Fairtrade - what you don't see...
Filed under: Author: Dan
According to myth or legend, when the Romans razed the mighty city of Carthage, the soil was strewn with salt. In this way, they ensured that agriculture would be ruined, so that never again could Carthage become a great power to challenge Rome.
Agriculture was the powerhouse of ancient economies, but even today, many countries depend heavily on their agricultural economy for their people's welfare or survival. However, there is a new kind of salt that strews the land of developing countries.
If a farmer cannot receive a fair price on their crops, then they cannot afford to feed their families, or educate their children or develop their villages. If an entire country dependent on agriculture cannot receive a fair price, then it impoverishes its people, and cripples it in efforts to combat disease, provide clean water, develop infrastructure, and start new industries.
At this point you're probably thinking this note is about the Fairtrade movement - that I'll ask you to buy Fairtrade bananas and coffee or something. Well, actually its more about the shortcomings of the Fairtrade movement - my wish is for it to be improved into something better. I'll explain what and why!
You see, wealthy (OECD) nations currently divert an enormous amount of tax dollars into their agricultural industries, which pushes the price of crops so low that it can be below how much it costs to grow in even developing countries. These subsidies make prices so low that poor nations cannot make much money off their crops, or they would even make a loss trying to sell it. It is thus understandable that developing countries have repeatedly pushed for OECD countries to eliminate their subsidies, but time and again such efforts have failed (as seen in the Doha trade talks). Developing countries would rather the chance to help themselves than ask for charity, but instead we are hindering them, and effectively throwing salt on their lands. Please don't mistake me - it is not globalisation that is intrinsically to blame here, but the currently lopsided structure of trade that has been setup between OECD and developing countries.
While it is extremely commendable that the Fairtrade Foundation transferred 80 million Euros to developing countries in 2007, it is important to put things into context. The size of OECD agricultural subsidies is approximately 280 *billion* dollars, which makes the contribution of the Fairtrade Foundation less than one twentieth of one percent (0.0003) of subsidies. Are you surprised at the disparity? I certainly am, because the Fairtrade Foundation is seen as the pre-eminent brand for combating injustices in agriculture.
When people buy Fairtrade goods they believe they are giving money to combat these injustices, and that they have been ethical by paying for someone to address these injustices for them. What I fear is that most people see their responsibility end with the purchasing of Fairtrade goods and don't stop and think about the much larger issues beyond what Fairtrade currently handles. Is it possible this enormous Fairtrade presence in our minds is currently crowding out awareness of issues and coming at the expense of more effective action? It doesn't need to be this way.
The Fairtrade movement has a truly impressive grass-roots following and its UK executive director Harriet Lamb described at a recent talk how it is the most recognisable and powerful ethical brand as seen by consumer surveys. When consumers buy Fairtrade, they expect and believe that the Fair Trade movement is taking their money and using it to truly combat poverty. The transformation the Fair Trade movement has made to the families and villages of supported farmers is truly impressive and inspiring. But the real question is not whether good deeds are being done, but whether even greater deeds can be done with their resources.
I believe it is high time that the Fairtrade Foundation truly embrace the hopes of developing countries, the underlying expectations of consumers, and the real dreams of its grassroot base by directly lobbying and pressuring governments in Europe and the US to end agricultural subsidies. As both a respected business-oriented foundation and with an impressive grassroots following, I believe that the Fairtrade Foundation is in a truly unique position to do so. Indeed, I believe they have a *responsibility* to their consumers, their supporters, and the farmers they support, to truly act on the behalf of ethically concerned consumers and weigh in as a counterbalance against the powerful pro-subsidy agricultural lobbyists.
I don't think I am alone in wanting the Fairtrade movement to truly achieve its noble aims. I want it to put its money where its mouth is and fight against the poisonous salt of OECD agricultural subsidies. It has the credibility, support and financial resources to have a real chance of swaying politicians into action - and the annual monetary benefit to developing countries would be worth thousands of times what it has achieved so far. Surely that is a prize worth fighting for?
Agriculture was the powerhouse of ancient economies, but even today, many countries depend heavily on their agricultural economy for their people's welfare or survival. However, there is a new kind of salt that strews the land of developing countries.
