

Nurses Launch Campaign to Alert Public to Dangers of Medical Technology - nrjones8
http://www.nationalnursesunited.org/press/entry/nurses-launch-new-campaign-to-alert-public-to-dangers-of-medical-technology/

======
athenot
I don't think RNs need to feel threatened. If anything, medical technology
will enhance their status and make doctors more dispensable. Nurses are the
ultimate interface between the medical system and the patient.

Right now, there is a trend to allow NP (Nurse Practitioners) a greater
autonomy in what they can do. While they still work under the authority of a
physician, that's becoming more and more of a rubber-stamp.

More and more doctor activities can be replaced with an algorithm. Diagnoses
are made before even seeing the patient and only rely on data from nurses and
EMRs. That's the territory of software right there. (Of course this is not to
say docs are obsolete, but their work can shift to research. And (at least for
now) surgery remains more cost-effective if done by docs than by robots.)

~~~
Brakenshire
I think you're being far, far too gung-ho about the demise of doctors. Their
presence might be at risk over 50-100 years, but for the foreseeable future
technology will act primarily as an aid, not as an independent decision maker,
and time saved for medical staff will just be reallocated to other clinical
tasks.

------
hershel
Medical professionals have used FUD(fear,uncertainty,doubt) and requiring very
high burden of proof(trying the technology for a very long term, even though
preliminary results show favor ability) for ages as a tactic to scare the
public and politicians from accepting innovation and change.

I wonder, what are good tactics to fight such efforts ?

~~~
tapp
I'd start by highlighting the truth at every opportunity, which is this:

Medical mistakes kill an estimated 200,000 to 400,000 Americans every year[1],
making it the third leading cause of death after heart disease and cancer[2].

"Frank from IT" isn't killing those patients - doctors and nurses are, largely
through really stupid stuff like failing to wash their hands adequately,
leading to hospital acquired infections.

[1] Journal of Patient Safety
[https://www.documentcloud.org/documents/781687-john-
james-a-...](https://www.documentcloud.org/documents/781687-john-james-a-new-
evidence-based-estimate-of.html#document/p1/a117333)

[2] CDC [http://www.cdc.gov/nchs/fastats/leading-causes-of-
death.htm](http://www.cdc.gov/nchs/fastats/leading-causes-of-death.htm)

~~~
CHY872
That's where you're wrong. The user interfaces to so many medical devices are
tacked on, almost as an afterthought. The devices are made by hardware people,
and the software people never get a look-in (as usual). They're messy to use
and make it easy to do Bad Things, and the testing (though generally better
than a web-app) is still frequently lacking. The canonical example is the
Therac-25, which killed a number of people after a software bug blasted them
with massive amounts of radiation. These problems still happen now - the
modern radiotherapy machines are still capable of delivering horrendous doses,
but the biggest killers now are infusion pumps - which have many different,
confusing interfaces which make it easy to make big mistakes really quickly
(55,000 adverse events, 710 deaths over the course of just five years).

The regulators are incompetent or captured, and the nurses get blamed for the
fatalities.

[http://cs.swan.ac.uk/~csharold/cv/files/IHCIkeynote2013.pdf](http://cs.swan.ac.uk/~csharold/cv/files/IHCIkeynote2013.pdf)

Yes, medical mistakes are problematic, but to say it's generally the staffs
fault is a gross oversimplification. If it's because staff aren't washing
hands, it's because the operational procedures of the industry are bad.

Just to be clear, those 200,000-400,000s aren't all things like washing hands.
They occur when there are misdiagnoses or when an inappropriate form of care
is chosen, as well. Which is probably the vast majority. Doctors and nurses
aren't going to get better - medical training is already some of the most
rigorous around, and the bad ones usually don't make it.

What does make a difference is making things easier for them - simpler
devices, better analysis, better operations procedures. Trying to place some
kind of blame on doctors and nurses for killing their patients (in the
abstract statistically-large-number-of-people-died case) is stupid - if it
happens everywhere, it's the system's fault and not the individual's.

------
Houshalter
There is no criticism of algorithms in this article at all except saying "they
are unproven".

I want to be treated by FRANK. A computer might very well be inferior at
first, but there's no reason it would suck as bad as portrayed in that
substanceless ad. And it could easily be better on some things where
statistics matter (and doctors are horrible at them.)

Sad to see them lose their jobs, but I would care more if I could afford them
in the first place.

~~~
pmoriarty
The article addresses you concern about the affordability of health care:

 _" Cutting costs is now seen as the prime directive in health care. Unwilling
to reduce their profits or limit excessive pricing practices, the means to
limiting expenses in the healthcare industry is by restricting or rationing
care."_

------
VMG
Very light on substance on how algorithms really destroy medical care, but
heavy on how it destroys jobs in the field. Not that this doesn't suck for
those affected, but let's be clear about the intentions here.

