Artificial Intelligence & the Social Role of Medicine Redefined

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Bryan Pilkington

Welcome to Health Ethics, a series of conversations with leading experts about ethical considerations associated with health and healthcare, both locally and globally. I am Bryan Pilkington, Professor of Bioethics in the Department of Medical Sciences at the Hackensack Meridian School of Medicine.

Bryan Pilkington

This series, like its predecessor, which

Bryan Pilkington

focused on the COVID-19 pandemic, relies on the idea that challenging ethical issues are best addressed by folks from diverse backgrounds practically reasoning together. and complements the Health Ethics Series with its panel of leading experts from medicine, nursing, politics, economics, philosophy, and the law. Thank you and enjoy the episode.

Bryan Pilkington

Welcome everyone to the Health Ethics Podcast. I'm Bryan Pilkington, and it is my great pleasure to be speaking with Dr. John Lantos. Dr. Lantos is a pediatrician and bioethicist. He's spent his career writing about bioethical issues raised by innovative technologies. He's discussed these on Oprah, Nightline, in the Wall Street Journal, and of course now on the Health Ethics Podcast. And he's been an ethics advisor to the President's Council on Bioethics, the American Academy of Pediatrics, and the Vatican. He's currently working on a book about the doctor-patient relationships in the era of AI, and it's the latter that we're really going to focus on today. So, John, thanks so much for joining

Dr. John Lantos

me. Hey, thanks for having me. This is great.

Bryan Pilkington

Among the host of topics you've written on, and you've been amazingly prolific over your career, is AI and the role of the physician, as I just mentioned. I had known your work in pediatric bioethics, but after reading the recent piece in JAMA around auras, which I think is sort of deeply philosophical in lots of ways, I actually went back and saw that you've been asking these questions for, I think, almost 30 years. It was 1999 that Do We Still Need Doctors came out.

Bryan Pilkington

Correct.

Bryan Pilkington

So I think you're the perfect person to really jump into these. Now, let's focus a bit on the paper. So in that recent piece in JAMA, you rely on a philosophical conception of an aura to help distinguish physicians from AI and to push physicians, or at least to ask them to think about their future in light of the increasingly extensive role AI is playing in healthcare delivery. So there's the big intro, the framing for folks who haven't read the paper yet. Help us sort of think through it. You make a comparison between... medicine and art that i think sort of the backbone of this so tell us a little about what got you into thinking about this and sort of the benjamin stuff on medicine

Dr. John Lantos

yeah complicated question let me see if i can uh uh uh set up a framework that might guide our discussion for it because there's really two two uh important points wrapped up in your uh question there one one was what i was thinking about 30 years ago when uh long before ai was

Dr. John Lantos

anywhere but in the MIT lab. But primitive AI, as we know it now, but primitive AI, what now seems primitive, was making inroads into medicine. And one of the things that I focused on in the book, Do We Still Need Doctors?, were devices that could interpret electrocardiograms. Electrocardiograms were... one of reading electrocardiograms was one of the skills that people thought you needed a cardiologist for. And when these new devices that could interpret EKGs came out, there were big questions about whether we still need the cardiologist to read them. And people did head-to-head studies. And they found, as they found in subsequent studies, that the machines are better than most doctors, but may not be as good as the expert electrophysiologists at reading cardiograms. Two points about that. One, there aren't expert electrophysiologists in most places where doctors need to interpret these. And so having a device that was better than anything available in the moment, particularly in an emergency room or a rural setting, or just in a primary care doctor's office, was a huge advance. and raised questions about whether this sort of technology for cardiograms would soon develop for x-rays, for retinoscopies, for all the things that in the subsequent years we've seen AI develop technologies to do.

Dr. John Lantos

So in that book, I speculated both about devices like that, but also about power professionals.