If a farmer cannot receive a fair price on their crops, then they cannot afford to feed their families, or educate their children or develop their villages. If an entire country dependent on agriculture cannot receive a fair price, then it impoverishes its people, and cripples it in efforts to combat disease, provide clean water, develop infrastructure, and start new industries.
At this point you're probably thinking this note is about the Fairtrade movement - that I'll ask you to buy Fairtrade bananas and coffee or something. Well, actually its more about the shortcomings of the Fairtrade movement - my wish is for it to be improved into something better. I'll explain what and why!
You see, wealthy (OECD) nations currently divert an enormous amount of tax dollars into their agricultural industries, which pushes the price of crops so low that it can be below how much it costs to grow in even developing countries. These subsidies make prices so low that poor nations cannot make much money off their crops, or they would even make a loss trying to sell it. It is thus understandable that developing countries have repeatedly pushed for OECD countries to eliminate their subsidies, but time and again such efforts have failed (as seen in the Doha trade talks). Developing countries would rather the chance to help themselves than ask for charity, but instead we are hindering them, and effectively throwing salt on their lands. Please don't mistake me - it is not globalisation that is intrinsically to blame here, but the currently lopsided structure of trade that has been setup between OECD and developing countries.
While it is extremely commendable that the Fairtrade Foundation transferred 80 million Euros to developing countries in 2007, it is important to put things into context. The size of OECD agricultural subsidies is approximately 280 *billion* dollars, which makes the contribution of the Fairtrade Foundation less than one twentieth of one percent (0.0003) of subsidies. Are you surprised at the disparity? I certainly am, because the Fairtrade Foundation is seen as the pre-eminent brand for combating injustices in agriculture.
When people buy Fairtrade goods they believe they are giving money to combat these injustices, and that they have been ethical by paying for someone to address these injustices for them. What I fear is that most people see their responsibility end with the purchasing of Fairtrade goods and don't stop and think about the much larger issues beyond what Fairtrade currently handles. Is it possible this enormous Fairtrade presence in our minds is currently crowding out awareness of issues and coming at the expense of more effective action? It doesn't need to be this way.
The Fairtrade movement has a truly impressive grass-roots following and its UK executive director Harriet Lamb described at a recent talk how it is the most recognisable and powerful ethical brand as seen by consumer surveys. When consumers buy Fairtrade, they expect and believe that the Fair Trade movement is taking their money and using it to truly combat poverty. The transformation the Fair Trade movement has made to the families and villages of supported farmers is truly impressive and inspiring. But the real question is not whether good deeds are being done, but whether even greater deeds can be done with their resources.
I believe it is high time that the Fairtrade Foundation truly embrace the hopes of developing countries, the underlying expectations of consumers, and the real dreams of its grassroot base by directly lobbying and pressuring governments in Europe and the US to end agricultural subsidies. As both a respected business-oriented foundation and with an impressive grassroots following, I believe that the Fairtrade Foundation is in a truly unique position to do so. Indeed, I believe they have a *responsibility* to their consumers, their supporters, and the farmers they support, to truly act on the behalf of ethically concerned consumers and weigh in as a counterbalance against the powerful pro-subsidy agricultural lobbyists.
I don't think I am alone in wanting the Fairtrade movement to truly achieve its noble aims. I want it to put its money where its mouth is and fight against the poisonous salt of OECD agricultural subsidies. It has the credibility, support and financial resources to have a real chance of swaying politicians into action - and the annual monetary benefit to developing countries would be worth thousands of times what it has achieved so far. Surely that is a prize worth fighting for?
I found it rather funny reading an article about why flies are so hard to swat. Apparently flies have a sophisticated response to the incoming swatter:
"Long before the fly leaps, its tiny brain calculates the location of the impending threat, comes up with an escape plan, and places its legs in an optimal position to hop out of the way in the opposite direction. All of this action takes place within about 100 milliseconds after the fly first spots the swatter."
If you ask me, I prefer to catch them and let them out the window. Who really wants to swat them and end up with a mess to clean up?
Yup, that's right - catch them!
I figured out the trick as a kid growing up in Sydney. Let me tell ya, there can be a lot of flies on a hot summer's day in Australia.