Edit: original title was "Algorithms Destroying Medical Care"

~~~
Terr_
Also, the hospital "market" has seen massive consolidation / mergers, so the
smarmy finance character might be his own separate problem.

------
mercer
While it doesn't invalidate the concerns in this article, I was reminded of an
article by the New Yorker I read a while ago on the importance of using
checklists (and, by extension, technology) in health care. It's been submitted
before:

[https://news.ycombinator.com/item?id=3360098](https://news.ycombinator.com/item?id=3360098)

------
christianbryant
Perspective: [http://www.tuxradar.com/content/karen-sandler-full-
interview](http://www.tuxradar.com/content/karen-sandler-full-interview)

------
dang
As the HN guidelines ask, please do not editorialize titles. (The submitted
title was "Algorithms Destroying Medical Care".)

~~~
huhtenberg
This guideline has been ruining HN discussions for a very long time. There
should be a way for a submitter to explain why the submission is relevant and
what is offered as a discussion topic. The only place to do that is in the
title. And the solution has been suggested a million times - keep both the
original and moderated titles and let people choose which one to see - any
plans to implement something along these lines, preferably soon?

PS. Just look at this very submission. "Algorithms ..." version would've made
me read through the linked page, because it clearly identifies the relevant
part of it. But seeing the "Nurses ..." title and skimming through the opener
makes me think that this is some sort of US-specific content that just happens
to be of a great local importance.

~~~
dang
You say "ruining"; I say it's one of the best design decisions PG ever made
and that it plays a critical role in establishing the character of this site,
which is to focus relentlessly on content, keep distortions and spin to a
minimum, and ask readers to engage with articles for themselves.

> The only place to do that is in the title.

That's obviously untrue. You can post a comment to the thread.

> the solution has been suggested a million times

There are countless suggestions, but rarely for the same thing, let alone "the
solution".

> any plans to implement something along these lines, preferably soon?

I doubt it, because the guideline is exactly in line with the values of this
site, as I described above. Any proposed change needs to take that into
account. Very few do. For example, you seem not to consider it.

I spend a lot of time thinking about the quality of the front page and, in my
opinion, few things would make it worse than opening titles to editorial spin.
It would certainly change HN dramatically, and almost certainly disastrously.

> Just look at this very submission

Indeed. The rewritten title was a severe distortion. The story is a campaign
by a trade association to protect its interests. "Algorithms destroying
medical care" hits the trifecta of a bad title rewrite: it's editorial spin,
it's linkbait, and it's misleading [1]. It's a sensational claim that requires
evidence to establish, which the existence of a political campaign falls far
short of. (I'm personally sympathetic with the campaign, if that matters.)

As long as we're talking about this, it should really be pointed out that I
posted a comment saying that we'd reverted the title and what the submitted
title was. It's reasonable for people to want to see a trail of what was
changed; for now, we've been posting those at the bottom of the threads.

1\.
[https://news.ycombinator.com/item?id=7797166](https://news.ycombinator.com/item?id=7797166).

~~~
huhtenberg
Jeez, Daniel. You obviously has a strong opinion on this subject and you are
simply not listening. What I mentioned is a simple solution to a major (if not
_the_ ) moderation issue that HN has that will work for _everyone_. What you
are defending is an approach that works for some cases, but fail in many.

    
    
      <edit>
    

For one, by editing a submission title you are effectively putting words in
submitter's mouth. That in itself is already an ethically questionable
practice. I had a title on my Tell HN post changed and I was absolutely
totally pissed by that. If you change a title, then do everyone a favor and
put your own name next to it.

For two, I happen to actually care for what particular angle the submitter had
in mind when posting a link. This is not a Reuters, this is a discussion place
and every discussion has a starting point. You change "Algorithms" to
"Nurses", you change the point. You do it halfway through the discussion -
congratulations, you just f#cked up the whole discussion. This is what I meant
by "ruining". Who the hell cares about eventual consistency of HN archives if
one can't readily understand the context of what's actually people are talking
about _now_.

    
    
      </edit>
    

Try this - say, HN adds an option of keeping the original title. Let's further
assume this is not a default. Can you please explain how did you arrive at "It
would change HN dramatically, and almost certainly disastrously"?

~~~
MaulingMonkey
> For one, by editing a submission title you are effectively putting words in
> submitter's mouth.

If that's the case, isn't editorializing the title putting words in the mouth
of the article writer?

~~~
huhtenberg
No, of course not.