Dr. John Lantos

In addition to AI and machines, doctors were being replaced in many, many settings by nurse practitioners, physician extenders, and other non-physicians with far less training who could, again, do many, and in some cases most of the things that doctors do, do them just as well. So it seemed like questions were importantly being raised about what's left. That's the special skill and talent of the physician and which things might be replaced. That was 30 years ago. Along comes ChatGPT, Claude, all the rest of the current crop of large language model generative artificial intelligence products. And it just takes those same questions and kicks them up. many notches or many degrees of complexity. So second part of your question, in the recent paper in JAMA, this concept of aura comes from a famous essay by the German philosopher, Walter Benjamin, who was talking about art, medicine. There was no AI for medicine, but his concern was whether in the age of mechanical reproduction, particularly film and photography, we would still need painters. And if so, what is it that painters do, or what is it that makes an original work of art special in a way that a high-quality reproduction is not special? And he proposed this vaguely defined concept of art. He said an original work of art has some ineffable, undefinable, but recognizable and special quality. its aura that has to do with its history, the purposes for which it was built, the specific place and time in which it is being seen by a particular observer that makes the original work of art

Dr. John Lantos

unique and special, even if you have a high-quality reproduction that almost nobody can tell the difference about. And he went on to look at the ways that the technology might change the way we think about the social function of art. Painting exists in one place in one time and has an original, but there's no such thing as an original photograph. You have the negative and then you can make dozens, hundreds, millions of identical reproducible reproductions of that work of art. So in the essay in JAMA, I said, It looks like AI is doing for the doctor-patient encounter what photography did for oil painting or the visual arts. It's taking something that once had an aura, was thought to be unique, special, located at a particular place in time, and derived its value from that moment, that interaction. between two human beings and makes it infinitely reproducible. You can consult your LLM doctor, your chatbot, anywhere, anytime, 24-7. The chatbot is never off duty. It is never moody. It doesn't need sleep. And so we'll... replace many of the functions of the physician. And in the paper, I asked what's left of the aura, the specialness of the doctor-patient encounter.

Bryan Pilkington

Yeah, and I think it's helpful to think about it in terms of the physician-patient relationship. Because when I first read the piece, I think I read it too quickly, and I thought, oh, the aura is something, right? It's the aura of the physician. But is the aura

Bryan Pilkington

really

Bryan Pilkington

applicable to that? to the interaction, to that kind of relationship, as opposed to just one of the parties? How are you thinking about where the auras look?

Dr. John Lantos

In Benjamin's work, he talks about that, about how the work of art exists in a place and time, but its aura comes from the interaction between the viewer seeing the work of art in that place and time. And he actually goes back to Neanderthal cave art and early... Greek sculptures and the relationship between art and religion, where these original works of art had a sacred function and often were placed in temples or were thought to have magic predict the future or somehow sanctify a moment when one interacted with them. And over the years, he talks about how they lost those functions, but then... developed a new kind of aura where they were placed not in temples, but in museums. And people would make pilgrimages to see the Mona Lisa or Michelangelo's David or other particularly famous, venerable, irreplaceable, aura-surrounded works of art, where seeing a reproduction was not thought to have the same magic, the same power, the same deep meaning. as seeing the original Michelangelo sculpted himself.

Bryan Pilkington

Yeah, I mean, that's really helpful because I'm thinking about, you know, the occasional interaction with, you know, hop on some LLM, Gemini chat, GPT, whatever, and you ask, oh, you know, I've got this cut, what do I do? Or whatever the right, you know, medical question is. That's different from the kind of conversation. And I don't use AI, I mean, spoiler, as much as most people I know, as much as I probably should, but that's different than you know, sitting in a physician's office talking about X. And so that's helpful to kind of get the aura. And it brings me back to some early work in bioethics by Paul Ramsey. And I remember reading,

