[HN Gopher] IBM's Watson Health is sold off in parts ___________________________________________________________________ IBM's Watson Health is sold off in parts Author : alexmorley Score : 501 points Date : 2022-01-23 14:40 UTC (8 hours ago) (HTM) web link (www.statnews.com) (TXT) w3m dump (www.statnews.com) | anm89 wrote: | I don't know if I'm the only one, but I always felt like Watson | was roleplaying being a relevant tech company. Something about | the way they marketed it just seemed like it was a big PR | campaign with no meat behind it. I always had a suspicion that | most people agreed but was never really sure. | hayesall wrote: | Article is paywalled, but this story has evolved over the last | few weeks: | | - 2022-01-05: "Scoop: IBM tries to sell Watson Health again" | https://www.axios.com/ibm-tries-to-sell-watson-health-again-... | | - 2022-01-07: "IBM reportedly shopping Watson Health just as | healthcare gets hot" https://techcrunch.com/2022/01/07/ibm- | reportedly-shopping-wa... | | A lot of the hope seemed to be in document summarization from the | latest medical literature, plus integrating patient data from | electronic medical records. | | The autopsy of this could be interesting. Some of the critiques | against using electronic health records previously was that many | of them were designed for medical billing (I don't have a good | link, but Eric Topol's "Deep Medicine" has some notes on this | problem https://www.basicbooks.com/titles/eric-topol-md/deep- | medicin...). | whoopdedo wrote: | The grand demonstration of Watson playing Jeopardy ended with the | question to an answer about U.S. Cities being "What is Toronto?" | [deleted] | ogogmad wrote: | What's the chances that we'll have robotic domestic servants | before 2032? With AlphaZero, AlphaFold and sort-of OK machine | translation, I think it's 50:50, no? | Barrin92 wrote: | as in physical android ones? More like 2:98. I'd be very | astonished if we see a robot plumber by 2050. | ogogmad wrote: | Plumbing seems harder than loading and unloading a dish | washer. Or doing laundry. | BlueTemplar wrote: | But none of this matters that much for the hardest part : the | robotics of it. You probably need to instead follow what Boston | Dynamics is up to... | lettergram wrote: | There were many, myself included, who called Watson vaporware | since day one. Glad to see it go. It was almost as bad as | Theanos, frankly. | cube00 wrote: | It will be interesting to see if self driving cars and the way | they've been rushed to market with the same brute force marketing | will meet a similar fate. | mnd999 wrote: | Self driving cars are just that, marketing. Tesla for all their | hype have limited driver assist only and even Google who seem | to have the most advanced offering only works in limited areas | in good conditions and the dataset that drives it requires lots | of maintenance. The general problem is too hard, and general | practice has some of the same problems. Probably less | adversarial data, but there's still litigation to be had from | confusing an AI GP. Or narcotics. | HiJon89 wrote: | Limited driver assist? Are all the videos of people using | Tesla full self-driving on YouTube fake? | isx726552 wrote: | What videos would those be, like this one? | | https://youtu.be/uClWlVCwHsI | | Tesla's safety claims are wildly overstated, as documented | here: | | https://news.ycombinator.com/item?id=26855608 | | In aggregate, Tesla's FSD is demonstrably not up to the | task. "Limited driver assist" is a much more fair | assessment of what their software is actually capable of | than the "full self driving" branding. | [deleted] | sixQuarks wrote: | Yeah I'm shaking my head as well. | saltminer wrote: | It's unpredictable enough that it should be considered just | "limited driver assist". Only a fool would look at | https://www.youtube.com/watch?v=2ub2F-UnXIU and go "yeah, | that's _full_ self-driving, all right. " Slapping a "beta" | label on it means nothing - you could be talking about how | Gmail was in beta, or you could be talking about Fallout | 76. | | Tesla's marketing is extremely disingenuous, IMO. The name | of your product creates expectations in peoples' minds, and | sure, you can absolve yourself of liability by putting in | the fine print "this isn't anywhere close to true FSD and | your car might not be powerful enough to support it by the | time we get there, so you gotta keep your hands on the | wheel," but that doesn't make it right. | | If they called it "advanced driver assist" or something | similar, I'd be fine with it (it is more advanced than | traditional driver assistance tools like cruise control and | lane departure warnings, after all). But I doubt they could | get people to pay $10k or whatever the current price is if | they were more honest. Instead, they would prefer to earn | more money by slapping that FSD label on it and letting | people immediately turn their brains off. | enragedcacti wrote: | Tesla advertises their technology as being on the cusp of | Level 4/5 applications but legally (when defending its | actions to the California DMV) argue that it is and will | continue to be a Level 2 (i.e. limited driver assist) into | the future and that FSD beta should not fall under | regulations concerning testing of L4/L5 autonomous | vehicles. | | Perhaps most importantly, all legal responsibility falls on | the driver, regardless of the fact that the car can cause | accidents faster than a human can realistically react even | if paying perfect attention. | | https://www.jurist.org/commentary/2021/09/william-widen- | phil... | cnlwsu wrote: | Self driving cars are not made by IBM. I wouldn't consider | their utter failure at everything they touch to be a sign that | that AI field failed. | laurent92 wrote: | Yes. The IBM Rationale suite failed even though it wasn't AI. | It's the IBM way they commercialize things by going to golf | with execs which is the problem. | echopurity wrote: | jjcon wrote: | Agreed, AI is just like any software. There are good, bad, | scammy and brilliant examples of it. With AI somehow though | people like to use one bad example as a referendum on | everything. | | I think I understand why (because AI as a term is overloaded | by marketing teams), but the inclination is to paint with a | broad brush is still inaccurate here. | 8note wrote: | I expect roads to adapt to make self driving car's easier to | run over time. Both in terms of handling people, other cars, | signage, and obstructions. | xnx wrote: | Google started its self driving project 13 years ago. It | doesn't seem like they're rushing anything. | crispyambulance wrote: | I wonder where the search engine Blekko ended up? | | It was acquired by IBM for use in Watson back in 2015. Blekko was | an interesting attempt at addressing search engine problems using | a thing called "slashtags" to better categorize searches. | JCM9 wrote: | Watson was mostly data science powered consulting pretending to | have/be a product. They played heavily on the Jeopardy thing from | a marking standpoint but what they were actually trying to sell | was a hot mess. | | I do consider this a good milestone in getting past the latest | "AI" hype cycle and focusing on what actually works in that | space. Sat through too many meetings with non-technical execs | saying "what if we apply Watson here?". The likes of McKinsey | were pushing this stuff hard in what they were whispering into | executives ears. | hn_throwaway_99 wrote: | Can we post a non-paywalled version of this news? TechCrunch has | a better version of this IMO: | https://techcrunch.com/2022/01/21/francisco-partners-scoops-... | trollied wrote: | They are a nightmare. I was part of a huge project to replace a | large part of a telecom operators infrastructure. IBM global | services ran the operators IT outsourced. The project failed | after a year because of them. It was the 3rd such project to | fail. The company in question couldn't bring themselves to | realise it had been their outsourced operators fault once again. | Even though they had again lost the bid to do said work. | | PwC/Accenture were worse. Hire arts graduates because they got a | degree from a good university, chuck them on a 2 month | coding/consulting course. Happy days $$$ | ogogmad wrote: | I once went to a job interview at Accenture. I remember the | recruiter told me they only considered me because I went to a | prestigious university. When I got there, they practically IQ | tested me, were rude to me, and never contacted me again even | after they said they would. The job was to write GUIs in C#. | | Listen up Accenture, I will drink expensive champagne when you | go bust, or get bought. | 7thaccount wrote: | Not getting contacted again was probably a blessing in | disguise. They don't really do much, but kind of act like | PMs, but aren't very effective as they don't know the | business very well. I think they're generally only used when | a company temporarily needs like 20 warm bodies to assist | with a large project. | alfiedotwtf wrote: | > drink expensive champagne when you go bust | | You'll have to get in line | formeribmer wrote: | I worked at IBM Watson as one of the early engineers when they | first started commercializing the product. It was a fucking joke | - Ginni Rometty would go up on stage and said that Watson can | help diagnose cancer from CT scans and we would just look at each | other and be like "Dude, Watson is just a glorified Lucene index, | wtf is she talking about." They started selling Watson as the | end-all for everything from cancer diagnosis to customer service | chat - they even had a stupid Watson Chef thing at SXSW one year | - but none of that used the original Watson codebase - it was all | built from the ground up and lots of it was just simple logistic | regression | dllthomas wrote: | > they even had a stupid Watson chef thing at SXSW one year | | I loved Chef Watson, am sad that it's gone, and would pay a | small amount for renewed access. | | It wasn't "smart", and its recommendations needed to be | tempered with human understanding, but I wound up with some | great recipes that I wouldn't have thought of otherwise. | | I think the best was goat milk mac & cheese with radishes and | red miso. | | The funniest was when it told me to remove the connective | tissue from tofu. | mNovak wrote: | I remember reading some very amusing Chef Watson cocktail | recipes. Lots of savory concepts like putting chicken or meat | into a drink. | bilekas wrote: | Is it possible to get a non paid link ? | 0898 wrote: | Watson was sold as being able to spit out answers without you | having to think of the question. | | Could somebody more familiar with its capability reveal whether | that was at all true? | achow wrote: | Non-Paywalled | | https://www.nytimes.com/2022/01/21/business/ibm-watson-healt... | | https://archive.fo/uFNnJ | | _The business is being sold for an undisclosed price to | Francisco Partners, a private investment firm.. Watson Health was | set up as a separate business in 2015. IBM then spent more than | $4 billion to acquire companies with medical data, billing | records and diagnostic images on hundreds of millions of | patients._ | pettycashstash2 wrote: | IBM has a large consulting business. They make a lot of money on | Services. | nwsm wrote: | That business was spun off into Kyndryl. | [deleted] | kumarvvr wrote: | History will see our current decade of AI and only see over | promises and under deliveries. | | I have decent amount of hope for AI, but corporate greed, hype by | practitioners, a general explosion of various edTech companies | hyping up the hype to drive online course sales and general | excess of VC money is driving an embarrassing amount of AI | failures. | | I am sure that any fad now and in the future, will have a similar | cycle. | bpiche wrote: | Nothing to be afraid of | | https://en.wikipedia.org/wiki/AI_winter | lvl100 wrote: | The bigger and more interesting question for me right now is | who's going to be this decade's IBM? I want to say Amazon. | JohnJamesRambo wrote: | You can count on it. | | https://en.wikipedia.org/wiki/Gartner_hype_cycle | tomrod wrote: | This is wholly unsurprising. IBM's big play was to integrate data | science methods into the workflow. But they approached it from a | "we will replace your labor costs" versus "we will augment your | labor costs." Besides their AI models being fairly poor in | quality, technology doesn't replace people very well where | extrapolation is needed. So the quality of service Watson brought | was significantly lower than what these businesses offered prior | to adoption. So keeping Watson became an exercise in how well the | business understands sunk costs and switching costs. | lvl100 wrote: | This so much. They basically let Snowflake (among others) eat | their lunch. Back in 2015, IBM actually had a good chance but | leadership just dropped the ball. | 1024core wrote: | Watson was a big PR machine wrapped around a little kernel of | AI/ML. | sdenton4 wrote: | The American healthcare system is littered with the dead bodies | of both startups and large tech companies... | civilized wrote: | Who could have seen it coming? | | IBM created a machine that could win at Jeopardy, not a universal | expert or problem solver. | | Say what you want about Google, but they didn't claim to solve | any practical problems by creating AlphaZero. | ProAm wrote: | Google is the next IBM. | spookthesunset wrote: | I don't know. Does google do consulting? | | IBM is its own category of tech company really... Oracle | would fit the bill better. | derwiki wrote: | 60 years of prosperity before the wheels start coming off? | Probably | zwischenzug wrote: | Tbf IBM didn't either when deep blue beat kasparov | nwsm wrote: | Meanwhile Google is unfolding Google Health. | jonas21 wrote: | Not sure what you mean by "unfolding". But, unlike Watson, | Google Health seems to be building tools that may be useful | for healthcare providers rather than just marketing hype. | | https://www.youtube.com/watch?v=71DVIWZnOho | nickysielicki wrote: | I do not understand how IBM stays in business. | | As far as I'm concerned the only cool engineering thing IBM does | anymore is POWER, which has a sort of unique memory architecture | but otherwise is well behind everyone else. | | What else did they do in my lifetime? They took a profitable | RedHat and gutted it, they took the best Laptop line and sold it | to Lenovo and almost ruined it, they tried to be a front runner | in ML but blew their budget on marketing (remember Watson on | Jeopardy?) | | The final straw for me was watching football with a techhy friend | and a commercial for IBMs "hybrid cloud" came on. There's some | executive mulling over whether to "go to the cloud" or whether to | go with on premises, and they have a eureka moment where they | learn about IBM hybrid cloud and they go into a board meeting and | save the day. We both just burst out laughing. | | IBM doesn't make stuff anymore. That's the core problem. | zitsarethecure wrote: | > They took a profitable RedHat and gutted it, | | I know they bought Red Hat but I didn't hear that they gutted | it. Can you expand on that? | louniks wrote: | I'm a Red Hatter, and I'm not sure what they mean either. I | obviously only know my own little corner of engineering, but | I've seen no signs whatsoever of being gutted. From where I | stand, it's just a change of ownership that, at least for | now, is completely transparent on the ground. I expect the | situation to continue for as long as Red Hat keeps making | money. | frost_knight wrote: | Traveling consultant-architect for Red Hat here. | | Before IBM purchase: Travel to clients, build and/or fix | their things, suggest improvements. | | After IBM purchase: Travel to clients, build and/or fix their | things, suggest improvements. | | At least from my side of Red Hat I've experienced zero | changes in how I go about my work. In fact, my schedule is | even more packed now, we can barely keep up with the demand. | As far as I can tell IBM has left us alone to do our thing. | Maybe it's different for other departments. | dralley wrote: | They haven't. I have no doubt that IBM has historically | mishandled a great many acquisitions but thus far I haven't | seen any changes that feel pushed by IBM. | | Source: I work at Red Hat. | | It's a bit of a strange comment considering it blames IBM for | Lenovo's management of the Thinkpad line and a commercial | that they later realized (but still haven't corrected | themselves) was actually an HPE commercial [0]. | | [0] https://news.ycombinator.com/item?id=30047062 | hackerbrother wrote: | Was going to say, Red Hat seems to be doing fine/great. Very | innovative Linux company. | gigatexal wrote: | Yeah ... My thoughts exactly. | tmccrary55 wrote: | Living off those mainframe MIPS bucks... | blip54321 wrote: | I was surprised by some companies too, until I worked outside | of tech. | | The whole rest of the universe needs software too. Most | companies are grossly incompetent to develop it themselves. | Most are things that SWEs of the type which visit HN would | never, ever want to work on. IBM does that adequately well. | That's "services." | | If I need a tool built which will manage workflow at a | management consulting firm, a custom tool for managing cases at | a law firm, or some custom supply chain kludge -- the 99% of | other "boring" software -- and I happen to know nothing about | technology, who do I turn to? | | IBM isn't a bad choice. It's a major step up from Indian firms | in terms of both price and quality. It has significant in-house | technology to leverage. It's a safe choice. It will usually do | better than in-house IT. | | I recently evaluated the business of a company which builds | ships. They developed software in-house with an IT staff who | weren't qualified to tie their own shoelaces. They had huge | military contracts. They didn't subcontract to IBM, but it | wouldn't have been a bad choice. | [deleted] | Aeolun wrote: | Honestly, I'm not sure IBM is a step up from the Indian | firms. It's certainly more expensive (like, ridiculously so) | for not much more quality, if any. | treis wrote: | IBM is basically an Indian firm these days | aquaticsunset wrote: | Rational comes to mind | scrubs wrote: | Is it? Really? No. In fact it's not. Name one Indian | company that ever reached 1/10th of what ibm had so that | it's a candidate for seeing it on the way down. | | A serious insult because it'd be much more true would be | to look at it's OD, culture and demise since Gerstner. | Gerstner wasn't happy with a lot of IBM slop, paper | pushers, and corporate BS either. That'd keep it on track | rather than spurious comparisons. | | Gerstner layed of somewhere around 20% of work force, | sold off tons of ibm art, real estate etc because IBM was | lost ... And losing money. That says something. Spurious | comparisons don't. | | Labeling IBM bad because it out sources to India is a | vieled insult to indians and it's culture I guess. If | that's the position -- not mine --- have the galiteantry | and courage to just say so. | | I'm reminded of the Futurama line: do you idiots where | you're from? Nobody nowhere can say no to that. American | culture, OD, and common sense when it's not losing money, | playing golf, splashing around shareholder cash on art or | tieing up innovation in BS (all of which IBM did pre | Gerstner and was called out for) expects problems fixed, | brings out the best in all comers, and expects comers to | be value add. Thosr that cant play that game are out. | | Regrettably this has one dark corner. Management isnt so | good at overseeing itself. So in really bad situations | they are good at shifting blame. Well nobody said it'd be | easy. Let's start by not gossiping however. | vidarh wrote: | > Name one Indian company that ever reached 1/10th of | what ibm had so that it's a candidate for seeing it on | the way down. | | I'm not sure what your point is here, but based on Forbes | 2000 for 2020 via Wikipedia [1], by market cap Tata | Consultancy Services and Reliance are both _larger_ than | IBM. Both have grown faster than IBM since 2020. In terms | of companies overall a number of other Indian companies | are larger than IBM. | | If you look at infotech alone, Tata Consultancy Services | is the one bigger than IBM, and Infosys (>50% of IBM | market cap), HCL Technologies and Wipro are all larger | than 1/10th of IBM. | | [1] https://en.wikipedia.org/wiki/List_of_largest_compani | es_in_I... | relaxing wrote: | IBM itself has large divisions in Southeast Asia that | function basically the same as Indian IT firms. | masalachai wrote: | This assumes that IBM's core business is the same as | their Services business. I doubt they have any overlap. | They got onto the bandwagon after seeing how successful | some of the early Indian services companies were (in | terms of revenue) such as Infosys, Wipro, and TCS. | | I would put the IT services business of Accenture, Cap | Gemini, and IBM in the same bucket as the rest of the | Indian firms. | yardie wrote: | > IBM isn't a bad choice. It's a major step up from Indian | firms in terms of both price and quality. | | Oh, my sweet child. You might be surprised to learn that IBM | and those SWE boiler rooms like WiPro are basically the same. | shakna wrote: | Wasn't most of that spun out into Kyndryl last year? [0] | | [0] https://newsroom.ibm.com/2021-11-03-IBM-Completes-the- | Separa... | didip wrote: | > It's a major step up from Indian firms in terms of both | price and quality. | | Will it be? Don't they outsource a lot of their subcomponents | to Indian firms? | blip54321 wrote: | There is a world of difference between a US ship building | company outsourcing to India and a US tech firm | intermediating that transaction: | | - A US intermediator can know the climate in India and | navigate the cultural differences because they do this day | in day out. | | - A US tech company can properly vet whom they're | subcontracting to because they have engineers in-house | | - A US tech company will have a contract in US | jurisdiction. If there is e.g. a data leak, there is | liability through US courts. A step down from that, a US | company can have US-based oversight and escalation | mechanisms | | - Social networks and relationships matter too. If you're | working with Bob from the golf course, and his company | messes up, you'll see Bob again next month at the golf | course and chew him out. | | ... and so on. | | I'm not suggesting you or I (personally) should subcontract | through IBM, but for a US-based non-tech firm, it can make | a lot of sense. | | To flip this around, whom would you rather hire to do your | accounting (presuming you're not an accountant and know | nothing about accounting): | | - A US company which outsources to India | | - A random company in India | | I would go for the former, since I know there would be | liability if they messed up, and they'd make sure the US | tax code was properly complied with. There's nothing wrong | with the latter, but I'd have no way to vet them, and if | they messed up, no recourse. | theduder99 wrote: | https://www.zdnet.com/article/ibm-now-has-more-workers-in- | in... | ab_testing wrote: | > IBM isn't a bad choice. It's a major step up from Indian | firms in terms of both price and quality. It has significant | in-house technology to leverage. It's a safe choice. It will | usually do better than in-house IT. | | Having been there, I can say that IBM is no different than | the other Indian tech firms like Infosys, Wipro, HCL and | other. Infact, there is a rotating door of employees among | IBM and other Indian firms. | | 1. Since the last 5 years, IBM has more employees in India | than in the US or any other country [1] | | 2. Secondly IBM pays more that the Indian companies in India | to poach employees but shortchange their US counterparts. [2] | | Infact, the only difference between IBM and other firms is | that the initial sales procoess is handled by American | counterparts. Once the sales piece is done and the actual | project starts, it is replaced by the offshore team. | | [1] https://www.zdnet.com/article/ibm-now-has-more-workers- | in-in... | | [2] https://www.postbulletin.com/opinion/ibm-to-give-raises- | to-i... | MattGaiser wrote: | They will deal with all the crappy and lazy and incompetent | clients. They bid on all the government work, the bank work, | the insurance work, etc. | | The kinds of places where HN devs would say your career goes to | die, along with your soul. | | They will do the stuff the internal teams at those companies | pass on. | newaccount2021 wrote: | rwbaskette wrote: | I don't suppose you remember the "IBM OS/2 Fiesta Bowl"? | jessriedel wrote: | The number 2 experimental quantum computing group in the world | is at IBM Research. | tinyhouse wrote: | > I do not understand how IBM stays in business. | | I understand why you're saying this. I have no idea either. | However, open their 10-K and you'll find out how they make | money. In fact, while their revenue and profits are declining, | they still make more than $70B in revenue a year with a profit | of about $4-5B, so their ability to stay in business is higher | than many tech companies that are not profitable. | jiscariot wrote: | I work in a role where half of our stuff is in IBM's cloud (for | decisions made before my tenure). On a day in Mid-November, we | started receiving alerts from our UAT and PROD environments. | Logged in, all our stuff was gone. Opened a ticket and did some | digging and found in our audit logs an IBM SRE had deleted all | our stuff. They then told us there was no way to recover and | we'd have to rebuild from scratch. | | They had apparently been doing some "cleanup" and somehow our | site number got on to a list. All our servers, attached | volumes, subnets, load-balancers were deleted. | | My boss and I spent the next 30 hours applying terraform and | rebuilding anything not automated. | | Would not recommend IBM Cloud. We are moving off in next 6 | months. | JediPig wrote: | so I worked at IBM cloud, and can confirm this. They bought a | cloud service, that by itself, and if left alone would been | great. Soft(....something...) was the company... then IBM | came and changed everything. I remember the SVP / President | of ibm cloud showing up... talking 3 hours about how her son | is so great and that we should 'follow' his example... after | hour 3, man goes and interrupts and asks a question that was | "please get to the point of talking about your son". | | Few weeks later, massive layoffs, that triggered the warn | act. So now I know how IBM works, see first hand meeting, | after meeting being totally worthless. I would say stay far | away from anything the touch. Just be glad you could move off | their platform and not stuck using their platform with their | CICD ... else you would be in living hell. | dangrossman wrote: | I stopped using Softlayer after IBM took over. I still get | emails about the daily "incidents" in "IBM Cloud", as well | as monthly billing notices for my $0 bill. I don't know my | "IBM Id" or "Softlayer Id" to log in any more as it's been | almost a decade, so I can't unsubscribe from any of it. | MerelyMortal wrote: | Sounds like a violation of the U.S. CAN SPAM Act. | dangrossman wrote: | Relationship messages (like incident reports and bills) | aren't typically covered by the CAN SPAM Act, but that | law's never stopped anyone anyway. I don't have enough | fingers to count the number of daily commercial emails | from otherwise respectable US businesses that don't | include a mailing address or don't honor opt-out | requests. Cold sales mails from tech startups are a big | offender... | HollywoodZero wrote: | Isn't this the typical corporate acquisition process? | | * Bring in Deloitte, McKenzie, or other consulting group. | | * Gut the acquired company to reduce costs. | | * Fold newly acquired divisions into existing mediocre | division. | | * Service gets run into the ground without the original | people who made it great. | | * Eventually the service degrades and customers leave, | business line stops generating profits | | * Company goes through the process again. | rileyphone wrote: | Gives me the unpleasant thought of how much value is | destroyed and lost in these mindless corporate | acquisitions. Incentives are broadly misaligned with what | we should want as a society, instead investors want a | payday as well as founders, and the acquiring corporation | wants a fresh coat of paint and has access to the finance | that can make it happen and only hurts 10 years later. In | the end promising human efforts are destroyed because the | rewards for doing so are too great. | jahewson wrote: | OTOH the average startup is garbage held together with | duct tape that naturally falls apart without the founding | team who created it. By the time of acquisition it's | usually reached a point of technical debt bankruptcy. | This goes hand-in-hand with an over-heated sales team | pushing hockey-stick growth that will crash back down | when those brand-new customers churn at the next renewal | - because the product, while nice-looking, is | unmaintainable garbage. | | Nice payday for the founding team and the ticking time | bomb is paid for out of bigcorp's wallet. They go on to | great new things and the eventual demise of their garbage | pile will be blamed on bigcorp. | | Not to say that large companies don't destroy value - | they absolutely do, frequently - but that the main error | they make is not being able to appraise which startups | are smoke and mirrors and which are legit. The rest of us | are not so great at it either. | belter wrote: | After being on the inside of many of these, can confirm | 100%, this post could not be more accurate:-) | thomasahle wrote: | > This goes hand-in-hand with an over-heated sales team | pushing hockey-stick growth | | This seems like just another argument for limiting | startup acquires. Perhaps if a big exit wasn't the goal, | the company would focus on more long term viability. | | Anyway, I don't think they big companies care as much | about whether they destroy value, as long as they destroy | a potential competitor. | rtkwe wrote: | It's not just the company internally that want (needs?) | those big exits, the whole VC architecture is built | around shot gunning out money for the occasional huge pay | off. | jahewson wrote: | I see competition often being less about the startup and | more about which other competing big tech company could | buy the startup to consolidate an existing market | strategy. I'd more charitably call it "revenue | protection" to preemptively acquire them. | | Startup acquisitions, in the absence of astoundingly deep | due-diligence should probably be placed in portfolios | where a 5:1 failure rate can be tolerated. I'm not sure | how such an acquisition would be compensated. | Hokusai wrote: | I have seen that with General Electric. | | It's not easy to know when is the right time to jump your | old trusted provider. At the beginning of the acquisition | not much happens. Things degrade slowly because employees | take the burden of doing the job for two people. But | nobody can be subjected to the stress for too many years. | | Big corporations create nothing, only abuse the good | faith of employees and the cost of moving providers of | small companies. I have seen that happening in tech. When | small innovative companies grew they got enough economic | power to not have to innovate anymore. Purchase small | good companies and drain them is the new business model. | | And it's a shame, there was a time that liked IBM, and | others. | aunty_helen wrote: | I've sat in an all hands like that before. Literally 50k$ | an hour being wasted listening to some guy we'll only ever | see once talk about his sons 18th birthday. | | Weird experience. | hacknews20 wrote: | Same here- if they start talking about their kids, it's | over for someone, possibly lots of someones. | rch wrote: | Yeah, I surround myself with people who have their stuff | together but don't feel compelled to go around flexing | about it. | aunty_helen wrote: | To be fair, it was the general manager's bosses boss. No | body was surrounded by him and by the time we were due | another visit by this position, he had been promoted on. | Damogran6 wrote: | Owner of the company spent half the meeting talking about | how they take their grandkids anywhere in the world they | want to go when they turn 16...I look at the audience | paying rapt attention and I'm thinking 'this is a little | odd' | | Then he mentioned the 'merger of equals' and I thought | 'this isn't good news' | | Narrator: It wasn't. | belter wrote: | Also been on one of those. One of the employees raised | the fact salaries had been on a freeze for the last two | years. Answer from VP doing the all-hands meeting: "My | wife also wanted me to buy a new boat this year but I | could not" | | Started looking for a new job that same minute... | hogrider wrote: | It's about power, just like mandating going back to the | office. | borski wrote: | There are lots of reasons other than power to want people | on-site. This is a strawman. | [deleted] | daenney wrote: | Mandating it is a power move. You can give folks the | option to come back to the office if they so chose, and | let others work from home if they want to. | projektfu wrote: | I think it's a power move. Nobody got up and said, "Fuck | you, I have better places to be." So they win. You | probably thought it was about the business or something. | after_care wrote: | I have 100% opened up a laptop and tuned out a meeting | like that. Never go to a corporate meeting without a | laptop. | TheCraiggers wrote: | I used to do that too. Then I got accused of not being a | team player or whatever. OK, fine. | | Turns out sitting on my ass and listening to something | useless pays the same. | twexler wrote: | Softlayer is the name you're thinking of. They were pretty | decent 10 or so years ago, but never touched them after the | IBM acquisition. | mrweasel wrote: | Everyone wanted to be on Softlayer for a time. It was THE | hosting provider. I don't know if they where any good, | but the got great press coverage. | | Two years ago I had to help a customer debug some weird | nginx behaviour, resulting in their traffic spiking at | ten times the expected rate. The IBM/Softlayer VPN | required that I used Internet Explorer, but it still | failed to work. We spend three month with IBM and IBM | Cloud consultants to make it NOT work. | | IBM destroy everything it buys. They have POWER, their | mainframes and associated software left. How that keeps | them afloat is a mystery. | wrs wrote: | Softlayer had the idea of API-driven bare-metal server | hosting (as opposed to ticket-driven or phone-call- | driven) early on, which was a big differentiator for a | while. But AWS came along with an even more extreme | version of API-driven hosting and they never caught up. | | As an example, most network or server changes you made | through the API resulted in an automated email saying | your sales representative would be in touch about your | order, followed a minute later by an automated email | saying the change was done at $0 charge. | Operyl wrote: | It had really gone to crap since then, we were softlayer | customers before the acquisition and everything is beyond | brittle now. | zaidf wrote: | Softlayer was solid at providing colo and dedicated | servers. But they were never really architected with the | cloud in mind. The pivot to cloud came later on. I always | wonder why IBM didn't buy a provider like Linode. | Operyl wrote: | Likely because at the time (am unsure now) Linode did not | own any actual data centers, they were all collocated. | robk wrote: | That seems negligent enough for your company to sue them | jiscariot wrote: | We're a pretty small org, and not sure we have the | organizational heft or resources to do so. That being said, | the $1k discount they gave us for Nov based on the broken | SLA (resources down) was kind of a slap in the face. We had | our minimal core services up in 16hrs, but recorded about | 100-120 internal engineering hours for config, testing, and | other fallout +1 month. | | When we opened the initial ticket, the IBM engineer kept | saying "you should ask X why they deleted your stuff". | Eventually after attaching the LinkedIn page for the IBM | SRE in the audit logs, they realized something was screwed | up on their side. | Bombthecat wrote: | Good luck suing ibm.. | Aeolun wrote: | It may take a while, but you'll win. | throwaway98797 wrote: | pyrrhic victory is not good for business | wussboy wrote: | At what cost? | jcranmer wrote: | My guesstimate of the legal fees to try the case would be | in the region of $100k. | axiosgunnar wrote: | In civilised lands the loser has to reimburse the | winner's legal costs, so at no cost. If you don't live in | civilised lands, well you have other problems. | wussboy wrote: | Does your civilized legal system also force the | inevitable loser to front your legal fees while the case | is ongoing? Or is it possible the plaintiff with deeper | pockets can just stretch things out until the legal | system has bled you dry and you must withdraw? | jjeaff wrote: | I'm not sure that is as civilized as you think it is. | Loser pays discourages any small company or individual | from suing because the cost is too great if they lose. | axiosgunnar wrote: | But the thread here was talking about a slum dunk case of | contract breach. | kortilla wrote: | Even AWS contracts are vague enough to not make this a | slam dunk. They pretty much explicitly say if you don't | store stuff in multiple regions you are going to take | outages/data loss. | tomrod wrote: | For material breach of contract and negligence? Easy | peasy. | rkk3 wrote: | Reminds me of the IBM lawyer scene in _Halt & Catch Fire_ | shakna wrote: | For breach of contract and negligence, IBM were | successfully sued, and then banned from all future | projects, by the Queensland government in 2013. [0] Which | sets you up with a nice precedent and set of documents to | see their angle of attack. | | > IBM will not be allowed to enter any new contracts with | the State Government until it improves its governance and | contracting practices. | | With that ban _still live today_, it astonishes me that | any corporation would trust the organisation to actually | carry through with their obligations. You have to really, | really, royally screw up for a government body to | consider you anathema. | | The old adage of "No one was ever fired for hiring IBM" | is no longer true or reasonable. | | [0] https://statements.qld.gov.au/statements/72961 | acdha wrote: | > For