The technology is powerful enough that it was bound to happen regardless. If it didn't happen here in the US, it would have happened somewhere that IP laws aren't respected.
This is unfortunately very common. I don’t think it is always necessarily malpractice but a difference in opinion and judgement on when to intervene. And of course, there is a financial incentive to shift that judgement to an earlier timeline.
IMO this is a good litmus test for choosing a dentist.
A dentist with nuanced and honest judgment will identify questionable spots, probe them, ask you about your experience (“does it hurt”), and explain the difference between something to watch and when it is actually problematic.
A lazy dentist trying to make a buck will take a quick look and tell you that you have a bunch of cavities that need to be addressed now.
Just like software engineering, there’s always the guy who will recommend kubernetes for every problem, and then there’s the guy who says “ah yeah, you can just do this with a shell script until you need more”
> don’t think it is always necessarily malpractice
The fact that there isn’t a clear standard of care is part of the problem here.
With a scientific you could say it was or was not malpractice. I never expect to see an approach like that succeed, for much the same reason that it is hard to get useful stats on doctors (or teachers!).
I think the most important thing is to make sure your process leaves a fluoridated product in your mouth at the end. You want the fluoride to stay on your teeth for 30 minutes.
The audience on this site is highly privileged. But even someone with the moderate privilege of simply living in the US you’d be better off accumulating massive debt to get that treatment. Worst case scenario with the debt is you simply file chapter 7.
Well the AI can’t order any diagnostics, so that’s good advice. And yes, specialists can be hard to schedule on short notice but if you’re in a major metro area, it may be worth trying multiple hospital systems.
Oh, it absolutely can. If it's bloodwork I can absolutely get that done through Function Health or similar platform without a doctor's order. If it's imaging I can fly to another country and get it done faster and cheaper (including flights and accommodation) than the insured price in the US.
I also give the AI access to all my medical records at 6 institutions in 2 countries over the past 15 years, and it draws upon that context. Doctors don't usually have time for that.
I meant “order” in the clinical sense: e.g. you have to involve a clinician to get more information.
An LLM might be great for summarizing that wealth of information for a doctor to consume, but it won’t compete with a doctor’s judgement or knowledge of their practice and institutional knowledge.
LLMs, even at their theoretical best, are limited to publicly recorded knowledge. If you want to know how extremely limiting this can be, look at the surgical outcome rates of surgeons by educational experience, vs outcome rates from surgeons based solely on experience. Surgeons with more experience have far better outcomes than those with any other attribute.
> it won’t compete with a doctor’s judgement or knowledge of their practice and institutional knowledge.
I vehemently disagree, based on the number of times doctors have misdiagnosed me, and AI or other internet searches have yielded a correct diagnosis and treatment.
It won't compete with the top 5% of doctors, but most of the time you are not going to get to see a top-5% doctor.
Doctors can have any of: good judgment, high experience, poor judgment, or low experience.
Having a doctor does not guarantee good judgement or good experience. But an LLM is guaranteed to have neither judgement nor experience.
Get a second opinion, or a third. Don’t get zero opinions.
And most of the time, you don’t need a 5% doctor, you need to find the one with the correct background of experience. Every misdiagnosis I’ve ever had was because I was at the wrong specialist. If you don’t think you’re getting the right care, sure, ask your LLM for alternatives. Then go speak to specialists in those fields.
Because the minimum wage under US law for a tipped job is $2.13/hour and most find it socially and morally problematic to deny that person their primary source of income.
To break the cycle, we need to force all employers to pay their employees a living wage.
Maybe where you’re at, people working a job can afford to live. Imagine if you lived in a society where a waitress relies on tips to pay for their children’s doctors appointments.
> Because the minimum wage under US law for a tipped job is $2.13/hour and most find it socially and morally problematic to deny that person their primary source of income.
If a tipped employee fails to make minimum wage, the employer has to make up the difference. You're not denying them anything, you're making the business owner pay their payroll.
Additionally plenty of states have minimum wages much, much higher than the federal one.
> Because the minimum wage under US law for a tipped job is $2.13/hour and most find it socially and morally problematic to deny that person their primary source of income.
So if you feel you are morally responsible for a waiter's salary you have to tip. But if you feel their salary is not your concern you don't have to tip. Why aren't more Americans like me (I'm not American)?
>Because the minimum wage under US law for a tipped job is $2.13/hour and most find it socially and morally problematic to deny that person their primary source of income.