It turns out to be really easy! Their vision is not like human vision - its tuned to be sensitive to change/motion. So just grab a tissue and very slowly bring it over them like lowering a white ceiling. All they'll see is a blanket of white with which they can't detect change/motion. They're trapped and buzzing under your tissue before they realise their predicament. Rarely does this not work. Why not try it next time and calmly let it out the window, instead of madly chasing it around the house with a swatter?
"Long before the fly leaps, its tiny brain calculates the location of the impending threat, comes up with an escape plan, and places its legs in an optimal position to hop out of the way in the opposite direction. All of this action takes place within about 100 milliseconds after the fly first spots the swatter."
If you ask me, I prefer to catch them and let them out the window. Who really wants to swat them and end up with a mess to clean up?
Yup, that's right - catch them!
I figured out the trick as a kid growing up in Sydney. Let me tell ya, there can be a lot of flies on a hot summer's day in Australia.
It turns out to be really easy! Their vision is not like human vision - its tuned to be sensitive to change/motion. So just grab a tissue and very slowly bring it over them like lowering a white ceiling. All they'll see is a blanket of white with which they can't detect change/motion. They're trapped and buzzing under your tissue before they realise their predicament. Rarely does this not work. Why not try it next time and calmly let it out the window, instead of madly chasing it around the house with a swatter?
Sometimes I like to observe society and, well, just kinda think about the human condition a bit. There's this psychological phenomenon I see now and again, which if you'll bear with me you might find equally strange. You see, it seems that practically everybody, at some stage, sees themselves as an underdog... That, by itself isn't strange, but it is interesting. It's like this weird mass delusion that seems to grip whole segments of society from time to time, and ironically enough, the rich and powerful as well.
You see, there's an appealing Romanticist element in the underdog story. I mean who wouldn't like the story of how the less powerful, courageously battles against the oppression of a dominant enemy, and then against all odds, have justice prevail and emerge triumphant? There's just something seductive about that narrative that lures people into identifying with it.
Now for the weird bit. You'd think it'd be pretty clear cut who the powerful oppressor is and who the courageous, oppressed weaker party is, right? Well, no, because both sides often believe themselves to be the oppressed victims taking a gutsy stand. The thing is, they can actually both be right....and wrong.
Let's start with one example to illustrate and then explore some more examples later. There's been a bit of a battle recently concerning Japanese whaling around Australia. It's interesting seeing the reactions and dialogue here.
From the perspective of Australians, the actions of the government, of Greenpeace, and especially of the Sea Shepherd activists, it is the story of a comparatively weak party defending whales from slaughter by battling a very rich, powerful Japan. I mean, it's obvious isn't it - especially when footage on TV shows little boats saving defenseless whales against huge ships with harpoons?
For the Japanese, it is not the Sea Shepherd, or Greenpeace or even Australian public opinion that constitutes the enemy. In their narrative, they see themselves as courageously battling the overwhelming forces of Western cultural imperialism. In this view, Australia is merely an agent of a much wider Western hegemony. They see condemnation from Western cultures as an absolutist imposition of hypocritical Western values and beliefs, and it is equally obvious to them who the weaker victim is.
What's happening is that both sides choose how they define the enemy and the agenda of the battle. Instead of an appreciation of each other's views, there is just a wide chasm of indignity.
Another danger of the underdog narrative is the temptation to excuse dirty tactics. Afterall, in an unfair battle, surely one is allowed to use anything at their disposal to level the playing field? Japan plays dirty tricks with the whaling commission and their 'scientific whaling' programme, whilst many Australians applaud the more extremist actions of the Sea Shepherd Society.
The thing is, dirty tactics by one party merely exaccerbate the underdog delusion of the other, spurring further polarisation and encouraging even more dirty tactics. Everyone feels more incensed and justified in their actions if the other party seems to be not only dominant and oppressive, but morally bankrupt.
Elsewhere, Intelligent Design advocates see themselves as under attack by a powerful scientific body. They can't get their papers published in prestigous journals, and their theories are ridiculed. They see themselves as silenced victims censored by a powerful body with government sanction, unable to educate even within their own schools. On the other end, athiests see themselves as rejected or persecuted by society at large, wrongly stereotyped as evil or amoral. They see lies being spread about evolution, and about themselves. To them, they are the heroes of truth battling an overwhelming ocean of public ignorance, superstition and intolerance.
