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We do have qualified people to do the work of doctors, and they're called nurses. But arbitrary lines are drawn between what they can do and what doctors can do, just to maintain the existing salary structure.

If nurses are to do more of the work of physicians, nursing education needs to drastically change. Nurses are mostly taught the how of nursing and not the why of medicine. If you look at the curricula of DNP programs, which are often touted as a way to get nurses practicing with lots of autonomy in places where they are short on physicians, they're heavy on nonsense nursing theory and light on things that actually matter like pathophysiology and pharmacology.

We actually do have a better model in the form of physician assistants. They're taught the same kinds of things physicians are taught, just in less depth.


That is the kind of thing makes me wonder how much of "things that actually matter like pathophysiology and pharmacology" can be factored out into the automation land now.

AI isn't perfect, but even loosely scaffolded generalist systems show promise in the field of medicine now. And the alternative isn't some hypothetical "perfect healthcare" - the status quo is often closer to "nurses running near the limits of their competence" or "physicians stretched thin almost to the breaking point".

The fundamental problem of healthcare is that it struggles to scale. The need for well educated, well paid professionals is inescapable. Or, was inescapable? We might be at the point where this can start changing.


> That is the kind of thing makes me wonder how much of "things that actually matter like pathophysiology and pharmacology" can be factored out into the automation land now.

I would say not much. AI is still often wrong and a clinician needs to know when the LLM is saying something crazy. I think AI has the most promise for increasing the productivity of well trained professionals, not replacing them (or their training) entirely.


Human clinicians are also "often wrong", for a given definition of "often". "Get a second opinion" didn't originate with AI.

Are AIs wrong more often or less often?

Would the healthcare get better or worse if the "first opinion" was AI more often than not?

"Increasing the productivity" and "replacing them" is two sides of the same coin. If a human can do five times the work, because AI does most of the work and the human performs "exception handling"? You need less humans. And healthcare, historically, is almost always human-constrained. That's why you get insane wait times and overworked clinicians. Most other inputs scale more readily than human expertise.

Thus the impetus to figure out where "human expertise" can be substituted for that of a scalable machine system - and what would be the best ways to implement that.


I was replying to "how much of 'things that actually matter like pathophysiology and pharmacology' can be factored out into the automation land"

I'd argue they aren't being factored into automation land if they're still the responsibility of a human expert, even if there are fewer more productive human experts.

(Though I do think AI will have a role in pathophysiology and pharmacology, initially catching errors, and probably some day taking responsibility, but not soon.)


The medical training involved for nurses and physicians is absolutely not equivalent

There are APPS as well that have more training than nurses.

Yep. I haven’t seen an actual MD in quite some time. Instead my general care provider is a Nurse Practitioner and he’s been handling all my routine healthcare needs.

lol

lmao even


This has the potential to be huge for computer use.

OpenAI has been teasing how fast computer use is with their models running on Cerebras chips but the difference here is a burning hole in your pocket.


I can think of many uses for this thing, robotics being one that could really benefit from something like this. A hybrid approach with this and action models and vllms could be really good mix, also agents inside simulated virtual environments, etc... basically anywhere where latency is important but you need some intelligence this will fill those gaps. Weave it with other systems and you have a nervous system as jev with other models like vllm or even text as the slower deeper thinker.

Like which elements to select? Similar to the doom and wikipedia runs?

Yeah. Computer use is essentially a model navigating the OS-provided accessibility tree. I imagine a model trained on it would operate the computer exactly as we saw it control Doom.

https://developer.apple.com/library/archive/documentation/Ac...


Coincidentally, the midnight theme was created specifically for the reason you asked this question: for using HN while lying down next to a toddler/partner. It has a reduced white point because most dark modes are too bright to use in bed near others. Def not a great daytime dark theme though – that's what the others are for :)

Thanks once again. You’ve totally improved my night time HN routine. My little one is asleep next to me as I type this :-)

appreciate it!

you can essentially mute words on hcker.news. You can set exclusion filters in the settings. Those can be turned into rss feeds as well.

Yeah, all possible, the infra for all of that is set up. I think I understand your request but can u send me an email so I can talk it through with you a little more?

Hm, I couldnt reproduce on firefox mac. Which version of firefox are you on? can you open the network inspector to see if you're hitting the api?

Firefox 155.0.1 Linux/x86_64 with uBlock Origin enabled. https://static.cloudflareinsights.com/beacon.min.js is blocked by uBlock, while https://hcker.news/api/reply-notifications/config and https://hcker.news/api/comments/49662990?include_user_stats=... return 403.

Perhaps it's Cloudflare that's doing the blocking.


Fixed it, it should work now.


I've been serving this to users for the past year. I like to believe that i've inspired others.

You can do a lot of this stuff w/ the feed builder on hcker.news.

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