Bryan Pilkington

first time I

Bryan Pilkington

read patient as person. And when he's talking, because he's really interested in research ethics questions, he says something like, you know, in thinking about the relationship between physicians and patients, it's such a joint endeavor. I think he calls them joint adventurers and says that at the end of this process, both the physician and patient can say, I cure. And I think, well, I get how that works if you have a well-oiled physician-patient relationship. I don't know if any patient who hops on chat GPT would ever think that chat GPT and the patient are curing together, right? I'm just going to find information about something. So I'm trying to sort of better understand, because I think there's something right there. There's something about your arguments for the aura that seems really attractive. I just can't, I can't, I'm not there. I think there's something right. I just don't know exactly what it is. So

Dr. John Lantos

in the paper, I borrow the concept of Barbara from this 100-year-old essay by Walter Benjamin, but use it to highlight a longer trend that I think set the stage for the current use of AI in medicine. And in that longer trend, I go back to Foucault's work, The Birth of the

Bryan Pilkington

Clinic.

Dr. John Lantos

and talk about how the rise of modern scientific medicine was, in large part, a movement to shift the focus of doctors' concerns from the patient's subjective experience and narrative of their illness and attempt to derive meaning from their suffering to what he called the clinical gaze, which attempts to abstract the patient. get rid of all those personal meanings in order to arrive at objective truths about disease that don't require subjective interpretation or understanding. So in the work, Foucault, who doesn't necessarily endorse this approach, he's working as a historian, unpacks a lot of the work that was being done in the late 18th and early 19th century, particularly in Paris. where many clinical biologists and experimentalists in medicine sought to find measurable objective findings that could be used to categorize disease. So it was the rise of auscultation, listening to lung sounds. It was the rise of microscopy. In particular, it was the autopsy that correlated the clinical symptoms when the patient was alive, pathological findings

Dr. John Lantos

seen on autopsy after they died in order, to achieve this idea of saying, when you come in, I don't need to talk to you anymore. I don't need to know your story. All I need is the objective facts that I can find by listening through my stethoscope, by measuring your temperature, your heartbeat, anything else we can measure. And the more objective I can be, the more scientific my practice of medicine will be. And ultimately, the more effective it will be. At the time in... 1790 Paris, they weren't very good at doing that, but the philosophy developed over the next 200 years. And in the paper, I suggest that most of the successes of medicine, modern scientific medicine, came from steadily applying that point of view and making medicine more objective, less subjective, more dependent on precise measurement and less on narrative and storytelling. more about pathophysiology than about psychology or the patient's metaphysical or deep attempts to understand why they got ill and what illness means in the larger context of their life. I go through like the rise of the modern hospital, which moved doctors and their interactions with patients from the patient's home when they made skulls. and could see the patient's family, see whether they lived on a farm, see what sort of life they had to a hospital where they could get more of these objective measurements, but obliterate the patient's individuality. Surgery and anesthesia is another chapter in this long development where you effectuate your cure while the patient's anesthetized and unaware of what you're doing. The randomized control trial, The gold standard of evidence-based medicine seeks to obliterate anything that makes the individuals unique. Those are seen as confounders rather than important elements of the illness because we want to abstract what's common across all people rather than what's unique and individual. And I suggest that all of these developments led to what we think of as high-quality medicine, evidence-based medicine. and they're all dehumanizing, depersonalizing, and set the stage for a machine to come in and say, hey, if that's what medicine is, if it's just about measuring, predicting, and changing pathophysiology, what do you need a human interaction for? Machines can do most of that stuff better.