breach of contract and negligence, IBM were | successfully sued, and then banned from all future | projects, by the Queensland government in 2013. [0] Which | sets you up with a nice precedent and set of documents to | see their angle of attack. | | I mean, yes, but also think about how long a government | can afford to have their lawyers pursue a case like that. | If you don't have those kind of resources, it's a lot | riskier. | vidarh wrote: | They also have a very significant _interest_ in pursuing | it, in that they often have to follow procurement rules | that prevent them from excluding vendors without good | reason. If you think a vendor will be a problem in the | future, getting a legal judgement in place may sometimes | be necessary to save a _lot_ of grief that a private | company can avoid by just privately and quietly | blacklisting the vendor in question. | themanmaran wrote: | > Watson on Jeopardy | | Marketing aside. Lets not forget how cool that was. It was a | great public demonstation that AI / ML is possible now. | five82 wrote: | csallen wrote: | My stepdad manages a team in IT for a very large, very slow | company in the banking/financial sector. The decisions about | what software and hosting solutions they'll use are made by | execs at the upper echelons, probably over games of golf by | people who don't know that much. They just know, "I really like | Jim over at IBM, he's got a real swagger to his step" and | "other big companies are using them" and "hell they just bought | a Super Bowl commercial." So a $2M deal gets done, and IBM | stays in business. | wussboy wrote: | I spent 10 years at a small (<80 people) CX company that was | full of intelligent, motivated employees. We were smart and | quick and lean and did very good work. But we never dragged | in big deals because no one at the company had that | swagger/access to high-levels. The scenario you describe is | dumb and ruinous and, unfortunately, true. | Bayart wrote: | I think a lot of engineers shoot themselves in the foot | looking down on social networking skill and the ability to | _speak corporate_ , as it were. | wussboy wrote: | 100% agree. I know many capable developers who will never | do anything other than close tickets because they cannot | build relationships. Some of them do not even understand | why building a relationship might be fruitful. | kitd wrote: | Big corps tend not to do deals with small corps. They don't | want the small corp to become dependent on them. Simple | contract termination becomes costly and litigious | otherwise. | | Let the big fish swim together. | sangnoir wrote: | Add counterparty risk to that too: if things go south and | Big Corp decides to sue, small corp may go bankrupt in | the process. | rdtwo wrote: | Big deals can really put a company in danger. If the | company you work with closes or cuts the deal or whatever | you could loose half your revenue. On top of that big | clients can be really needy especially dinosaurs companies | that aren't nimble. They take forever to pay, have lots of | meetings and unreasonable expectations and expect lots of | free stuff and service because they are incapable of | processing Non standard invoices due to internal politics. | It's a mixed bag to deal with the big guys | andi999 wrote: | Well, dont forget it takes 6-12 month for your company to | be registered as a suplier in the ERP. | 35fbe7d3d5b9 wrote: | I saw this play out first hand: a local digital agency | run by a friend essentially ended up "captured" by a | major player in the aerospace industry, to the point that | 65-75% of their business came from $BIGCO. They grew by | 100%+, had employees flying all over the world to set up | for trade shows, and were making money by the truckload. | | Then Covid hit, nobody wanted to fly, and $BIGCO took an | earnings haircut and decided to cut back. My friend had | to let dozens of people go. It ended up costing him his | company because he'd neglected bringing other work into | the pipeline. | rdtwo wrote: | Yep that's super dangerous especially cyclical industry | like aerospace. Plus aerospace companies are notorious | for paying late are having unreasonable demands. | | Coworker dad went from being a millionaire to living in a | truck this way too. | masalachai wrote: | While that's true, the execs who make these decisions | usually don't care about the actual implementation. Once | the deal is done, it falls on their "IT division". And | two things happen: Jim over at IBM still pampers the exec | with a dinner or two. And the exec also suspects that | some, if not most, of the problems are with his IT team. | rdtwo wrote: | Big companies have very strong anti kickback rules. You | can get around them through board level connections but | not much sort of That. Nobody Is risking 500k a year | compensation over a dinner or 2. | deagle50 wrote: | I've worked as a sales engineer/architect in teams selling to | people like your stepdad's execs for almost a decade. I can | 100% guarantee the sales reps and their leadership constantly | practice "swagger" and remind each other of its importance. | It's hilarious. | cycomanic wrote: | I think what many people don't realise is the insane amount of | research that is being done at IBM. In lots of areas, I know of | quantum computing, silicon photonics, process development for | integrated circuits, processors... They still file the most | patents per year in the world by quite a margin (9000, the only | one being remotely close is Samsung at 6000, for comparison | apple and MS have 3000) and while I am not a big fan of | patents, I do realise that one has to do significant research | for getting this amount. | | They probably could just run much of the business just on the | licencing fees they get. If you think they are not doing | anything you're likely not their target customer. | bastardoperator wrote: | Easy. Governments, emerging countries, and heavy handed | consulting. Once you're on their garbage it becomes near | impossible to leave it. | [deleted] | riddleronroof wrote: | Because people who make that fatal decision read Gartner magic | quadrants. | Joeri wrote: | A former employer tried for years to get onto the magic | quadrant, and never succeeded. Until they started paying | gartner for access to their "specialist knowledge", and | suddenly they were on the magic quadrant ... in the lower | left, with gartner pushing them to pay more to get better | access. | wussboy wrote: | As a worker drone who has spent my career in Sector 7G, I'm | continually amazed at how many business decisions seem to be | based on these "magic" quadrants. We spend 12 months building | a capable and flexible infrastructure on Product A, only to | have our management ask us why we haven't moved everything on | to Product B, which is slightly closer to the top-right | corner in the magic quadrant. | | I always answer, "Sure, we could, if you're fine with not | other progress getting made towards your business objectives | for 6 months." | bredren wrote: | Magic quadrants are not kidding around. | | I set up briefings to Gartner Analysts seeking to get our | consultancy on a quad early in the mobile era. | | One of them was on the earliest examples of hybrid HTML / | native views in iOS. One of our engineers was implementing | them in the Apple Store app. | | IIRC, Gartner was not ready to split out boutique mobile dev | but getting an earworm into an analyst with influence over a | quad is still valuable. | | I presume there is chatter on potential forming of quads | before they make print. | | Working these executive-influential information sources, and | our firm continuing to land major app dev contracts led to an | acquisition by Deloitte Digital. | rbobby wrote: | Hmm... maybe the magic in magic quadrants is in how they | attract the sorts of people that will act on the information | conveyed by the grid. Way better than an Ouija board for IT | recommendations. Ouija is very hit and miss, really depends | on what spirit you get connected with. Magic quadrants just | work. | | /lol | beckingz wrote: | They just work if you dont' care about money. | Sharlin wrote: | I don't think "doing cool engineering" has anywhere _near_ as | much to do with staying in business than you think it does. And | IBM of all tech companies is the one that always was more about | suits and sales than technology. | bproven wrote: | you just need to think of IBM as a service and consultancy | company - because that is what they are (and have been for | quite a while). | 300bps wrote: | They're a public company. Here's how they make money: | | https://www.ibm.com/investor/att/pdf/IBM-2Q-Earnings-Press-R... | stefan_ wrote: | That's a joke. If you read that drivel prepared for the stock | market, you would come away thinking IBM is the biggest Cloud | operator in the world. In reality of course they have just | rebranded all kind of cash flow streams as "cloud" - because | they know "cloud" will make the stock go up whereas | "mainframe" makes it go down. | rbanffy wrote: | They also provide mainframe-based Linux VMs for clients | that require the encryption technology built into those | machines. If you need to give certain assurances by law or | contract, they may be a good option. Apart from that, if | you need on-demand VMs for IBM i or AIX, they are one of | your only options. | thallium205 wrote: | Although small in comparison, they also bought weather | underground for a cool billion or so and completely ran it into | the ground. | duck_bacon wrote: | I was part of that acquisition. To be fair, Weather Channel | was already running Weather Underground into the ground when | they acquired it first. IBM just came in and helped them | finished the job. | | A huge part of it was the incompetence with which IBM pushed | us to use Watson modules in our products, which I could see 6 | years ago were worse than open source AI options and had no | application to Weather Underground's services. They were | basically toy projects being advertised as ground-breaking | AI. I'm not surprised at all to see Watson finally collapsing | under the weight of its vacuous claims. | sandworm101 wrote: | >> They were basically toy projects being advertised as | ground-breaking AI. | | They were media events that lead to powerful media events, | which in turn lead to investors pumping money into the | stock price. Shareholder value is the only real profit. | Watson being on Jeopardy no doubt garnered investment | dollars from thousands of wealthy retirees. Those toy | projects earned their keep many times over. | raincom wrote: | This is a great insight. Even if execs know $x billions | will be wasted on such trendy projects (toy projects to | those who know what's going on), they will still go and | spend $x billions. Why? Since it keeps the market cap | going up. This positive delta in the market cap is almost | 10 times more than $x billions. | lotsofpulp wrote: | Not for IBM. | | https://www.macrotrends.net/stocks/charts/IBM/ibm/market- | cap | | It is even worse than it looks considering the | opportunity cost of not sticking the money in basically | risk free and cost free SP500 ETFs. Even Warren Buffett | took a huge bath on IBM. | KKKKkkkk1 wrote: | > They were media events that lead to powerful media | events, which in turn lead to investors pumping money | into the stock price. | | That can't be the reason. Over the last 5 years, IBM | underperformed the S&P 500 by 16%/year. | deebosong wrote: | I don't mean to inject cryptocurrency cynicism & NFT | skepticism into this discussion about IBM Watson... | | But as someone who doesn't know the tech, but worked in | the media side as a vendor at the tail end making | marketing materials for IBM during their "Internet of | Things" craze, I couldn't help but feel, as a laymen, so | excited at what IoT (and other crazy developments like | Watson) could be, because apparently IBM at the time was | hitting up a buncha different vendors and just blanketing | a certain sector of the marketing industry with jobs. Any | colleagues I talked to were on some IBM marketing job or | another. | | Fast forward to about 7 years later, and I still have no | clue what IoT is or does, but I sure saw a buncha | marketing material flood mainstream media for a minute, | with IBM saying it'd be revolutionary! | | Just makes me think about web3/ crypto/ NFT's, how it's | coming down hard with media campaigns, claims, yada yada. | Definitely seems about hype & optics, just like IBM in | their IoT media carpet bombing era. | davidgerard wrote: | IBM's Blockchain division was merged into the Watson | division, so it's more on-topic than you might have | thought. Put all the vapor together! | spookthesunset wrote: | They completely destroyed the iPhone app. It's been, what, | more than a year at least and the new version's hourly | forecast still shows the beginning of the day (1am) even if | you look at it at 7pm. So