Why AI worries 1 orthopedic surgeon

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Although artificial intelligence has the potential to advance healthcare in certain ways, it could dampen efforts to provide individualistic care, according to Gary Brazina, MD. 

Dr. Brazina is an orthopedic surgeon at Pacific Coast Sports Medicine in Los Angeles. He recently spoke with Becker's about challenges in the healthcare industry and the trends he is following today.

Editor's note: These responses were lightly edited for clarity and length.

Question: What are you most proud of from the last year?

Dr. Gary Brazina: Surviving and that I'm still practicing and still enjoying it. It's much harder to practice. We're seeing that it's extremely difficult to practice as a private practitioner. I think that reimbursements have dropped significantly. More and more documentation is needed and it's more difficult to get authorization to treat patients ... I think that the insurance companies are running roughshod over the medical industry and they are controlling the cash flow. You have to follow the menu that they have to answer the correct question in the right way to get authorization and they have no clinical judgment [or] expertise to make some of the more subtle calls. 

Q: What are some of the biggest trends you're following in healthcare right now?

GB: The biggest trend is the shift of physicians becoming employees of larger corporations. Right now, my understanding is that 75% to 80% of all physicians coming out of training end up being employees of large groups, multispecialty groups or employed by hospitals. 

I think the next biggest trend is large corporations like CVS and Amazon taking over primary care. I think it's a bad thing. It's harder and harder for anybody with any kind of sophistication to access appropriate medical care. 

Q: What are you most worried about for 2024?

GB: [Artificial intelligence]. I think it has some good things and it has some bad things. Medicine is an art as well as a science, and you can't rely on cookbook medicine because what's right for a lawyer who sits behind a desk is different than a rancher who needs to get on and off his horse. Their demands, wants, needs and desires are different. I don't think AI is sophisticated enough to give that personalized care [and] understand the individual. Medicine is about understanding an individual's wants, needs and desires. What's right for you may not be right for me with the same age, body habits and everything else. I want to be able to ski at 80, and I have other people who just want to be able to get off of the couch at 80. Which one is correct? [AI] can follow a menu, but it still doesn't understand individual needs. 

I think it can eliminate some unnecessary testing. It gives one pathway. I don't think it's entirely bad, don't get me wrong. I think it can help guide decision-making and may open up to more subtle diagnoses that may not be evident right away. 

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