This is part 1 of 2 where we explore the work of Dr. Lawrence Weed. If you haven’t already, before you listen to this episode, have a look at his 1971 Grand Rounds lecture to an audience at Emory University. Well worth watching- here’s the YouTube link.
In response to the comment by Lincoln Weed, I have not read Medicine in Denial and will put it on my reading list. LLW’s comments on the podcast, as well as some other things (at least one published interview) I’ve read, when taken to their logical extent could be construed as a proposal that external processes supplant the thinking clinician. However, I was unaware of the first stage-second stage model. It does make a little more sense and I look forward to learning more.
Dhaliwal and Weed differ fundamentally in one respect at least: Dhaliwal is inspired that a clinician can go “from good to great.” Weed seems to think you’re in denial to aspire to even being good as a clinician in the traditional sense. Can AI help? Probably. I do think the differential diagnosis generators are useful (eg Isabel). Can AI replace? Who can imagine what might be available in 100 years but consider the longest running experiment in computer diagnostics, in arguably the a uniquely algorithmic, formulaic area of medicine: computerized interpretation of ECGs. In 40 to 50 years with multiple… Read more »
Dr Weed in essence said the clinician is obsolete and clinical reasoning is obsolete. His premise undermined everything Gurpreet Dhaliwal teaches.
He was a genius but geniuses sometimes go off the rails.
Thanks Robert. I’m not sure Dr. Weed so much saw the clinician as becoming obsolete as his/her role evolving into an advisory/interpretive one. I think he recognized, as does Dr. Dhaliwal, that the clinician’s mind is imperfect and that AI will likely replace or significantly augment our diagnostic efforts in the future.
Having recently come across Dr. Donnell’s comment, I would like to respond from my perspective as son of Dr. Weed (to whom I’ll refer as LLW) and co-author with him of the book Medicine in Denial and other publications. LLW’s views might not seem “off the rails” if you recognize a distinction he makes between two stages of decision making. The first stage is assembling and organizing the information (data and knowledge) that needs to be taken into account for the patient’s problem situation. Once assembled, this information needs to be organized into options with evidence for and against each… Read more »