many things about that app that | made it great got ripped out. | | A shame... | ravedave5 wrote: | I used to use it as my sole source until the site became so | slow that I couldnt handle it anymore. | keewee7 wrote: | They do "boring" IT like making ticketing systems for the | railways and metros. | acomjean wrote: | I worked breifly at IBM research last century. The spent a lot | of money on research (6 Billion). software, chip design and | algorithms and a lot of just basic research. | | But when I left to go back to school "global services" a | business to business consulting division was the big up and | coming division. It seems that division is where IBM decided to | go. Honestly they'll just sell to some big businesses so likely | you'll never hear about what they're doing. | | I'll agree they seem to have lost their way. Its a shame | really. They did some good things: I remember a lot of the | engineers there would travel to schools and promote engineering | careers. | Spooky23 wrote: | They have since pivoted again. IGS was just spun out into a | new company whose name is gibberish. Lol. | ferdowsi wrote: | They coast on enterprise lock-in while pretending they are | innovative by shoveling money into non-useful blockchain | projects. | spookthesunset wrote: | Remember when they were all in on Second Life? They had some | virtual town hall or something and there were flying penises | everywhere? | | Those were the days... | bobbob1921 wrote: | And MARKETING, ofcourse. | chefandy wrote: | > I do not understand how IBM stays in business. | | I don't think they do either, judging by my experience working | there as an upper-level-support technician 15 years ago. | | It seemed like the organization was book-ended with decent | brains: engineers and front-line managers were decent to | fantastic, and the upper-management seemed to be decent at the | time. However, both ends seemed to be choking to death on a | hundred layers of middle management. 7 years after Office Space | was released and I actually had three(3) managers. Three! I had | a technical manager with whom I had bi-weekly meetings where we | talked about nothing, a non-technical manager with whom I had | monthly meetings where we talked about nothing, and the head of | my department who was the only one who meaningfully managed me | in any way. (And he was absolutely fantastic.) | | For example-- they made some big announcements about their | impending migration from windows to linux for everybody from | admin assistants to sales to developers. Exciting! I loved that | linux was getting more professional credibility, and my product | ran on Solaris, so having a local UNIX environment would reduce | some of the cognitive load for networking, scripting, etc. etc. | There was no internal mandate to start the migration yet, but I | was too eager to wait. I found the official image on the | intranet and started writing documentation for my coworkers. It | was pretty smooth! The complex GUI apps like the Lotus suite | worked great! Well, as great as they did on windows, anyway. | The installer was quite polished! I was excited! | | I had one more thing to install-- the ancient, internal defect | and ticket tracking clients used by every technical worker, | product designer, all of their managers, etc. Neither the | intranet page for the clients nor the Linux image docs had any | info. Hours later, I found a months-old internal note EoLing | the Linux port, directing people to use the obtuse CLI instead. | No problem-- we're all technical people here, right? Problem. | The API used by the GUI client supported necessary | functionality the CLI didn't. That alone rendered the Linux | initiative dead-in-the-water for most technical workers who'd | benefit most. | | I'm sure the manager who canned the Linux client was solving a | very real problem, but a) a decision directly affecting | company-wide strategy getting lost in the ether, and b) nobody | checking to see if these big overtures were even basically | feasible, embodies their organizational shortcomings. (I might | have gotten some of the details wrong-- it was a long time | ago-- but you get the gist.) | | That's almost certainly why they're getting sued for | purportedly blatant age discrimination, too. Managers in the | middle with too much sway to have that little top-level | visibility solving their problems using means that end up | screwing lots of people. | | That they style themselves as a technology-focused business | consulting company rather than just a tech company is pretty | rich. | agumonkey wrote: | IBM is old, it's good and bad (probably not the first time they | made bad decisions). Let's see if they can wash off the last | decade or two that were full of mistakes. | | They still do stuff but it's hard research and niche so | business wise it won't make them short term success. You | mention power but they also have a good hand in Quantum | Computing. | davidgerard wrote: | > Quantum Computing | | which may take over the world, but is presently at the stage | "call me when it can reliably factor 35" | permalac wrote: | IBM has acceptable tape systems. Would be nice if they did not | keep changing tape buffer sizes/times and other conditions | without properly advertising the changes, but LTO is bad at | scale so they have that going for them. | jeremyjh wrote: | I think they still make a lot of money from their legacy | business, z/OS & mainframes, DB/2 etc still run basically all | large banks, insurance companies and many other types of | businesses. IBM can charge whatever they want for the hardware | and services to support these things because their customers | have no alternative. So they have just been farming this for | decades, and can afford not to succeed at anything else (so | they don't). | lokar wrote: | They also run th backed for major airline booking systems, | and charge outrageous amounts. | sofixa wrote: | The biggest airline booking system, Amadeus, can actually | run on Kubernetes and some airlines are migrating to it. | | Fun fact: a few years back Amadeus employees were in the | top 15 of k8s contributors by company. | rbanffy wrote: | I'd love to see their architecture. Do they publish much? | ed25519FUUU wrote: | Is airline booking software very complex? I don't see why | that software would necessitate the updating of k8s. | raverbashing wrote: | > Is airline booking software very complex? | | If this is surprising to you, you have no idea. | | It's a 24/7 business as a start. Multiple flights, | multiple fares, multiple ways of booking a flight, | airline agreements, etc | relaxing wrote: | Yes, it is. Read up on the history of SABRE and you'll | get pretty much the entire history of digital computing, | post-UNIVAC, in the process. | mbreese wrote: | I'm not sure about the architecture, but airline booking | is very complex. You basically need to support a | traveling salesman algorithm. It's also one of the | original use cases for large scale computers. The Sabre | airline booking program dates back to the 60's so it's | also very legacy. The Arstechnica article (below) has a | good history of the original military program and how it | helped to spin out airline booking. | | Modernization for these systems was probably long | overdue. | | https://www.ibm.com/ibm/history/ibm100/us/en/icons/sabre/ | | https://arstechnica.com/science/2022/01/the-most- | important-c... | lokar wrote: | I recall talking to people who worked at a company that | competed w/ Sabere/IBM | | There was a project they did not want to do. To avoid | saying "no" and risking the relationship they quoted what | they thought was an outrageous price, expecting to loose. | The customer said yes. They had underestimated how much | IBM had been gouging them for so long. | spookthesunset wrote: | Every single airline they ingest probably has a phone | book sized list of special cases and edge conditions that | are distinct and unique. Multiply that by every airline | on the platform and every consumer of the dataset and | yeah... it's incredibly complex. | | Not to mention the uptime requirements and other SLAs in | place (which probably are all different for each contract | they sign)... yup. It's probably a monster. | virtue3 wrote: | It's kind of similar in some ways to the traveling | salesman problem. Which is not considered np-hard. | | "How do you get to tokyo from paris", the cheapest, the | shortest time, the least layovers, add a stop in X, etc. | Not that easy. | | Then you have to remember all the stuff under the hood | like how are you caching all that information, how do you | actually register the sales of all those tickets. Are | they in your flight alliance? Are they goign through your | regional airline systems too? | | I would never want to touch that stuff. Way too hard. Way | too many legacy systems powering it too, probably. | | See also: https://franz.com/success/customer_apps/data_mi | ning/itastory... | | Which is now owened by google and probably powering | google flights lol | HollywoodZero wrote: | Just like Oracle. | | No one talks about Oracle. But they're still around. We did a | major tech project to migrate off of Oracle after an | acquisition of a large org that was running it. | | It was a year-long effort to migrate. But it was worth it | since Oracle renewal costs were going to be nearly 50% of our | IT budget. | threeseed wrote: | a) Oracle is proven at scale. | | b) Large global talent pool of Oracle experts. | | c) First-class professional support. | | Not everyone is looking to innovate on their database. Many | just want something that is reliable and easily supported. | jeltz wrote: | Oracle is also arcane, buggy and poorly documented (the | buggy really surprised me when I first started using it). | And there are much less resources online compared to the | other big databases. | pmlnr wrote: | >c) First-class professional support | | Ah, this was a sarcastic comment! It was, right? | dean177 wrote: | This is hilarious. | narrator wrote: | I did a similar year long migration off Oracle. What helped | were all the automated integration tests that had been | built previously. It made it so much easier to verify that | everything would work after the migration. | tormeh wrote: | Afaik they're a consultancy now. That means all their other | activities are more or less just lead generation | gitfan86 wrote: | They also do a lot of reselling. They will pitch some sort of | cyber security upgrade to their client and after the client | signs they will ask Akamai to onboard that client | mathattack wrote: | They are in the audit business. Large companies have pockets | where outsourced engineering teams have installed or forgotten | to delete their outmoded software. They send in an audit team, | and come up with a massive payment due. Then they negotiate | with their "customers" to have them buy new software for | approximately half the cost of audit payment. IBM gets new | revenue (and new products to audit) and companies pat | themselves on the back for averting disaster. And the new | software never gets used. | colonwqbang wrote: | Do you have a link to the commercial? | nickysielicki wrote: | Yikes, I misremembered, it's a Hewlett-Packard commercial. | | https://youtu.be/0EL3ZkcMNS4 | | This commercial still makes me laugh. The way she finishes | his sentence with "our digital transformation" is the kicker. | jjnoakes wrote: | It'd be nice if you edited your post with the correction. | asveikau wrote: | There's still a phenomenon in advertising where it | increases your awareness of a category, but you don't | correctly ascribe it to the correct advertiser in that | category. So funnily enough, I could still see someone | going to IBM based on this ad. | axiosgunnar wrote: | Or when Microsoft spent millions on giving NFL reporters | tablets while in air, only for the reporters to refer to | the tablets as ,,iPads"? :D | rbanffy wrote: | HPE is kind of even more baffling. They make generic | servers while, at least, IBM can sell you a brand new POWER | 10 (running AIX, Linux or IBM i) or a mainframe. A new | generation of mainframes is due this year and the crazy | cache architectures they have shown last year is quite | unique. | HollywoodZero wrote: | I love these commercials that at the end everyone is | sitting at their desks with their suit jackets still on. | Who does this? | pfraze wrote: | That line really is the kicker. I compulsively muttered | "god damnit" when I heard it. | ThinkBeat wrote: | They make awesome mainframes. | | Extremely reliable, and extremely good at what they do. They | sure are expensive. | | A lot more companies should adopt them. | | Yet its going the way. | | They run at scale at a lot of companies. | | AS/400 / iSeries was awesome at least in the beginning. | | I think it may be discontinued now. | | Those machines were extremely reliable and well made. | | Often companies who had bought one had