I'd bet that even George W. Bush and his crew, who we see as being incredibly powerful, see themselves as underdogs. They not only have to battle what they see as a biased Leftist Press (except underdog Fox News), as well as a Leftist House majority, but even generals, internal government agencies, and members of their own party that disagree with them. Bush probably sees himself as trying to steer his nation through the right path to greatness, valiantly protecting it from danger against the harsh elements of the world, whilst dealing with nothing less than a mutiny. As far as he is concerned, he is both a victim of powerful conspiring forces, as well as a hero whose countless sacrifices will be appreciated many years later. Another underdog.
So the next time you hear the story of a courageous underdog and their powerful oppressor, just spare a moment and consider the flipside too. It might not be comfortable, but it may help you better see where both sides are coming from, and how they justify their actions.
P.S. If you're interested, there is a recent paper with studies concerning the 'underdog' perception as it relates to Olympic matches and the Israeli-Palestinian conflict. It's especially interesting seeing how presenting two different maps of the Israeli-Palestinian conflict changes the perception of who the underdog is. There's a publicly accessible version here including the maps and results.
You see, there's an appealing Romanticist element in the underdog story. I mean who wouldn't like the story of how the less powerful, courageously battles against the oppression of a dominant enemy, and then against all odds, have justice prevail and emerge triumphant? There's just something seductive about that narrative that lures people into identifying with it.
Now for the weird bit. You'd think it'd be pretty clear cut who the powerful oppressor is and who the courageous, oppressed weaker party is, right? Well, no, because both sides often believe themselves to be the oppressed victims taking a gutsy stand. The thing is, they can actually both be right....and wrong.
Let's start with one example to illustrate and then explore some more examples later. There's been a bit of a battle recently concerning Japanese whaling around Australia. It's interesting seeing the reactions and dialogue here.
From the perspective of Australians, the actions of the government, of Greenpeace, and especially of the Sea Shepherd activists, it is the story of a comparatively weak party defending whales from slaughter by battling a very rich, powerful Japan. I mean, it's obvious isn't it - especially when footage on TV shows little boats saving defenseless whales against huge ships with harpoons?
For the Japanese, it is not the Sea Shepherd, or Greenpeace or even Australian public opinion that constitutes the enemy. In their narrative, they see themselves as courageously battling the overwhelming forces of Western cultural imperialism. In this view, Australia is merely an agent of a much wider Western hegemony. They see condemnation from Western cultures as an absolutist imposition of hypocritical Western values and beliefs, and it is equally obvious to them who the weaker victim is.
What's happening is that both sides choose how they define the enemy and the agenda of the battle. Instead of an appreciation of each other's views, there is just a wide chasm of indignity.
Another danger of the underdog narrative is the temptation to excuse dirty tactics. Afterall, in an unfair battle, surely one is allowed to use anything at their disposal to level the playing field? Japan plays dirty tricks with the whaling commission and their 'scientific whaling' programme, whilst many Australians applaud the more extremist actions of the Sea Shepherd Society.
The thing is, dirty tactics by one party merely exaccerbate the underdog delusion of the other, spurring further polarisation and encouraging even more dirty tactics. Everyone feels more incensed and justified in their actions if the other party seems to be not only dominant and oppressive, but morally bankrupt.
Elsewhere, Intelligent Design advocates see themselves as under attack by a powerful scientific body. They can't get their papers published in prestigous journals, and their theories are ridiculed. They see themselves as silenced victims censored by a powerful body with government sanction, unable to educate even within their own schools. On the other end, athiests see themselves as rejected or persecuted by society at large, wrongly stereotyped as evil or amoral. They see lies being spread about evolution, and about themselves. To them, they are the heroes of truth battling an overwhelming ocean of public ignorance, superstition and intolerance.
I'd bet that even George W. Bush and his crew, who we see as being incredibly powerful, see themselves as underdogs. They not only have to battle what they see as a biased Leftist Press (except underdog Fox News), as well as a Leftist House majority, but even generals, internal government agencies, and members of their own party that disagree with them. Bush probably sees himself as trying to steer his nation through the right path to greatness, valiantly protecting it from danger against the harsh elements of the world, whilst dealing with nothing less than a mutiny. As far as he is concerned, he is both a victim of powerful conspiring forces, as well as a hero whose countless sacrifices will be appreciated many years later. Another underdog.
