DiscoverConcepts with Shawn Whatley#58 Ross Upshur: AI in Medicine, Limits of Evidence Based Medicine, & What Does It Mean to be Human?
#58 Ross Upshur: AI in Medicine, Limits of Evidence Based Medicine, & What Does It Mean to be Human?

#58 Ross Upshur: AI in Medicine, Limits of Evidence Based Medicine, & What Does It Mean to be Human?

Update: 2025-10-14
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Description

This episode is (ostensibly) about medicine, not politics.


What does human-centred care mean in a world of AI? Are doctors becoming obsolete, when it comes to decision making? When should we hand over our clinical judgement to AI?


I asked Ross Upshur for his thoughts on logical positivism. Are most doctors positivists?  


"Despite it being... as a philosophical and epistemological doctrine... been rather thoroughly discarded... a long time ago. It's the self understanding of our profession," Ross said.


Of course, ideas about what counts as knowledge are inseparable from our political assumptions. So although we do not mention politics in this episode, these ideas are core to how we approach medical 'systems', 'planning', and politics in general.


Articles:


"Three problems with big data and AI in medicine" (Chin-Yee & Upshur, 2019)


"Looking for rules in a world of exceptions: reflections on evidence-based practice" (Upshur, 2005)


Book:


How Doctors Think: Clinical Judgment and the Practice of Medicine by Kathryn Montgomery (2012) 


 


AI summary:


In this episode of Concepts with Shawn Whatley, we are joined by Dr. Ross Upshur, head of the Division of Clinical Public Health at the Dalla Lana School of Public Health, University of Toronto. With over 30 years of experience in the intersection of theory and practice in medicine, Dr. Upshur provides a comprehensive discussion on the role of AI in medicine, the limitations of evidence-based practices, and the critical importance of human judgment and patient history. We explore the impacts of AI and big data on clinical care, the pitfalls of technological dependence, and the ethical ramifications of potential AI-driven healthcare. This thought-provoking conversation dives deep into the philosophical and practical aspects of modern medical practices, providing listeners with valuable insights into the future of healthcare and what it means to retain human-centered care in an increasingly automated world.


00:00 Introduction: Can AI Replace Doctors?


00:02 The Limits of Evidence in Clinical Practice


00:41 AI and Evidence-Based Medicine


01:03 Wearables and Real-Time Data: A Misguided Direction?


01:35 The Public's Frustration and Acceptance of AI


01:44 Human-Centered AI vs. Bot Care


02:19 Welcome and Guest Introduction


02:56 The Evolution of Evidence-Based Medicine


03:53 The Gap Between Theory and Practice


05:26 Patient Stories: The Heart of Clinical Medicine


10:21 AI's Role in Future Healthcare


11:00 The Challenges of Big Data and AI


14:18 Epistemological Concerns with AI


18:38 The Human Experience vs. Quantifiable Data


25:42 Clinical Tools and Judgment


32:38 The Role of Clinical Judgment in Patient Care


33:48 Challenges with Evidence-Based Medicine


34:10 Interprofessional Model of Care


35:29 The Inferential Gap in Medical Practice


38:08 Philosophical Perspectives on Medical Practice


40:02 The Future of Clinical Judgment in the Age of AI


43:27 The Importance of Practical Wisdom in Medicine


48:09 Concerns About AI and Automation in Medicine


53:31 Final Thoughts and Reflections

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#58 Ross Upshur: AI in Medicine, Limits of Evidence Based Medicine, & What Does It Mean to be Human?

#58 Ross Upshur: AI in Medicine, Limits of Evidence Based Medicine, & What Does It Mean to be Human?

Shawn Whatley