no idea where it was. | Someone had set it up for them 7 years ago and after that | nobody paid attention. | | Some places were better and did proper backups. Which means | stuff the right tape of a rotation into the slot. | | They would also call home to tell IBM of a proper that is | developing and they would send a tech out to switch the parts | prior to anyone using it had any problem. | | (and that is when the machines were sometimes hard to find. One | was buried in a closet, with tons of paper cases, paper | archives. stack buttom up to the floor. | Karunamon wrote: | I wish there was a way to learn mainframes that were | accessible to mere mortals. Some toying around with a (almost | certainly illicit) emulated copy of z/OS revealed an | extremely complex, no doubt powerful, but entirely alien | system that I'd have loved to get my head around, but alas, I | could find no good resources. | relaxing wrote: | Hiding that knowledge behind expensive certifications is | part of the business proposition. | streetcat1 wrote: | You should read more about the history of IBM. | | IBM is a sale driven organization. I.e. sale first - tech | after. so it cannot be judged as an high tech company, I.e. on | the tech. | | A point of reference is SUN - which was tech first - sale | after. | | Another point of reference is HP. HP was tech first, but turned | into sales first. | vishnugupta wrote: | Last I heard they were dabbling in Blockchain. Atleast they | were publicly making noise about it. | NikolaeVarius wrote: | https://www.ibm.com/blogs/blockchain/2021/05/why-digital- | hea... | | NYC Covid pass was build on blockchain. Such a goddamn | pointless waste of time | jiscariot wrote: | Marketed as Blockchain with Watson(TM) most likely. | ta988 wrote: | Same salesman, same lobbying, same results. | reidjs wrote: | They have a product called Hyperledger Fabric that is | marketed as an enterprise-scale permissioned-blockchain. I've | tried to get it working before with some free credits and | couldn't figure it out. | ta988 wrote: | Oh my, I saw a presentation of that. Dabbling is not even the | word. | absoluteharam wrote: | Most big tech companies got out of or significantly scaled | back their blockchain business, it is solution chasing a | problem. The web3 people apparently haven't caught on yet | | https://petri.com/blockchain-bust-microsoft-joins-ibm- | with-b... | Jansen312 wrote: | I think secretly they are aiming for the digital currency | aspect of blockchain, e.g. Bitcoin but couldn't understand | how it works as MBA schools havn't mint out bitcoin | graduates yet. Maybe in abother 10 years. | wussboy wrote: | > MBA schools havn't mint out bitcoin graduates yet | | Genius! | samarama wrote: | The problem is infinitely printable FIAT, controlled by | corrupt and incompetent politicians that is very slow and | very expensive to to transact overseas and mutable. | | The solution is 100x faster, cheaper, more secure, | immutable, less prone to fraud and limited in supply. | | It's a very simple calculation. | dymk wrote: | > less prone to fraud | | whut | californical wrote: | Those are problems in theory, but I don't think most | people are concerned or affected by them. I'm certainly | not. | | I never need to transfer money quickly between accounts | -- it's never once been a problem to wait a couple days. | And sure there are real economic problems with printing | money, but again, the government does a decent enough job | at keeping the dollar stable that it doesn't affect me. | | And there's the fact that the US gov has tons of power to | maintain the validity of the fiat dollar through | legislation, and as a backup they have the use of force | through police and jail (in the case of tax evasion, or | avoiding the laws). Then there are international | alliances, and there's the largest military in the world | also with a strong interest in maintaining the dollar's | value. | | So I'm not worried about the value of the US dollar in | the long term -- at least I certainly trust it more than | a purely technical solution with none of the US Gov | benefits. | | Faster: I don't have any problem with speed of USD | transactions. In fact, most transactions are faster than | crypto via credit cards or cash. | | Cheaper: there are $0 transaction fees for cash, and low | fees for credit. | | Secure: US laws do a decent enough job | | Fraud: crypto exchanges get hacked and there is often no | recourse -- if my credit card is stolen, there are laws | that protect me | | Limited supply: by definition, that makes the currency | deflationary, which is horrible for a growing economy. | And it's obvious in bitcoin. Nobody spends money today if | it'll be worth more tomorrow -- that's why everyone just | buys and holds bitcoin as an investment, not uses it as a | currency | Edman274 wrote: | I thought shilling operations don't operate on Sundays. | Do they not give you the day off? | amelius wrote: | How does any IT person stay in business if they do not create | cool stuff? | | There's your answer. | Tade0 wrote: | > I do not understand how IBM stays in business. | | They make money on those who have more than they know what to | do with. | | Case in point: I spent six months in a project, which at its | peak had about forty people working on it. Eventually it was | scrapped and replaced with a solution from IBM, which in turn | ended up... not being used at all. | | Overall it was a hilarious waste of everyone's time, but | somehow that was okay. | twistedpair wrote: | Similar. Worked on a project where there were 50+ contractors | to automate simple biz workflows. Run that for a few years @ | their rates and you'll see how much enterprises spend on | relatively simple software projects. | seanp2k2 wrote: | I'm guessing that governments are keeping them afloat, | especially on long-term contracts and with bespoke projects. | throwaway4good wrote: | They have a very big consultancy business. Probably has a much | better brand name than say Tata consulting. Plus their products | like db2, websphere or openshift have thousands of businesses | locked in. | tsywke44 wrote: | The tech sector prints money. Large companies can leech off | past heroics built by former employees for decades, even if the | current employees are incompetent. A zombie company if you | will. | ibmfud wrote: | IBM identified back in the 70s their core asset and were very | explicit about what it was. "No one gets fired for buying IBM." | Their key strategy since then has been to monetize this asset | in a variety of creative, and mainly very effective ways. | | Thinkpads were a great example of this. Laptops which promised | decent quality and support for a high price. When the laptop | market was demystified and commodified, IBM correctly got out | of it - for a decent price. | | If some random start-up, or even Google, had built Watson, it | would have correctly been seen as a gimmick. Instead it sold | literally billions of software consulting to people who thought | they needed AI but actually just needed a search box with | dynamic autosuggestion. Would you rather get some junior guy to | hack something together using open source tools, or would you | rather pay IBM 50 times as much? If you chose the former, | you're simply not in the target market. | | The hybrid cloud is exactly the same game - as is made quite | clear in that ad, it's pitched at middle management who don't | want to look like chumps for ignoring the cloud, but don't want | to fuck up by moving to it. | | Reputation is a difficult asset to monetize - effectively you | make money from it by degrading and then destroying it. After | all, if you carry living up to your good reputation, you're not | extracting any advantage from it. IBM can't sell their | reputation or their name to the highest bidder. All they can do | is keep trawling for business lines where it gives them a | comparative advantage. | | It's easy to see this as unscrupulous - but their customers | genuinely do get a benefit from the confidence they have in | IBM. | hintymad wrote: | Another insult to the injury: they were doing e-commerce with | WebSphere Commerce series as early as 1998, yet they could not | even go beyond the limited presentation-controller-db tiered | architecture, and could never imagine something like shopify. | dvh wrote: | IBM is current record holder for largest number factored of | quantum computer using Shor's algorithm: 21. And in 2019 they | almost succeeded for 35. | czbond wrote: | What was the deal with this? Was it that the internal management | team just mis-managed the product they had? | max_ wrote: | On a long enough time horizon, everyone's survival rate goes to | zero. | | [0]: [Why Cities Keep on Growing, Corporations Always Die, and | Life Gets Faster] https://www.youtube.com/watch?v=jOnWowd-7HQ | lotsofpulp wrote: | It was just IBM throwing stuff at the wall to try and keep up | with big tech companies. They have been in decline for a long | time, and I assume this marketing stunt did not fool anyone | actually involved in the businesses of healthcare or tech. | DebtDeflation wrote: | It wasn't a product. It was a business unit created by the | acquisition of (at least) 4 separate companies that had wildly | disparate products, data sets, and consulting teams. The only | thing they had in common was the focus on healthcare (and even | that could mean anything vaguely related to providers, payers, | or life sciences). "Watson" in general evolved into little more | than a branding that was applied to anything remotely related | to AI, analytics, or data management. | fault1 wrote: | It kind of sounds like a cautionary tale for other tech | companies wading into the health space or medicine (e.g, | calico, deepmind). | raverbashing wrote: | "billed as a revolution in medicine" by whom? IBM's marketing | department? | | Anything "Watson" (together with 95% of that company - | optimistically) is marred too deep in bureaucracy and yes men to | do anything productive and innovative. | RotaryTelephone wrote: | Heh, imagine a comma "and yes, men, to do anything productive" | m2f2 wrote: | Better still, no comma and no space. | ezconnect wrote: | ramphastidae wrote: | I imagine IBM quantum computing will go to same route. IBM has | become a husk of its former self -- mostly marketing, and | generally 5-10 years behind the cutting edge. | cantrememberpw8 wrote: | I'm excited by this. | | I recently left Red Hat for greener pastures. From where I sat, | IBM was slowly turning toward wisdom again, having been run | aground by its previous few CEOs. I was skeptical when IBM bought | Red Hat, but after several years of not screwing it up, I'm | pretty hopeful. Now, Krishna is working on streamlining the | business and making the rest of IBM more like Red Hat. Splitting | off the low performing Kyndryl, and selling Watson, are part of | this by cutting obsolete sectors; focusing on getting Red Hat the | resources it needs to rapidly accelerate, and on building the | talent pool by hiring more junior engineers, are the positive | changes working to turn IBM back into a powerhouse. | kumarvvr wrote: | Curious, what does RedHat actually do ? | cantrememberpw8 wrote: | Red Hat is the premier organization doing open source | development. They optimize the experiences for enterprises: | lots of support and a goal of helping it be easy to use so | enterprises can focus on their business logic. | | Lots of well-hated projects come from Red Hat: systemd, | wayland, ... but they have also contributed well to some | other projects which are much less controversial. | leokennis wrote: | They make sure enterprises can run Linux that doesn't | "suddenly" (read: with less than 2-3 years notice) break | their critical workflows because some component loses support | or some dependency reaches EOL - they do this by extended | maintenance, backporting (security) patches to old versions, | providing tailored support etc. | | This is very valuable to enterprises and so they pay a lot | for it. | | For example, you can still run Red Hat 6 safely and securely | until 2024; by that point Red Hat 8 will have been out for 5 | years already. | staz wrote: | To save you a web search : Red Hat 6 was relased 6 November | 2010. Roughly 1 year after Window 7, which ended support 2 | weeks ago. | KindOne wrote: | Windows 7 went EOL in on Jan 14, 2020. | | Are you talking about the Extended Security Update? That | ends Jan 10, 2023. | | https://docs.microsoft.com/en- | us/lifecycle/products/windows-... | ako wrote: | Services/products of a company usually bring one of the | following to customers: 1) improve revenue, 2) lower costs or | 3) manage risks. RedHat is probably mostly about the last | one, manage the risks of running linux. | haltingproblem wrote: | Often I see projects like Watson, Libra, Wave... which makes a | very insistent voice say, the chance of this being real is really | really small. This is