So the next time you hear the story of a courageous underdog and their powerful oppressor, just spare a moment and consider the flipside too. It might not be comfortable, but it may help you better see where both sides are coming from, and how they justify their actions.
P.S. If you're interested, there is a recent paper with studies concerning the 'underdog' perception as it relates to Olympic matches and the Israeli-Palestinian conflict. It's especially interesting seeing how presenting two different maps of the Israeli-Palestinian conflict changes the perception of who the underdog is. There's a publicly accessible version here including the maps and results.
Every year we can pack more and more data into a tiny little space. That's great news for your iPods if you want to store countless songs and movies on them.
But just how much further can we keep shrinking things? In 1959 Feynmann famously said "there's plenty of room at the bottom". The thing is, fifty years later, he's still right - and by a lot.
Okay, if you're a non-technie, then skip this paragraph for the juicy bit! Now, for techies out there - lets start with carbon and assume we can encode 1 bit for every 4 carbon atoms. At that density there's over a trillion terabytes of data in one gram. Wow. To put this into perspective, we can think about the amount of data needed to store a year of 3D video at high quality HDTV (1080p). Lets say we have 45Mbit/s for each eye, that's 90Mbit/s for stereo. Well, that's about 350 terabytes per year including when you're sleeping. If we recorded 100 years of footage, that's still only about 23 micrograms of carbon!
But just how much further can we keep shrinking things? In 1959 Feynmann famously said "there's plenty of room at the bottom". The thing is, fifty years later, he's still right - and by a lot.
Okay, if you're a non-technie, then skip this paragraph for the juicy bit! Now, for techies out there - lets start with carbon and assume we can encode 1 bit for every 4 carbon atoms. At that density there's over a trillion terabytes of data in one gram. Wow. To put this into perspective, we can think about the amount of data needed to store a year of 3D video at high quality HDTV (1080p). Lets say we have 45Mbit/s for each eye, that's 90Mbit/s for stereo. Well, that's about 350 terabytes per year including when you're sleeping. If we recorded 100 years of footage, that's still only about 23 micrograms of carbon!
Think about that for a minute - your entire life recorded in 3D High-Definition Video. That's every single thing you have ever seen or heard or said or written in your entire life, and it weighs only 23 micrograms - about the weight of a single grain of sand.
If we recorded a year of every single person on the planet, that's a population of 6.6 billion, then its still only 150g of carbon, or in rough kitchen terms - ten tablespoons of water. Just recording everyone in the US would be about 7 grams, about the same as one and a half teaspoons of water.
In a mere kg you could store six years of everyone's life on the planet, like some kind of ultimate YouTube. That's astonishing and somewhat scary all at once! Yes, there really is plenty of room at the bottom...
In 1517 Martin Luther started a revolution - challenging the pervasive authority and power of the (Catholic) Church at the time, and forever changing the landscape of Christianity. He wasn't a King or a person of any great political power, but he was a professor of theology and his pen was his weapon of choice.
Before Martin Luther, the people believed that the only salvation was through priests, many of whom were corrupt with power. At the time, priests were the guardians of 'divine power', as they were the ones able to read the New Testament in its Latin and relate it to people. When Martin Luther translated the Bible into the vernacular, he took exclusive power away from the priests and spread it out to the people. He took something inaccessible and made it easy to understand by all, and although not everyone could read, more than enough could to empower the masses. In short, the Bible was democratised.
In this information age, we are undergoing a dramatic revolution as well, and in future it will affect many areas of life where we have had to rely on our modern day 'priests'. For knowledge, by itself, is rapidly becoming cheap. If we want knowledge we can google it. It is creativity and understanding, and their ability to generate new knowledge that is valuable.
The revolution is already underway - and all those modern day 'priests' of knowledge should be aware. That certainly includes many doctors, and in particular specialists.
For the majority of what most GPs and specialists do can be described as 'knowledge experts'. They look at the symptoms, consult their internal 'database' of diagnoses, weigh up the respective probabilities and crank out the most likely explanation and solution. Are doctors then, really just glorified databases?
