Critical Thinking and AI
- Dr. Thomas J. Lewis
- 8 hours ago
- 4 min read
This is an essential talk to listen to regarding the loss of critical thinking.
AI firmly asserts that medicine follows critical thinking and evidence. A good friend, however, accurately coined the term "evidence-based medicine."
What is your experience with traditional doctors? Do they exercise deep contemplation before prescribing a statin, BP med, or metformin (and now Ozempic)?
The insurance coding system - ICD (International Classification of Diseases), by its very title, contradicts the idea that doctors perform critical thinking. Instead, they must have a strong memory to recall the plethora of classification codes and pick one that is most advantageous to billing - and maybe the patient. However, in most cases, they have already written the prescription.
How can you think critically if your only option to deliver care and get paid is to pick from a list?
Here is the recent history of "critical thinking" in medicine.
ICD-9, 1970s: The ICD-9 system contains approximately 14,000 diagnosis codes and 3,900 procedure codes.
The International Classification of Diseases, Ninth Revision (ICD-9) was released in the 1970s, with the clinical modification (ICD-9-CM) adopted in the United States in 1979.
ICD-10, 1990s - 2015: As of October 1, 2023, the International Classification of Diseases, 10th Revision (ICD-10) contains approximately 71,920 diagnosis codes (ICD-10-CM) and 71,932 procedure codes (ICD-10-PCS).
The World Health Organization (WHO) initially endorsed the ICD-10 in 1990. However, the first WHO member states began adopting it in 1994. In the United States, ICD-10 was adopted for mortality coding on death certificates in 1999. The US later adopted ICD-10 for morbidity coding with its own standards based on ICD-10 codes, which became effective on October 1, 2015.
How can medical professionals really exercise critical thinking when they have to be fluent in 140,000 codes?
This is the definition of PRESCRIPTIVE, NOT CREATIVE.
Prescriptive: relating to the imposition or enforcement of a rule or method.
AI correctly defines the two concepts, including strengths and weaknesses.
However, keep reading beyond these definitions to see how AI influences the actions of medical professionals. It is completely contrary to the coding system, which imposes rigid rules.
When we talk about "creative" versus "prescriptive," we're generally referring to two distinct approaches to problem-solving, learning, or even strategic management.
Creative approach
Focus: Emphasizes originality, novelty, and thinking outside the box.
Process: Often involves techniques like brainstorming, divergent thinking, and exploring multiple possibilities to find unique solutions.
Strengths: Encourages innovation, adaptability, and the development of higher-order thinking skills like critical thinking and problem-solving, according to Innovative Teaching Ideas. It can be particularly effective in unpredictable environments.
Weaknesses: Can be less structured and may require more time and resources to explore possibilities, notes the National Institutes of Health (NIH). It might also lead to resistance to change from those accustomed to more traditional methods, says brainly.com.
Prescriptive approach
Focus: Emphasizes following established rules, procedures, and guidelines.
Process: Involves adherence to predefined methods and structures, aiming for consistent and controlled outcomes, according to Oxford Reference.
Strengths: Can lead to efficient decision-making, especially for well-defined problems or in fields requiring strict adherence to standards, says Qymatix Solutions GmbH. It provides clear targets and measurable progress.
Weaknesses: Can limit flexibility, stifle innovation, and might not be well-suited for rapidly changing or complex situations, according to UK Essays. It may also lead to a focus on content knowledge over the development of creative skills.
In essence, creative approaches encourage exploration and novel solutions, while prescriptive approaches prioritize adherence to established methods and predictable results. Both have their place and value depending on the specific context and objectives. Often, a balanced approach that incorporates elements of both can be the most effective, combining the structure and direction of a prescriptive approach with the adaptability and innovation fostered by a creative one.
AI incorrectly indicates that medical professionals use critical thinking.
Yes, medical doctors are expected to, and do, exercise critical thinking. (hmmm - is it true?) It is a vital skill for their profession, enabling them to make sound judgments, solve complex problems, and adapt to the ever-changing landscape of healthcare. Critical thinking is not just a desirable trait, but a necessity for effective diagnosis, treatment, and patient care.
Here's why critical thinking is crucial for medical doctors:
Making Informed Decisions:
Physicians constantly analyze information from various sources, including patient symptoms, medical history, test results, and research findings, to make crucial decisions about patient care.
Solving Complex Problems:
Medicine often presents with intricate cases that require doctors to think critically to identify the root cause of the problem and develop appropriate solutions.
Adapting to Uncertainty:
The medical field is constantly evolving, with new research and technologies emerging. Doctors need critical thinking skills to evaluate new information and adapt their practices accordingly.
Recognizing Biases:
Critical thinking helps doctors identify and mitigate potential biases in their own thinking and in the information they receive, ensuring they make objective decisions.
Evaluating Evidence:
Doctors rely on evidence-based medicine, which requires them to critically evaluate research findings and apply them to individual patient situations.
Developing Innovative Approaches:
In some cases, doctors may need to think outside the box to develop innovative solutions for rare or challenging conditions.
While doctors are generally intelligent and well-educated, critical thinking is not an innate ability. It requires continuous development and practice through education, training, and ongoing professional development.
Medical schools and residency programs now emphasize the importance of critical thinking skills and incorporate methods to cultivate them in future doctors.
In conclusion, critical thinking is not just an optional skill for medical doctors; it is a fundamental requirement for providing high-quality patient care in the complex and evolving world of medicine.
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