completely anti-thetical to agile. | | What is the chance that this makes it through the gauntlet of | product-market fit in-spite of the massive marketing dollars | behind it and actually becomes a useful thriving product? | | I wish there was some way to _short_ individual product or | initiatives at tech companies. Perhaps it could create a feedback | loop of sorts and actually be useful rather than just being a | ego-validation mechanism for the shorters. | mromanuk wrote: | There should be a way to bet (short) against "projects" or | products, not the whole company. When they hyped about Watson | Health, I "knew" it will fail. | cuteboy19 wrote: | Sometimes companies use their failed or loss making products to | help promote their successful products. YouTube is a prime | example | frosted-flakes wrote: | What failed/loss-making products is Google using to promote | YouTube? | donkarma wrote: | you think YouTube is profitable? | colinmhayes wrote: | Yes, I think youtube is making billions of dollars a | year. Youtube's revenue was $25 billion last year. It's a | mature product. You don't think it's making money? | baobabKoodaa wrote: | Revenue is not profit. | mardifoufs wrote: | Google still doesn't release the profit figures for | youtube, only revenue. Even the revenue figure was a | secret until 2--3 years ago, so it was probably not that | high. If youtube was very profitable, I'm not sure why | Google would hide it in its earnings since they almost | always try to show how they aren't exclusively dependent | on their search ad business. I'm not saying youtube does | not make any profit at this point, but if it wasn't tiny | there's no reason for them not to talk about it. | brendoelfrendo wrote: | I mean, the opposite is also true, isn't it? If Google's | search ad revenue was going down while YouTube ad revenue | was going up, I feel like Google would want to keep that | a secret so that people don't realize that search ads are | shrinking in relevance. | | Basically, I don't see that Google has any incentive to | break out its profits by line of business unless someone | forces them to. They're better off if you just look at a | black box of ad revenue and say "yeah it's all | profitable, so ads are as strong as ever." | emilsedgh wrote: | Being profitable is only one angle though. Youtube is the | biggest media network right now. I wouldn't be surprised | if it beats Spotify as a music streaming service and a | host of other unrelated sectors as well. | mromanuk wrote: | That's true. Definitively this was on the plus side for IBM | PR and Marketing. | politician wrote: | Prediction markets are one of those things that | cryptocurrencies are good for. | todd8 wrote: | Why? | politician wrote: | Good question. Prediction markets [1] allow people to bet | on outcomes and benefit financially if they are correct. | | However, many jurisdictions ban them outright claiming that | they a form of gambling and challenging the unregulated | nature of questions leading to misaligned incentives ("When | will that building burn down?"). | | Yet despite these issues, the scheme can offer a neutral | ground for betting against overhyped technologies or | registering dissent against the policies of authoritarian | regimes. | | Cryptocurrency based prediction markets further protect the | participants by masking or hiding their identities. | | The combination of these features makes prediction markets | an effective way to deliver global-scale censorship- | resistant voting to the masses. | | [1] https://en.m.wikipedia.org/wiki/Prediction_market | listenallyall wrote: | So all you're saying is that cryptocurrencies can be | deployed to facilitate illegal behavior. We've known that | for quite a while. | cuteboy19 wrote: | Neutral ground is useless if the blockchain doesn't have | an oracle to know what happens in the real world. | | The blockchain only knows about things on the blockchain | itself. So someone has to do the actual data entry into | the blockchain, and that person is the weakest link in | any 'prediction' scheme. | projektfu wrote: | I'll give a different answer, which is that a blockchain- | based prediction market can be used as an oracle for other | blockchain-based contracts. So there can be both a final | answer and a mark to market for the contract which should | approximate reality in some way. However, being | unregulated, there's always the possibility of cornering | the prediction market and causing the derivative contracts | to end with unreality. So you may need another kind of | oracle to finalize the market price of the prediction | market. | | Probably could be accomplished without crypto, but it can | also be accomplished on some blockchains with minimal | additional investment. | phphphphp wrote: | being cynical is easy because most things fail, the challenge | is in identifying winners early or identifying losers after | they've had some measure of success. | draw_down wrote: | hindsightbias wrote: | Watson Health and Watson are not synonymous. Who gets to use the | name, idk, but there are a hundred Watsony things in consulting. | nickdothutton wrote: | Watson is a great example of what happens when your marketing is | better than your product, or to be more accurate technology | toolkit. | | IBM will probably send RH the same way as they sent Softlayer. | user3939382 wrote: | I could be mistaken because it's been a while, but I read that | Watson's diagnostic capabilities turned out to be mostly | marketing and that eventually IBM ended up hiring teams of | doctors to process the diagnosis requests that were coming into | Watson. | MattGaiser wrote: | > that eventually IBM ended up hiring teams of doctors to | process the diagnosis requests that were coming into Watson. | | Sounds like another health care company where the exec just got | convicted. | gexla wrote: | So, they invented a Mechanical Turk? | ta988 wrote: | One that lost games yes. | absoluteharam wrote: | Watson became a marketing term after the company spent hundreds | of millions to brand Watson to be synonymous with AI. The term | Watson then got appended to existing businesses as it allowed | them all to benefit from the brand equity and Watson ads. This | unfortunately happened even if there wasn't any AI | capabilities, so it eventually backfired. | | Watson Health seems to have been focused on selling the | narrative of AI in healthcare, even though the technology | wasn't there. | | The divestiture is only for IP also, and it seems most people | in the group will be laid off. | deelowe wrote: | As someone with no inside knowledge, it seemed to me that | watson started as a technology (or maybe solution/set of | solutions) and as time went on, it was pivoted to be a brand? | Hard to tell for sure with how difficult it is to get IBM to | answer questions about what they actually do... | HumanReadable wrote: | Worked for IBM for three years, this is accurate. To solve | some clients problem we would build an ML solution from | scratch just like everyone else, and then try to shoehorn | some Watson service into it so we could use the Watson | Brand to distinguish our product. | | The solutions we built were generally pretty good and our | clients were happy, but the Watson part was never anything | more than marketing, | [deleted] | pram wrote: | Sounds like what happened at Theranos! I read the analysis | Watson was generating was ultimately just ignored by doctors | because it came to inaccurate conclusions, so that makes sense. | sixdimensional wrote: | I personally feel Watson was an extremely clever marketing | boondoggle. If you think of it, machine learning, neural | networks and AI were just making a return into the public mind | around the time they announced Watson. | | I think somebody thought if they "humanized" AI by making it | seem like it was a character, it would make AI seem all that | much more closer to the dream. | | On the face of it, not a horrible idea, but applied to what was | essentially a bunch of separate algorithms.. pretty misleading, | but that's just an opinion. | cgearhart wrote: | Worth noting that Jeopardy Watson had very little ML and | absolutely no deep learning (it was a few years pre-AlexNet). | I don't even think it used any neural networks; certainly not | in any major way because they're not a major topic anywhere | in the press releases, working group notes, or the papers | published by the Watson research group. Watson was an | incredibly complex mixture of bespoke implementations of | "classical" AI and NLP techniques to handle questions of | different classes by transforming them into search & | information retrieval problems. They were able to make it | work pretty well for the very limited domain of questions | that arise in Jeopardy, but it was also obviously a Herculean | task to generalize that approach. I can totally believe that | as executives started to grok what Watson really was they | realized that it had more value as a brand than as a | technology. | kgin wrote: | This has real shades of Theranos | perardi wrote: | I worked for one of the companies that IBM acquired to make this | non-product. | | https://www.reuters.com/article/us-merge-healthcare-m-a-ibm/... | | I have no idea what they got for the money they spent. Merge | Healthcare was the most miserable work experience I have ever | had. They had patents, I guess, but the actual technology was | garbage. And the owner was...a piece of work, let's say that. | | https://www.npr.org/2018/12/12/675961765/tribune-tronc-and-b... | jackcosgrove wrote: | > Merge Healthcare was the most miserable work experience I | have ever had. | | Was it the orange ties? | perardi wrote: | Ha, in a way. | | Because they were indicative of Ferro's "leadership": flashy | branding gimmicks, with nothing to back them up. | | Like when he bought an orange Tesla roadster to bring to | trade shows. He'd just pop an orange car in the middle of the | booth. What's that got to do with health care? I dunno. | | _(And this was all a while ago, but this job just always | stuck in my craw, because it made "Silicon Valley" feel like | an understated documentary and not a parody.)_ | lvl100 wrote: | Healthcare IT is all garbage. It's as if the people who | invested in the space specifically did not want any of the | inefficiencies to go away. | goodluckchuck wrote: | The inefficiencies are where all the money is made. After | all, patients don't pay and they certainly don't pay for | results. | | Patients may pay for insurance, and buy the right to not | worry. Insurance delivers peace of mind by with appointments, | papers, and pills. Look at all the bureaucracy and money, it | must be fancy and effective. In the course of producing these | papers are human doctors, nurses, coders, etc. They sometimes | feel a sense of human decency and help people pro bono. | morpheuskafka wrote: | As someone doing a CS degree now, I seem to be the only one who | doesn't want to have anything on my resume to do with "AI", | blockchain, ML, NFT, chatbots, etc... all I see is overhyped | product after product, one-size-fits all solutions that frustrate | customers and create problems for humans to clean up, hugely | valued companies that have very little real improvement over | conventional technology, etc. | | An "AI chatbot" is far inferior to a real user interface. A real | user interface allows discoverability (looking through menus to | notice functions that may be useful later), experimentation, and | puts the user in control of the program. | | For example, my bank apparently only supports viewing the reason | for card declines through the chatbot--something I never knew, | because I took the time to go through the menus when I first got | the app and learn what functions existed. | kkjjkgjjgg wrote: | Searching movies to watch with Alexa works better than with the | clumsy TV keyboard. I think for some applications or some | people chatbots may be better than traditional UIs. Also they | should be getting better over time. | fsloth wrote: | Most solutions to real-world problems offer tons of deliciously | complicated CS issues to chew through. | | Just find problems to solve that are interesting _to you_ , | hype is irrelevant in finding a worthwhile thing to do (i.e. | that a thing is hyped does not make it worse than something | else - it does not make it better, either, though). | alar44 wrote: | You're missing the trees for the forest. I'm implementing a | slack chatbot right now for our customer service team. Our | customers ask for updates on jobs and these simple questions | clog up the pipes for people who actually need to talk to a | real person. It's likely going to reduce the number of CS reps | we need by half. Figuring out whether a customer needs to be | put in the phone queue or not is the perfect job for a chatbot | AI. Maybe you should like, learn about CS and get some real | world experience before you toss out edgy