Well no, for there is more to being a doctor than just that. At the very least, a lot of people skills are involved that computers really don't replace - the talking and the emotional reassurances, and there's the physical examination process itself. Hopefully, the doctor also instills confidence in the patient of their competance. Nonetheless, what separates a nurse from a doctor is the gap in knowledge. In fact, I'd say nurses may tend to have better people skills than doctors do, and for common conditions, nurses could easily do just as well as doctors in diagnosis.
With the rate of publications and new results, doctors can find it very hard to keep on top of the latest developments. Even if they spent every minute studying the new results, the rate of new medical results is growing too fast to keep up, and even if they could read enough, could they really be expected to digest and remember it all? Doctors have increasingly flocked online, searching for information about less-common diseases and looking for medicines and new treatments. Of course, they often do this when their patient isn't around.
Already the balance of knowledge is shifting online, however the diagnostic process still needs human attention. With advances in Computer Vision and Machine Learning, I can see more of the traditional doctor and specialist roles moving to medical diagnostic devices. These devices will be able to visually photograph the patient's condition, instantly analyse blood or cells, and guide the user in the diagnostic process.
Should we be worried about computers and algorithms making medical diagnoses? The fact of the matter is they have already been doing so for quite some time. Algorithms are tools, and humans apply our reasoning and understanding of things to create new algorithmic tools. For a while I researched a process for narrowing thousands of genes to a handful that can diagnose a cancer. A human can't possibly be expected to think and process through all the information gathered - which is why computer tools are built to more robustly 'learn' and create diagnostics for us. As humans, we no longer directly construct a new medical diagnostic by our reasoning, we embody our reasoning processes into a computer tool that then 'builds' one for us. At the end of the day, however, there's nothing miraculous about it - they really are just tools that help us.
As more of the visual analysis and knowledge database shift to medical devices, it is the people skills and the device skills that become more and more important to the patient. These skills are considerably easier to obtain than the process of becoming a doctor or specialist, and it is this lowering of barriers that is democratisation. Just like not everyone was able to read Luther's translation, perhaps not everyone can safely use such devices at first, but they have wide access to those that can, and over time everyone may be able to use them.
Is this the end of doctors and specialists? Well no, but the skill sets will change and what they predominantly handle will change. Surgeons will probably stick around for quite a while longer, but there will be more doctors working with unusual cases, or on the frontiers of medicine, creatively researching new medicines and diagnostic tools.
Funnily enough, at a meeting discussing startups, one company candidly described their experiences trying to sell a remote medical monitoring device. Their device monitors the patient's vitals in their homes, and remotely alerts staff of problems. The initial market was remote communities where nurses have to travel very far to check up on patients. At first they had a poor reception for them - as the devices were seen to entirely replace the nurse. Indeed, they were built for just that.
What they didn't understand was who their true customer was. Doctors and nurses were the trusted medical intermediaries for patients, and it was to them that they had to sell. By redesigning the device so that it became an automated aid to nurses, but still needed the nurse, they suddenly found a very warm reception for the modified device. Nurses no longer had to travel quite as frequently to monitor their patients and they could more reliably monitor them as well. Rather than replace them, it made their job easier, and those who tried them became highly enthusiastic advocates for the technology.
There is no reason, however, for nurses to be the only ones to use such a helper device. Indeed, family members may be worried and want to make sure that their parents are okay. With trust and acceptance of such devices, they will likely be democratised further and accessible to a great many more people. This sounds great for the masses, but bad for the nurses. What one must remember is that those nurses will move up the ladder, and using other devices will do a lot of what doctors currently do, whilst doctors will move into the frontiers of medicine, and better handling of unusual cases. Far from removing responsibility from doctors and nurses, democratisation makes their new role even more fundamental.
Before Martin Luther, the people believed that the only salvation was through priests, many of whom were corrupt with power. At the time, priests were the guardians of 'divine power', as they were the ones able to read the New Testament in its Latin and relate it to people. When Martin Luther translated the Bible into the vernacular, he took exclusive power away from the priests and spread it out to the people. He took something inaccessible and made it easy to understand by all, and although not everyone could read, more than enough could to empower the masses. In short, the Bible was democratised.
