Pearl is a medical and business school professor.
Imagine a ship at sea, its engine idle. The boat drifts dangerously close to the shoals, a mere hundred yards from land. The captain, fearing the worst, radios for help. The lighthouse watchman responds, sending an experienced mechanic named Charlie to the rescue. With a single precise hit of his hammer, Charlie gets the engine roaring back to life.
Thrilled, the captain asks Charlie to send his invoice. A week later, shocked by the $10,000 charge, the captain demands an itemized bill. Charlie complies, sending a new invoice that reads: “Hitting the engine with a hammer: $1; Knowing where to hit: $9,999.”
The philosopher and statesman Sir Francis Bacon is credited with saying, “Knowledge is power.” Indeed, for most of history, knowledge has proven itself to be an isolated resource, held closely by the few who, like Charlie, spent a lifetime acquiring it.
In our modern world, however, this kind of knowledge is becoming a collective treasure — a power that’s accessible to all.
This sentiment resides at the heart of this excerpt. Here, we’ll delve into the evolution of human knowledge, pinpointing three pivotal moments that have expanded our access to information. And now, we stand at the cusp of a fourth, unparalleled leap, promising to redefine the landscape of American medicine and society at large by democratizing not just knowledge, but also expertise.
Our journey to the future begins 600 years ago with the advent of the printing press. In the heart of 15th-century Mainz, Germany, Johannes Gutenberg leveraged his skills as a metalworker and goldsmith to invent the printing press. This machine, inspired by the wine presses of his time, revolutionized the accessibility of knowledge. The book-making process, which once took months or even years of hand transcription, could now be completed in days. Books became mass-manufactured, turning knowledge from an elite privilege, affordable only to the wealthy, into a public commodity.
Fast forward to the mid-20th century. The internet emerged as a pivotal technological leap. Originating as a government defense project, the World Wide Web evolved dramatically, transitioning from an era of room-sized computers to the advent of personal computing in the late-20th century. By the 1990s, the internet had become a dynamic force, bringing unprecedented access to information to millions, and eventually billions, around the globe. It broke down geographical barriers to education and information, reshaping societies, economies, and individual lives. It made knowledge readily accessible to all.
The third big leap in knowledge began in 2007 with the introduction of the iPhone. This device wasn’t just a phone, it was a portal to the world’s knowledge. It embodied the fusion of communication, entertainment, and information access in a single device that put the world’s largest libraries and the power of the internet into the pockets of millions, further facilitating access to information.
Each of these technological jumps made it easier for doctors to access medical information. Today, clinicians can simply reach into their pockets and quickly research unusual symptoms, complex medical problems, and the most up-to-date treatments wherever and whenever they want. In the operating room and on rounds, this kind of immediate access proves invaluable.
But for patients, these advances haven’t proven as helpful. Navigating medical information online without the necessary expertise leads to confusion more often than clarity.
While patients can consult “Dr. Google” about their symptoms, it rarely helps. Frequently, they find themselves overwhelmed, misinformed, or even misled by unverified sources. Clicking on links works for clinicians who have the expertise required to interpret and apply the scientific information presented. But few patients have the ability to use the information they find in books or online to resolve their own medical concerns.
This distinction — between accessing medical information and applying actionable medical expertise — is profound. Despite the plethora of medical information available today, the doctor’s office remains the place Americans must go for clinical expertise. Patients, therefore, remain as reliant on their doctors now as they were in the past.
Looking back upon the explosion of knowledge across these three technological innovations, all share a common truth. Each leap made clinical and scientific knowledge more accessible, improving the efficiency and breadth of care doctors could provide. But none of them empowered patients with the expertise they needed to reliably diagnose their own medical problems, understand the treatments available, and choose the best one for themselves.
That is about to change. Soon, people without medical training will turn to ChatGPT for access to medical information and for its ability to translate that information into actionable expertise.
For those who doubt ChatGPT’s ability to infiltrate the once-exclusive world of medicine, consider all the ways generative AI is granting access to complex skills and enabling mastery in an array of disciplines.
Creating high-concept art traditionally required years of training and innate talent. But with the advent of generative AI, even those without a background in drawing or painting can produce visual masterpieces. Beyond artistic endeavors, generative AI allows individuals with no IT background to write sophisticated computer code, much faster than programmers with years of experience.
With training on how to enter comprehensive medical information, patients will soon have the ability to make an accurate diagnosis, monitor their chronic diseases, and obtain reliable answers to medical questions — skills that today remain the sole purview of clinicians.
AI platforms have undergone an incredible evolution, setting the stage for a future where medical expertise is accessible to anyone with a computer or smartphone. We should all be prepared for both the benefits and consequences to follow.
Robert Pearl, MD, is a Stanford University professor in both the medical and business schools and former CEO of Kaiser Permanente. This excerpt was adapted from his new book, ChatGPT, MD: How AI-Empowered Patients & Doctors Can Take Back Control of American Medicine, which he co-authored with ChatGPT. All profits from sales of ChatGPT, MD will benefit Doctors Without Borders.
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