the fastest-growing consumer application in history. It currently has over 1 billion users, having crossed this threshold in March 2023. In comparison it took Facebook almost 9 years and Tik Tok 9 months to get to this milestone.
But what makes it so compelling and concerning?
Chat GPT is a natural language processing (NLP) tool driven by AI that allows human-like conversations that are very sophisticated. It is an example of a large language model (LLM).
The language model can answer questions and assist with tasks, for example, composing emails, writing essays or writing code.
Auto GPT is now the new kid on the block that is capable of performing tasks with little human intervention. While it is built on Chat GPT’s framework, Auto-GPT has the ability to make decisions autonomously, a feature that is not present in Chat GPT which requires human prompts. Auto GPT can self-prompt and produce every necessary prompt required to complete a task. For example, it can create a fully functioning website from a single prompt by interacting with other services and software online.
The video accompanying this editorial was created entirely by AI. The image was created by Midjourney which turns a text prompt into a high-quality unique image. The speech and voice required Chat GPT and D-ID software and the entire process took 10 mins.
There has been a lot of interest in the potential role of Chat GPT in healthcare.
In the recent paper in JAMA (May 2023) physician and Chat GPT responses were compared to patient questions posted to a public social media forum. In the study, clinicians preferred the chatbot's response to the physicians in 78.6% of the 585 scenarios. The chatbot's responses were not only more concise but were rated 3.6-times higher in quality and surprisingly 9.8-times higher in empathy than those of the physicians.
Chat GPT has also passed a medical licensing exam and diagnosed a rare condition that may have taken much longer with conventional methods.
How will it support the work of a surgeon?
1 As a symptom checker it can help with and speed up surgical diagnosis
2 Medical record keeping is another area where Chat GPT will improve the life of a surgeon by summarizing patient medical histories, effectively streamlining the record-keeping process. Theoretically, surgeons could dictate to Chat GPT, which could automatically summarize the key details.
3 It can benefit surgical patients as it has real-time translation. The advanced language processing capabilities could be utilised to translate technical terms and medical jargon, ensuring patients fully understand their diagnosis, treatment options, and instructions quickly and accurately.
4 It has the potential to enhance surgical education by providing medical students, surgical trainees and specialists instant access to surgical information and resources.
5 It can help design clinical trials and then provide statistical analysis of the results as well as helping with the quality of the written manuscript.
However, there are just as many concerns rightly raised by the power of AI with the rise of Chat GPT and other powerful players. A google engineer was sacked last year after raising the possibility that the LaMBDA AI Language model had become sentient i.e., self-aware and have feelings. Earlier this year more than 1,800 signatories, including Elon Musk, and Apple co-founder Steve Wozniak, called for a six-month pause on the development of systems “more powerful” than that of Chat GPT.
The singularity refers to the point in time when the development of robotics and intelligent machines will become as effective or better than humans. When will we approach the surgical singularity?
Undoubtedly there needs to be immediate attention on setting the regulatory and ethical framework and creating safe standards as well as effective monitoring.
Back to the question of whether AI will replace surgeons at the beginning of this editorial? The answer is NO, not yet. But surgeons who do not use AI will surely be replaced.
