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A file photo of Vinod Khosla, venture capitalist and founder of Khosla Ventures and Sun Microsystems in Washington, DC. Photo: AFP (AFP)
A file photo of Vinod Khosla, venture capitalist and founder of Khosla Ventures and Sun Microsystems in Washington, DC. Photo: AFP

Will doctors be obsolete?

Advances come thick and fast enough for Silicon Valley guru Vinod Khosla to predict the triumph of the algorithm

In the pantheon of new devices easing into—and easing—our lives, a cardiac device smaller than a pinhead caught my attention. Stanford University researchers announced last week that the prototype has no batteries, powered as it is by radio waves generated from the outside.

This is a significant breakthrough. Not only could in-body devices, such as pacemakers and cochlear implants, be massively lighter and surgeries to install them easier, doctors could eliminate surgery to change batteries.

With advances like this, you could forgive veteran Silicon Valley investor Vinod Khoslafor the little storm he caused last week when, during a talk in San Francisco, he likened present-day medicine to witchcraft and predicted that machines would replace 80% of doctors. Khosla said big data and growing computing power would make medical machines better, faster and cheaper than most human doctors.

Son of an Indian Army officer, alum of the Indian Institute of Technology, Delhi and Stanford, co-founder of Sun Microsystems and a mentor-investor in scores of technology companies, Khosla is known for such provocations, meant to spur a push for scientific frontiers.

This isn’t the first time Khosla has predicted the demise of the doctor and the triumph of the algorithm.

“The beginnings of ‘Doctor Algorithm’, or Dr A for short, most likely (and that does not mean ‘certainly’ or ‘maybe’) will be much criticized," Khosla wrote in January on TechCrunch.com, a website that tracks technology markets. “But Dr A will get better and better and will go from providing bionic assistance to second opinions to assisting doctors to providing first opinions and as referral computers (with complete and accurate synopses and all possible hypotheses of the hardest cases) to the best 20% of the human...doctors. And who knows what will happen beyond that?"

Indeed, the era of Dr A is quietly unfolding, some part of it funded by the irascible Khosla, who shows an affinity for investing in healthcare start-ups that piggyback their technology on personal devices. About three months ago Khosla’s company, Khosla Ventures, led a $10.5 million funding round for AliveCor, a company that, as a first offering, has turned the iPhone 4/4S into a cheap, mobile ECG (electrocardiogram) monitor. Android versions may follow.

Khosla Ventures is also an investor in Cellscope, a company that’s created a personal otoscope: an attachment that turns the iPhone into a microscope to check ear infections.

Khosla also has hopes for his investment in Jawbone, a company that last year released a smart bracelet called UP, which in conjuction with an iPhone tracks physical activity, sleep patterns and meals. He predicts that “within a few years", the band will monitor a variety of medical parameters, including heart, metabolic and respiration rate and detect changes in body chemistry, such as traces of certain cancers in breath.

To be sure, there is much work ahead before these advances come to fruition. For instance, there are patents pending on the Cellscope otoscope and is being tested in hospitals. The UP bracelet needs many technological breakthroughs before it realizes Khosla’s dreams. And scientists must verify if—at the heart of the Stanford device—a tiny coil that produces electricity when it receives radio waves is stable, reliable and safe. As with all medical breakthroughs, the little power mill will face much testing, tinkering and fine-tuning before—or if—it makes it to market.

There’s a particularly big “if" involved with technology related to medicine because it involves that most urgent of human desires: prolonging life.

The same week that Khosla made his speech predicting the eventual ascendance of the algorithm, the number of medical devices recalled for faults in the US—the world’s largest market—exceeded 123 million units during the second quarter of 2012, an 800% increase, year-on-year, in number of units affected, according to ExpertRECALL, a global company that offers product-recall services.

It can also be hard to separate hyperbole and hope from result and effect.

Consider the case of the intra-aortic balloon pump, the most widely used device to treat patients in cardiogenic shock, where a weakened heart cannot pump enough blood to the organs. Since it was introduced 44 years ago, the balloon pump—inserted into the aorta, the body’s largest artery, to increase its blood-ferrying capacity—was thought to have saved several million lives. But a study conducted across 37 medical centres and released last week reported scant evidence that one of the oldest devices in cardiology was saving lives. “This large multicentre trial was unable to show a benefit for the currently most widely used mechanical support device in cardiogenic shock," Holger Thiele, a professor at the University of Leipzig Heart Centre in Germany, said while presenting the results.

The algorithm may well hold unimaginable promise, but it may not be wise to altogether dispense with the doctor.

Samar Halarnkar is a Bangalore-based journalist. This is a fortnightly column that explores the cutting edge of science and technology. Comments are welcome at frontiermail@livemint.com

To read Samar Halarnkar’s previous columns, go to www.livemint.com/frontiermail

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