Bryan Pilkington

Yeah, I mean, and the depersonalization point I thought was very powerful in the essay. I hadn't thought much about surgery, which fit really well. when we teach surgical ethics here, I mean, I've always thought, oh my gosh, that's a relationship where I'm always a patient and I'm a PhD. I'm not, I'm not a doc, but I think that's where, that's an instance where the relationship would be so important to me because I can't say anything. And when the surgeon is making particular kinds of valuating decisions about, right, where to cut, what to do, how risky to, and it's, or, you know, risk factors and those kinds of things. I hadn't thought about it, which was a great point to pay with. Oh, and, but Brian's not moving. I mean, you don't have to worry about that in some ways. So that was a really helpful sort of history of how we got to the point where we're at. Just before AI, when you're telling the history, you also make the comparison to telemedicine. And I thought that was super interesting, especially sort of coming out of COVID. It seems like that telemedicine's just everywhere. And in-person interactions had been prized, right? You did whatever you could to get to the doctor's office. You didn't miss that appointment. But you know that the aura that makes patients feel... maybe uniquely human, sort of that thing that was, maybe that's sort of what I find so attractive about the oral line. I want to know, is that something that patients want? I'm not looking for a big study. This could be anecdotal across your years. I mean, there are increased technologically mediated interactions today. So the, and there's a paper that came out, I can find, I can stick it in the show notes for folks who are interested. But, you know, I messaged my doc and I say, oh, hey, you know, my leg hurts. He writes back, come in, Brian, or hey, here's the test result. If AI is responding, it says, oh, sorry, your leg hurts, Brian. I heard the Mets lost yesterday. I'm so sorry. I know you really care about that. Did you bang it at the gate? And I'll find the paper. But there's research that suggests that it's really patients think AI, at least in certain contexts, is more empathetic than human beings, which I think is just perception. But... And so now this is turning into a long meandering question. Is this something you think patients want? Is the aura something that they would go in for? Or is AI a good enough replacement for a doctor?

Dr. John Lantos

I don't think there's a simple answer to that one. I think it is very context dependent, case dependent. Because of that, I think there are many things that people now go to doctors for that they will soon go to AI for. and feel like nothing is lost. And in fact, much is gained because AI is available 24-7. AI remembers that you're a medicine fan and asks you how you're feeling about it. AI reads all of the medical literature and remembers every bit of it in ways that doctors cannot. One of the points I made in the book, Do We Still Need Doctors? 30 years ago was... We need doctors the most where the science is the worst. To put it positively, the better the science, the less we need a doctor. The example I used in the book was immunization. They work really well, and they work well whether I know you, I don't know you, whether a doctor gives them a nurse, a pharmacist, or a clerk in the grocery store. The science is... impact on people who will argue with that, of course, today. But that's my belief. Where we need doctors the most is when the algorithms fail, when it's unclear what the best thing is for you today. And then a doctor and a patient, I think, really need to have that deeply personal value informed discussion. about the uncertainties associated with various approaches to a disease that maybe can't be precisely diagnosed, for which no good treatment is clearly the best, and for which the choices all involve deeply personal values and risk trade-offs for which there's no right answer. The irony that I pointed out in the book and that I think is as true today as it was then is We're all going to get to that point. The algorithms are good for certain diseases. We know which treatments work in which situations for many things, but the better treatments work, the more complicated become the diseases for which there is no longer any good science or treatment. We're seeing that today in cardiac care. We're seeing that today in cancer care. certainly seeing it in genomics and rare diseases. People have left the algorithms behind or back to that sort of Paul Ramsey-esque mutual exploration of what the appropriate response to illness, suffering, and embodied frailty ought to be.

Bryan Pilkington

Yeah, I mean, that reminds me of one of my favorite lines in your JAMA piece about sort of, I think... maybe capture, and I'll ask you to expand on it, but I think it captures what you were just laying out well. You wrote, artificial intelligence is but the latest development in this long struggle over the soul of medicine, which sounds especially weighty. And you're describing sort of a tension, and you've laid this out historically, you've painted the picture well, but a tension, I think, between technological efficiency and human presence. And so can you just say a little bit more about that tension? Because as you've framed it, I mean, it sounds like, oh, hey, look, there's some things Brian can go grab, you know, good AI for, there's some things, the really challenging stuff we don't have an answer, valuating questions, where I'm going to want to spend time with a physician. Some people have access to these things, some people won't. If I go to AI a lot, will I then maybe not want to bother with the physician because I'll conflate? Anyway, so say more about sort of this fight for the soul of medicine.