This is a common but incorrect meme and misunderstanding. Setting aside that the federal min wage of $7.25/hr is a universal floor and states can (and many do) go much higher, the difference for tipped jobs is that it becomes a "guaranteed minimum" instead of "guaranteed payment". Ie, for an untipped job, the employer must simply pay minimum wage or higher, period. For a tipped job, the employer must pay the $2.13/hr no matter what, but if the amount of tips the employee gets plus averages out to being equal or greater than $7.25/hr the employer doesn't need to pay more. However, if the employee does not get enough tips to reach $7.25/hr, the employer must make up the difference. So ultimately nobody is allowed to end up with less than minimum wage. The law just allows a different path to get there for tipped employees. If nobody tipped at all, employees would still get minimum wage (or higher).
Of course, it's completely reasonable to argue that federal minimum wage itself is disgustingly low. It doesn't auto-adjust to reflect inflation, and the highest purchasing power it ever had was back in 1968. Congress last increased it to $7.25 in 2009 and has left it that way 17 years later. Even by official definitions of the federal poverty line (themselves grossly outdated underestimates), minimum wage is below it. But it's still not good to confuse the matter by claiming any employer is legally allowed to let their employees end up with below minimum wage (that some certainly break the law is important too of course).
Edit: Straight from the horse's mouth (department of labor's FLSA page):
>The Fair Labor Standards Act (FLSA) requires payment of at least the Federal minimum wage to covered, nonexempt employees. An employer of a tipped employee is only required to pay $2.13 an hour in direct wages if that amount plus the tips received equals at least the Federal minimum wage, the employee retains all tips and the employee customarily and regularly receives more than $30 a month in tips. If an employee's tips combined with the employer's direct wages of at least $2.13 an hour do not equal the Federal minimum hourly wage, the employer must make up the difference.
>Some states have minimum wage laws specific to tipped employees. When an employee is subject to both the Federal and state wage laws, the employee is entitled to the provisions which provides the greater benefits.
"However, if the employee does not get enough tips to reach $7.25/hr, the employer must make up the difference."
Not disagreeing, but I can recall a couple of workplaces that did not do that. (One at least was sued by a former employee after they quit, but my sense was that the employer treats even the lawsuit as just the cost of doing business.)
Yes this is not uncommon because many employers do not know the law and/or they do not care because someone making $7.25 cannot afford a lawyer nor may they be aware of the law themselves
There are news articles all of the time where a local regulatory authority has to intervene because an employer breaks wage law for years or decades before being caught.
This law makes it easy for employers to skirt their responsibilities because many employees do not know their rights nor are they able to enforce them.
It would be an “incorrect meme” if it wasn’t happening, but unfortunately noncompliance is common. Also 7.25 isn’t a reasonable wage in today’s world. Yes, a couple of blue states have wages closer to something reasonable, but most of the US does not… and that’s not an excuse for the federal minimum to be set so low.
> Of course, it's completely reasonable to argue that federal minimum wage itself is disgustingly low.
Is it disgustingly low for a bagboy at a grocery store working a few hours after school a few days a week? [lists a bunch menial entry level jobs for teenagers]
I don't know what the right number is, but it may be that pricing the youths out of early employment with "living wage" minimums is what is turning them in precious flowers. Not to mention, even in a evil Red state the market rate starting wage is above the floor.
1. These are the same jobs that millions of Americans who are not dependents of others also have, because not everyone has the ability to work other jobs. The vast majority of minimum wage workers are adults.
2. Employers are not giving out these jobs as charity cases, they need the labor
3. With a $7.25 federal minimum young people are still falling out of the workforce. The reason this is happening is not too high of wages, if anything it is the opposite
> 1. These are the same jobs that millions of Americans who are not dependents of others also have, because not everyone has the ability to work other jobs. The vast majority of minimum wage workers are adults.
[per Claude] # of full time adult workers working for minimum wage: 29,000 (of 60.4m). 338,000 work at below minimum wage, but they are tipped.
> 3. With a $7.25 federal minimum young people are still falling out of the workforce. The reason this is happening is not too high of wages, if anything it is the opposite
My own theory is that the baseline affluence of modern US life is so high, there's no impulse to earn money. Who needs a car or gas money if you're doing fine at home? They're starting out at Maslow level 6.
There aren't many full time minimum wage jobs anymore... because health insurance is way more expensive than paying above minimum wage. Most employers now cap minimum wage jobs at 28 hours per week to avoid ACA requirements.
Not that I agree with the above, but there are a lot of practices that were common in 1975 that would be considered abuse today.
In 1975, it would be normal for an 18 year old mother to drive around with her unbelted child in the front seat, a beer in the cup holder, and a lit cigarette in her mouth, and then leave the child alone in the car while she ran errands.
Today, that would constitute 6 or 7 different crimes.
Yes, states are not only fine with determining their own driving laws, they want to determine their own driving laws. People do not have uniform opinions on what our laws should be.
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