In this information age, we are undergoing a dramatic revolution as well, and in future it will affect many areas of life where we have had to rely on our modern day 'priests'. For knowledge, by itself, is rapidly becoming cheap. If we want knowledge we can google it. It is creativity and understanding, and their ability to generate new knowledge that is valuable.
The revolution is already underway - and all those modern day 'priests' of knowledge should be aware. That certainly includes many doctors, and in particular specialists.
For the majority of what most GPs and specialists do can be described as 'knowledge experts'. They look at the symptoms, consult their internal 'database' of diagnoses, weigh up the respective probabilities and crank out the most likely explanation and solution. Are doctors then, really just glorified databases?
Well no, for there is more to being a doctor than just that. At the very least, a lot of people skills are involved that computers really don't replace - the talking and the emotional reassurances, and there's the physical examination process itself. Hopefully, the doctor also instills confidence in the patient of their competance. Nonetheless, what separates a nurse from a doctor is the gap in knowledge. In fact, I'd say nurses may tend to have better people skills than doctors do, and for common conditions, nurses could easily do just as well as doctors in diagnosis.
With the rate of publications and new results, doctors can find it very hard to keep on top of the latest developments. Even if they spent every minute studying the new results, the rate of new medical results is growing too fast to keep up, and even if they could read enough, could they really be expected to digest and remember it all? Doctors have increasingly flocked online, searching for information about less-common diseases and looking for medicines and new treatments. Of course, they often do this when their patient isn't around.
Already the balance of knowledge is shifting online, however the diagnostic process still needs human attention. With advances in Computer Vision and Machine Learning, I can see more of the traditional doctor and specialist roles moving to medical diagnostic devices. These devices will be able to visually photograph the patient's condition, instantly analyse blood or cells, and guide the user in the diagnostic process.
Should we be worried about computers and algorithms making medical diagnoses? The fact of the matter is they have already been doing so for quite some time. Algorithms are tools, and humans apply our reasoning and understanding of things to create new algorithmic tools. For a while I researched a process for narrowing thousands of genes to a handful that can diagnose a cancer. A human can't possibly be expected to think and process through all the information gathered - which is why computer tools are built to more robustly 'learn' and create diagnostics for us. As humans, we no longer directly construct a new medical diagnostic by our reasoning, we embody our reasoning processes into a computer tool that then 'builds' one for us. At the end of the day, however, there's nothing miraculous about it - they really are just tools that help us.
As more of the visual analysis and knowledge database shift to medical devices, it is the people skills and the device skills that become more and more important to the patient. These skills are considerably easier to obtain than the process of becoming a doctor or specialist, and it is this lowering of barriers that is democratisation. Just like not everyone was able to read Luther's translation, perhaps not everyone can safely use such devices at first, but they have wide access to those that can, and over time everyone may be able to use them.
Is this the end of doctors and specialists? Well no, but the skill sets will change and what they predominantly handle will change. Surgeons will probably stick around for quite a while longer, but there will be more doctors working with unusual cases, or on the frontiers of medicine, creatively researching new medicines and diagnostic tools.
Funnily enough, at a meeting discussing startups, one company candidly described their experiences trying to sell a remote medical monitoring device. Their device monitors the patient's vitals in their homes, and remotely alerts staff of problems. The initial market was remote communities where nurses have to travel very far to check up on patients. At first they had a poor reception for them - as the devices were seen to entirely replace the nurse. Indeed, they were built for just that.
What they didn't understand was who their true customer was. Doctors and nurses were the trusted medical intermediaries for patients, and it was to them that they had to sell. By redesigning the device so that it became an automated aid to nurses, but still needed the nurse, they suddenly found a very warm reception for the modified device. Nurses no longer had to travel quite as frequently to monitor their patients and they could more reliably monitor them as well. Rather than replace them, it made their job easier, and those who tried them became highly enthusiastic advocates for the technology.
There is no reason, however, for nurses to be the only ones to use such a helper device. Indeed, family members may be worried and want to make sure that their parents are okay. With trust and acceptance of such devices, they will likely be democratised further and accessible to a great many more people. This sounds great for the masses, but bad for the nurses. What one must remember is that those nurses will move up the ladder, and using other devices will do a lot of what doctors currently do, whilst doctors will move into the frontiers of medicine, and better handling of unusual cases. Far from removing responsibility from doctors and nurses, democratisation makes their new role even more fundamental.