Dr. John Lantos

Yeah, so long before AI,

Dr. John Lantos

Particularly in the last 30 years, we've seen the rise of so-called evidence-based medicine. I say so-called because I think medicine has always been evidence-based. It's just the quality of the evidence. The way we think about what counts as an explanation, but rival shamanistic healers were looking for evidence. It just wasn't the kind of generalizable scientific evidence that we think about today. It was much more of a deeply personal understanding of who you were and why your symptoms made sense in the context of what is going on in your life at this moment. Again, back to that. idea of R and the unique time and place of a particular interact. The rise of evidence-based medicine, it followed the logic of randomized controlled trials that I was talking about before. I don't want to know your life story. I don't want to know. I want to know your symptoms. I want to know your lab values. I want to know what your x-rays show. And then I will follow a practice guideline based on the best available evidence that shows that for people with your objectively measured pathophysiology, this form of treatment is the best. So the soul of medicine involves kind of the art of medicine or clinical judgment, clinical judgment that said, okay, there's a practice guideline. There's all this evidence, but I know I'm a doctor. I'm looking in your eyes. I can see the way you're describing your symptoms. And I think there's something unique and different about you. I'm going to leave the practice guideline behind. I'm going to deviate from evidence-based medicine and I'm going to apply my unique skill, my talent, laying on of hands, all the things that used to be the essence of a caring, empathic doctor-patient relationship. That becomes harder and harder to do and did before AI because the evidence, the practice guidelines, all these things were agreed upon as the

Dr. John Lantos

recommended standard of care for a particular set of treatments. And doctors were increasingly discouraged from exercising individualized clinical judgment because much of the time, their individualized clinical judgment led to worse outcomes than following the evidence-based practice guidelines. When that happens, medicine loses something of the soul. something of the idea of an art of medicine, something about individualized, personalized patient care, and AI is going to accelerate that process. It may lead to better outcomes, certainly will in many cases, but will come at the cost of this deeply personal, trusting doctor-patient interaction that people have valued.

Dr. John Lantos

centuries or millennia.

Bryan Pilkington

Yeah, that's, I mean, I think you've laid the tension, you've laid out the tension well. And when I hear different folks in this conversation, some folks say, well, look, if the outcomes are better, all my cards on the table, folks who listen to the podcast know I'm more of a virtues, vices guy than a rules or a consequential consequences guy. But, you know, I mean, the outcomes are powerful. When I go see a physician, I want something fixed

Bryan Pilkington

usually,

Bryan Pilkington

or if I bring my little kids, it's a little more complicated, but I, you know, I, I want them to be better. And so it's nice there. You know, I'd like my general practitioner, the pediatricians, my daughter said they're nice, you know, but reflecting on medicine as somebody interested in ethics, I think the relationship is just. tremendously interesting we're thinking about this aura stuff sounds great but as a patient i want something fixed and so this gets to another really nice line you have i think you you frame it well and you say when a profession's core competencies and this brings us back to the ben you mean stuff become reproducible the central question is not will it disappear

Bryan Pilkington

uh

Bryan Pilkington

as someone who teaches at medical schools i think medical schools should

Bryan Pilkington

always

Bryan Pilkington

be around and you know physicians always be around but uh it's not back to you uh is not whether it will disappear, but how its social role will be redefined. And so if this is the book, then just push us in the direction. And when the book comes out, we'll make sure we post the link to get it. But how are you thinking about defining such a role? Because I imagine the instances where we, where patients are most in need of physicians, where the science is less strong, those instances, I imagine, will become fewer as we know more and as the algorithms and the research become more sophisticated. So what do you envision the role of physicians being or the redefinition of the role in the

Dr. John Lantos

future? Great question. Difficult to answer at this point. But one of the points I make in the essay, again, drawing on Benjamin, is that his concern was that art might disappear, visual arts, painting in particular, replaced by mechanical reproduction, he found two things that modified his view on that. One is painting didn't disappear, but it did completely redefine its social role. So painting used to be either associated with religious iconography. Paintings existed to create, you know, enhance a sacred space and generate in us feelings of devotion and

