“You can resist an invading army; you cannot resist an idea whose time has come.” Victor Hugo

TODAY I am going to talk about two animals. One of them was thought to exist only in dreams. The other is consciously ignored as non-existent.

The first one is called the “Black Swan”. A radical thinker and popular writer, Nassim Nicholas Taleb, coined this phrase to denote things that we can never predict when they will emerge, but will have a massive impact on the way we live – take for example, the computed tomography scanner, the smartphone or the mobile speed camera.

The term was based on the discovery of black swans, which were previously considered to be non-existent until Australia was discovered. But, we live in the land of black swans. We have embraced the unpredictable – geological separation, evolution in isolation, technological changes and disruptive inventions, such as Wi-Fi, as examples. We invent ways around them.

Look at the ingenuity of our marsupials – they invented a built-in baby-carrier long before humans could file patents for inventions. Innovation is deeply entrenched into our souls.

But, wait a second. What about the other animal, “Elephantos locus”, the elephant in the room? As much as we embrace the black swans, we ignore this animal.

“Elephantos locus” is large. Its presence is felt. But no one talks about it. Perhaps it is disturbing to talk about it. Or perhaps we underestimate it. The truth is our eyes do not see what the mind doesn’t want to see.

Now imagine a cross between the black swan and “Elephantos locus”. That’s what health care robotics is.

Gary Kasparov, the famous chess champion, who lost to an artificially intelligent computer named Deep Blue in 1997, gave a popular  talk in April 2017. The title was “Don’t fear intelligent machines…work with them”.  He said: “Machines are going to be taxi drivers and … doctors”.

Unbeknown to him, in Australia, we were already designing a robot doctor named Dr Nao.

Kasparov made a very valid point, which is exactly what we were testing. “It is not about how far technologies such as artificial intelligence and robotics have come along and how far they can go further. It is about how we humans adopt them and adapt them to our needs.”

Health care robotics: the elephant in the room - Featured Image

Dr Nao is a specially trained humanoid robot that we tested at the North West Regional Hospital in Burnie, Tasmania – a first-of-a-kind social experiment that kindled the imagination of health care providers and the general public alike. Dr Nao instructed health care professionals, who acted as patients, and asked them to do a simple clinical task. We wanted to know what humans would think of a robot in the doctor role. Would we accept it? Could it even be empathetic? Can we trust such robots as doctors?

To answer these questions, we will have to wait until our statistician gets back to us with the results, which we will publish in medical journals.

The fact is that Dr Nao is far from being deployed in the day-to-day clinical encounter. Its capabilities are rudimentary. It will be many years before we will see it in daily practice.

But this is an opportunity for us to start the discussion. We need to be asking questions, such as what do we need out of robots in health care? Where can these robots be employed? What design changes do we want in them?

What about jobs? We have asked this same question every time when anything useful came along – the steam engine, the automobile and the computer, for example.

When we talk about taking away jobs, there is a distinction to be made between a “robot” and a “humanoid robot”. A robot is probably more efficient than a human – take for instance, a robotic vacuum cleaner or a robotic car assembly line. They do not need breaks. They do not ask for a salary. These swiftly enter the good books of a human resources manager at a corporation. There are potential time and cost savings to be made with such robots.

But, at this point in time, a humanoid robot with limbs is as inefficient as a human. In fact, our Dr Nao will complain of his “joints aching” if his motors get heated, and will go to sleep as and when it needs to. It will likely ask for more benefits, such as sick leave, than an average human doctor.

Then what is its purpose? The pinnacle of making a humanoid robot to perfection is that it becomes as purposeless as the human making it. Maybe they can provide us with company. They could be a bridge between us and the artificially intelligent world of autonomous cars, drones and the “internet of things”.

We are only limited by our imagination. Let us not ignore the “Elephantos locus”. Welcome to a brave new world.

Dr Balaji Bikshandi is a specialist intensive care physician and the clinical lead of the Intensive Care Unit of the North West Regional Hospital, Burnie, Tasmania.


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One thought on “Health care robotics: the elephant in the room

  1. Philip Dawson says:

    Hmm. Whether humanoid ( a pipe dream for a generation perhaps?) or simply robotic do you want something as intimate as a doctors consultation done by a machine? I certainly don’t. While simple everyday tasks might be more efficient, when you want that human touch you need a person. There is the added dimension of costs, already ballooning in health care. While a robot running a large expensive loader in a remote mining town might be more efficient and cheaper than a human who makes mistakes damaging the expensive machine, and people might like the fun of a robot, they are no substitute for people. When you don’t know what you want and go to a professional ( of any sort, not just a doctor) to ask their opinion you don’t want a robot. If you know what you want you probably don’t need one either, just get on the internet and order it! Robotic surgery requiring a super specialist is already done-but there is a human at either end supervising, the robot is additional too. medicine by rote, by protocol, by algorithm eg Nurse triage, is more expensive and wasteful than an efficient well trained GP.

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