You meet a lot of interesting and famous people in 'The Bubble' that is Cambridge University.
There are many Nobel Laureates around or passing through giving talks, and in the free flow of academic ideas, their filters can be off, and they really can say the darndest things.
Professor John Walker won the Nobel Prize for discovering the process of ATP synthesis in cells. ATP can be thought of as an energy currency for the machinery inside cells. He gave an interesting talk about the molecular motor he discovered that is part of the synthesis process. Yes, it spins, and this engine's power-to-weight ratio is phenomenal. Each cell in your body has an enormous number of these motors spinning around.
Afterwards, I asked a question along the lines of "given the global epidemic in obesity, what future do you see for methods or devices to artificially burn off energy". Personally, I was thinking along the lines of a patch that slowly burns a fixed number of calories by directly extracting it. I can see a number of ways to go about building such a patch.
Professor Walker surprised us all by instead suggesting the recreational drug Ecstasy (MDMA). It messes with the proton pump inside mitochondria, directly converting the energy into heat. It works so well that in high doses, ecstasy takers can die from heat-stroke complications due to overheating, but that heat is coming from burning off calories. People often drink water to 'cool down' but this is the worst thing one can do because MDMA messes with water retention and can lead to water toxicity. He suggested that people take Ecstasy and then regulate their temperature with a cold bath instead, as an effective weight-loss technique. Noting the surpised looks from the audience, he was then quick to say that, one should really try to lose weight by eating less food instead...
You have to wonder though - before it became a recreational drug, MDMA was widely prescribed by psychiatrists. In a controlled setting, with doctors and nurses carefully measuring intake and monitoring body temperature and reaction, it might very well make for a viable weight-loss clinic. Afterall, the weight-loss market is huge, with people willing to pay large sums to lose their extra pounds. Heck, you could even throw in a free glow-stick or two. :)
Mandatory Disclaimer: I'm not an expert on MDMA. I certainly don't recommend people go out and take Ecstacy to lose weight - as there may be many other side-effects to worry about. If that doesn't discourage you, and you are still inclined to try it out, please ensure you seek close medical supervision and advice.
There are many Nobel Laureates around or passing through giving talks, and in the free flow of academic ideas, their filters can be off, and they really can say the darndest things.
Professor John Walker won the Nobel Prize for discovering the process of ATP synthesis in cells. ATP can be thought of as an energy currency for the machinery inside cells. He gave an interesting talk about the molecular motor he discovered that is part of the synthesis process. Yes, it spins, and this engine's power-to-weight ratio is phenomenal. Each cell in your body has an enormous number of these motors spinning around.
Afterwards, I asked a question along the lines of "given the global epidemic in obesity, what future do you see for methods or devices to artificially burn off energy". Personally, I was thinking along the lines of a patch that slowly burns a fixed number of calories by directly extracting it. I can see a number of ways to go about building such a patch.
Professor Walker surprised us all by instead suggesting the recreational drug Ecstasy (MDMA). It messes with the proton pump inside mitochondria, directly converting the energy into heat. It works so well that in high doses, ecstasy takers can die from heat-stroke complications due to overheating, but that heat is coming from burning off calories. People often drink water to 'cool down' but this is the worst thing one can do because MDMA messes with water retention and can lead to water toxicity. He suggested that people take Ecstasy and then regulate their temperature with a cold bath instead, as an effective weight-loss technique. Noting the surpised looks from the audience, he was then quick to say that, one should really try to lose weight by eating less food instead...
You have to wonder though - before it became a recreational drug, MDMA was widely prescribed by psychiatrists. In a controlled setting, with doctors and nurses carefully measuring intake and monitoring body temperature and reaction, it might very well make for a viable weight-loss clinic. Afterall, the weight-loss market is huge, with people willing to pay large sums to lose their extra pounds. Heck, you could even throw in a free glow-stick or two. :)
Mandatory Disclaimer: I'm not an expert on MDMA. I certainly don't recommend people go out and take Ecstacy to lose weight - as there may be many other side-effects to worry about. If that doesn't discourage you, and you are still inclined to try it out, please ensure you seek close medical supervision and advice.