Dr. John Lantos

reverence for god or art existed to flatter the bourgeoisie to you know portrait painting people would sit they'd get a flattering picture to put on their wall the way people now put photographs on their wall once photography came along those functions uh diminished in importance but painting didn't go away it just said whatever it is we're doing has to change and so Realism gave way to Impressionism and Cubism and Surrealism and Dadaism, all these new ideas of what art ought to be and do. And there's arguably more art and maybe even better art or a wider variety of interesting ways to think about what counts as beauty in a painting or a museum than there ever were. Art didn't go away. It just looks nothing like it looked 150 years ago before the rise of technology. Benjamin was writing 100 years after the development of photography. So this was a long process. The second thing he pointed out didn't just allow more accurate depictions of reality. It enabled us to explore reality in new ways. Cameras could zoom in. They could zoom out. They could go in slow motion. They could show us things that were there that we had been unable to see at all before. So taking those two things together, I think AI is going to help us understand in new and different ways things that we thought we understood before. For example, trustworthiness, empathy, subjective perceptions of illness, the meaning of conversation and interaction. And you can do for those with a chatbot what a zoom lens could do for the way we see things. We'll suddenly see new things and different things. And one of my favorites is empathy. I mean, the studies showing that people perceive AI to be more empathic clearly represent one aspect of empathy, representational empathy. AdBots know the words that generate in somebody who reads those words a feeling that they are cared for. That's one piece of empathy. I don't think it's all of empathy. And so, but it will force us to think about what are the other aspects? How are they important? How are they different? How many will be machine reproducible and what will be left that's uniquely human that can be studied, can be deeply understood in new ways can be taught and can be developed as if it were a new movement in art. How medicine will reimagine its social role, I can't say. But I think if it doesn't, then we doctors are screwed.

Bryan Pilkington

Yeah. I mean, it's a great answer. It's both tremendously interesting. I mean, it gives us so many things to think about. And even just how patient populations, I mean, this varies across, you know, places and times, but might change. You know, I'm... I am much more concerned about privacy and confidentiality than some of my younger colleagues. And I imagine my daughters will grow up with just different kinds of views. And so I'm thinking, I teach medical ethics and I used to teach a lot of philosophy. And when The Matrix came out, if you remember that old film, every philosopher, oh my gosh, they're doing the things we've been talking about for a while, so it's always around. And there's a character who sort of knows things are diluted, but sort of is going to intentionally buy into the delusions. And that's where I think the sort of representations of empathy is super interesting. Are there future persons who are going to say, hey, I still feel good even though I know it's not. Anyway, that's just one of many, many things we can think about. And as I said, the answer is great. It's unsatisfying. And it reminded me of the first time I read in grad school of McIntyre's After Virtue. And so it goes through this long treatise. You get the history, you get arguments for, you know, we really need to be thinking more about virtue and characterism. And then at the end, it's like, okay, well, what's the answer? And he says something like, well, we're not waiting for a Godot, but for another doubtless, very different Saint Benedict. And it reminded me of your analysis. I mean, what that social role that physicians, how they will redefine it. We don't know what it is. And right, Magda was talking about sort of the Benedictine monk communities and all that. And so I think that's a powerful question. And so I'm going to move briefly to an education question, then I'll get you out on another one because I see we're closing out on time. Given all of your thought about these kinds of technological advances over 30 plus years, your practice, everything, I mean, if it were up to you, how would you shape medical education? So you've got the great work from Foucault and the Clinical Gaze that you mentioned, Ora and Benjamin. I mean, should medical students study philosophy? I mean, what's the... If you could give sort of one bit of advice to medical students or to deans of curriculum, where would you push medical education to help prepare future physicians for... a world of new social role?

Dr. John Lantos

It's the perfect question to ask, and I'll explain what I mean by that. I think we tend to forget a lot of the time how our current ideas of medicine, of what doctors should do, of what a healthcare system should look like, are deeply culturally embedded and deeply historically determined and therefore contingent. So we have a healthcare system... or non-system in the United States that has all these weird quirks. I mean, the way we do medical education is pretty much the way they developed a curriculum in Germany in the 1880s, this idea that doctors should be scientists. We start by doing physics and calculus and biochemistry, and then medical school, we do other basic sciences, pathophysiology. physiology, histology, all this stuff. And this idea that the doctor should be sort of a learned scientist in the model of Pasteur or, you know, the other great 19th century people is completely obsolete in terms of what doctors actually do and need to know today. But also, remarkably durable in its obsolescence

Dr. John Lantos

i've been on curriculum reform committees in medical schools and they say it's easier to move a graveyard than to change the medical school curriculum so ai might be the nudge that will allow a radical reconceptualization of what that would mean what might it look like The question would be, what do people want in terms of health or a system that can address the many ailments to which humanity is heir? Another quirk of the current system is that we have all these different kinds of health professionals, but they don't train together. So there's no concept that building a functional team that brings together the expertise of... physicians, nurses, physical therapists, speech therapists, psychologists, social workers, economists, administrators to develop a system that addresses some defined goal that all could agree on. That just doesn't happen today. Each gets their own siloed education and then they're thrown into a complicated institution like a hospital or an academic medical center or a primary care clinic. and somehow expected to complement each other and work together.

Bryan Pilkington

That's completely nuts.

Dr. John Lantos

And yet, that's the system we've ended up with, and we all just take it for granted. Of course nurses are going to go to nursing school. Doctors are going to go to doctor school. Mental health is its own gamish of social workers, psychologists, MDs, psychiatrists, all of whom have different kinds of training and all of whom are supposed to work together. What would it look like if we were going to reconceptualize that? I mean, here's the pie-in-the-sky thought experiment. Put together a group that includes philosophers, theologians, psychologists, physicians, administrators, and say, how can we work together to build a system that addresses the concerns of people who feel disease, who feel something is wrong in their life, and they don't know if it's physical, mental, social, emotional, economic.

Dr. John Lantos

and redefine what a caring institution ought to be. That could happen, probably outside of mainstream medicine. I mean, I think it's starting to happen in a lot of alternative healthcare settings. I think that process will likely accelerate. And the question of whether we can find the administrative skill, philosophical astuteness, or the willingness to challenge tradition, and received wisdom in ways that allow us to build something truly new and radical that harnesses the energy of all the biomedical technology and now the new energy of artificial intelligence do better than we've done.

Bryan Pilkington

That is quite a vision. I think it's very attractive. And I, of course, like the additional piece that maybe philosophers will have more jobs too. But that's the move because that's what people care about at the end of the day, right? It's responding to the dis-ease. Excellent. Well, John, let me get you out on this one. Last question for folks who've enjoyed this conversation. Where can they hear you next? We'll look out for the book whenever it comes out. But what's next for you if you're giving a talk, an expected paper, a recent paper that's good? Where can we... point folks to sort of read more and hear more?

Dr. John Lantos

I mean, they could go to my website, johnlantos.com. Usually when I have an upcoming talk or an article coming out, I'll post something on there about it. I'm focusing a lot on these questions of medical education. And so I have papers in press with academic medicine. I'm speaking at an international conference on ethics education next month. And I'm just trying to... keep up with a field that's rapidly changing, find out what other people are doing, and add a little something where I can.

Bryan Pilkington

I really enjoyed the article and it was great to chat. I appreciate the time. And we'll make sure in our show notes that we link to the page and we'll keep an eye out for the book when it comes and for the academic medicine article. So, John, thanks so much for the time. I really appreciate

Bryan Pilkington

it.

Dr. John Lantos

Thanks so much for having me. This was great.

Bryan Pilkington

To learn more about our work or to engage with the series' content, reach out to me, Bryan Pilkington, at brian.pilkington at hmhn.org.

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