takes on things you | literally know nothing about. | jonas21 wrote: | Since you're still a student, I feel like maybe I can offer | some advice: | | First, I think you're getting the wrong lesson from this. The | key takeaway is stay to away from IBM. Almost everyone in the | field has known that Watson is a bunch of marketing hype since | day one. It's no surprise that Watson Health didn't work out. | That doesn't mean that everything is overhyped, and it's | important to develop a good sense for what is and what isn't | when deciding where to work. | | Second, every technology looks stupid when it's new. Airplanes, | computers, the Internet, mobile phones -- they all had | drawbacks that made them vastly inferior to the alternatives | for most tasks for the first years/decades of their existence. | It takes a lot of iteration and improvement to make something | that's useful for everyone. Chatbots will probably get there | some day - but it will take some big improvements in NLP. | Perhaps this is the time to be working on them since we have a | good idea of what we'd like them to do, and we just need to | solve the challenges to get there. | | Finally, realize that you're not the typical user. I doubt if | very many people take the time to go through the menus like you | did. | wsmhy2011 wrote: | completely agree | opportune wrote: | If you want to do something less buzzwordy with lots of real- | life applications, look into distributed systems. Try running | an Apache big data project yourself and write some | programs/queries for it, try making a change to the project to | do something cool. My suggestion to check out an Apache big | data project is just that it gives you a good place to learn, | not so you can be a "hadoop specialist" or anything like that. | | There is way more real world usage of the distributed systems | concepts and skills you'd learn there (especially in large tech | companies) than any other flavor of the month. While ML is also | commonly used in the industry, the signal:noise is really bad, | because a lot of its uses are superfluous buzzword-driven | development. However, many many companies rely on distributed | systems to be able to operate at scale. | lifewallet_dev wrote: | Oh, so don't do current buzzwords but past ones like Big Data | are okay. | | And if you wanna learn about distributed systems nothing | better than Bitcoin or any cryptocurrency based on a P2P | protocol. | lcw wrote: | I agree that they are novel and interesting to learn, but | practically speaking, the person's point, is they are over | hyped, and honestly since most use cases popping up aren't | decentralized or are decentralized, but being regulated by | a centralized party, like a government, it seems that they | are the most inefficient way to run a distributed system. | opportune wrote: | Big data tools are just one example of distributed systems. | I suggested looking into them because there are a lot of | open source ones you can play with, not because I think big | data isn't a buzzword (though Spark is definitely used a | lot in industry). | | Crypto is of course a distributed system too (at least, | many are) but in practice it's a bit different than | anything you'd see in industry because it's trustless. | rlayton2 wrote: | Absolutely. I often joke that my work as a data scientist is | mostly creating bar graphs for people. The actual analysis is | often reasonably simple, its the aggregating of the data that | is hard (its messy, its not all in the one spot and there is | lots of it). | | So start with querying your big data to say what the top | three event types are. Then slowly crank up the analysis | complexity, but not too much. The data engineering has lots | of scope for real solid and obvious applications. | tyre wrote: | A few reasons for this: | | + People care about what other people are talking about. They | like to fit in, like they're part of the cutting-edge. | | + Less experienced people have less...experience with the | downsides of what they're reading about. | | + CS is no longer mostly people who care about computer | science, in the same way that economics isn't only for people | who want the understand economics. Tech salaries -- especially | engineers' -- are super high, like investment bankers. So | people study the respective fields as a means to an end. | | + Twitter is driven by VCs, tech press, and people marketing | themselves. They're work themselves into circular frenzies all | the time. Little of it matters. Almost none of them have any | record of predicting what's next and a long, long record of | being wrong. This is true of most people! But these are the | spaces many people look to to see what is "wanted". | | You seem to have good instincts. Don't be distracted by peers | who work at "hot" startups or big named companies. Find | something you believe should actually exist in the world and | work on that. It will give you an intrinsic reward that money | can't buy and status can't fill. | ravi-delia wrote: | > CS is no longer mostly people who care about computer | science, in the same way that economics isn't only for people | who want the understand economics. | | That's the main reason I decided against a CS major even | though I love the subject. It's just disheartening listening | to discount business majors butcher even simple technical | topics. The pure math track actually has more than a few | people in the same situation, so I wound up meeting some | enthusiasts anyway. | cinntaile wrote: | It's all about incentives. | | Joining the hypetrain is a great way to get a bigger budget to | play with. | | AI chatbots are all about saving money and hiding the real | customer service as much as possible, it's not about creating a | nice experience. | lifewallet_dev wrote: | Sorry but you're wrong, all those buzzwords have their merit | and there are real impressive and innovative companies or | projects built on those hypes, not all is "worthless" or a | "scam". Don't let your ignorance blur your mind, learn about | them, use them, have your own ideas cause this post sounds like | you've been reading way too much HN. | edgyquant wrote: | The only reason I care to have to AI or blockchain on my resume | is because both are interesting to work with. | cuteboy19 wrote: | A chatbot should be a search engine in disguise, with more | focus on context. Anything else is a downgrade from a normal | web interface | jollybean wrote: | John Kelly on Charlie Rose, 2016 worth a gander [1] | | [1] https://charlierose.com/videos/29530 | captainmuon wrote: | I think "Watson" was never a thing (a technology or a product). | Rather it was a marketing term. "Watson" meant any solution or | research project that was developed by IBM and had remotely to do | with AI. | | A bit like "Active*" or "NET" back in the day for Microsoft. | Forge36 wrote: | Capitalize on the "machine learning" hype with a unique name | sold as a developed product? | seibelj wrote: | A friend of mine wanted to show off his Tesla by making it come | to the front of the restaurant from where he parked it. Like he | hit a button and it was to drive up. It got stuck somehow and was | diagonal in the row. He was like "ehh sometimes it doesn't work." | | AI in general is very over stated. When it works it's great, when | it doesn't (which is often) then you lose all trust in it. | hiptobecubic wrote: | I think that's the wrong conclusion from this story. The | conclusion I draw is that some companies (and Tesla in | particular) don't appreciate the "last mile" when trying to | apply AI breakthroughs to consumer products. | | "The plane lands safely 99% of the time" is an impressive | demonstration and a completely worthless product, but if that's | all you have then what can you do other than launch it? | microtherion wrote: | That's NOT a product you should be launching with planes and | cars, considering what would be happening the other 1% of the | time. | deltaonefour wrote: | Except all self driving AI companies have failed to achieve | reliable AI. | | Every single one. | | So it says something about AI more than companies. | sputr wrote: | >that GPs in particular would be replaced by a lower-cost Watson | descendant | | Everybody is trying to replace GPs (and even specialists) with | AI. | | But I've experienced a massive issue in healthcare that does not | need an AI, just a good database. I was prescribed intensive | imunorepresive therapy... and they forgot to put me on | preventative antibiotics. | | If there was a very simple IF on my prescription (if Medrol > | 16mg && TimeOnMedrol > 3 months { checkIfOnAntibiotics() } ) I | would not have almost died with a PCP pneumonia. | | Engineers always focus on the interesting technical innovation. | But we have so much low-hanging fruit still to do, that just | needs to use our existing technical abilities in really, really | boring ways. | sedachv wrote: | > If there was a very simple IF on my prescription | | This was supposed to be solved by rule-based/expert systems in | the 1980s AI bubble. | rvense wrote: | The technology they sent on Jeopard answered a question, I think, | that was looking for the name of a specific king of Egypt with | "What are trousers?". | | Seems pretty obvious that anything that would do that is not | human-like intelligence, and probably the search results should | be taken with a handful of salt even if they stuck some | impressive natural language generation after it. | [deleted] | newsbinator wrote: | I'm okay with this: humans likely make hilariously bad guesses | about things that are obvious and easily accessible to | machines, and therefore the reverse is also true. | | Guessing "what are trousers" for king of Egypt isn't in itself | an indicator the whole Watson system is flawed. Although you're | right: it's an indicator the intelligence is non human-like. | | Just like, from Watson's perspective, a human named John making | hilariously bad guesses related to coin flips isn't in itself | an indicator that John isn't intelligent either. | | Just that there are some categories of knowledge or application | of that knowledge that some systems are bad at handling. | akira2501 wrote: | Humans understand the value of saying "I don't know" then | their internally measured probability of accuracy is very | low. | | AIs don't seem to have that "gate," and to a human, it does | make them appear to be very 'foolish' machines. | oneoff786 wrote: | AI do have measures of confidence. It's just most use cases | have them throw out a guess anyway. | ravi-delia wrote: | That's really a choice. I mean most machine learning models | wind up outputting a confidence distribution over possible | outputs, so it's up to the user to decide how to extract an | answer from that. They can and do have low confidence when | they aren't sure. | rvense wrote: | > I'm okay with this: humans likely make hilariously bad | guesses about things that are obvious and easily accessible | to machines, and therefore the reverse is also true. | | Yes, it's almost perfectly dual: the things we do easily, | without thinking, are hard for machines. Many things that we | can only do with years of training, machines do effortlessly. | | I think technology like Watson has a bright future when | applied in the right way, but I think it's counter-productive | to wrap it in anthropomorphic marketing, and especially to | give it these direct natural language interfaces. Because | that makes people misunderstand what it is. | avrionov wrote: | Many people shame the startups for fake it until you make it, but | IBM with Watson and Watson Health did exactly that for years and | 'serious' analysts were predicting how their healthcare AI | efforts will increase their revenue. | | Compare their results with Tesla. | [deleted] | tekstar wrote: | I worked for a large e-commerce company. I wanted to investigate | putting all our support data into Watson and see what sort of | recommendations it could provide, maybe a sort of auto-suggestion | to help our customers. Three really funny points stand out from | the experience: | | 1) To apply for Watson access you needed to show C-level | approval, so our CEO put his name and phone number on the | application (trying Watson was somewhat his idea). A few months | later, an IBM marketing team called HIS CELL and asked for ME. | Imagine how it felt to have the CEO walk up to me, deadpan hand | me his personal iphone and say "It's for you.".. | | 2) They told me they'd help me with the support data idea, and | every meeting we set up they tried to pitch "what if we put | Watson on all of your customer's storefronts, we could add a | 'powered by watson' banner on every page, and you give us a cut | of GMV?". I pivoted them to our plugin framework and told them to | build it themselves. | | 3) To demo the technology, the first step was to buy a $250k | server from IBM. To demo it. | | Big LOLs all around, never trust big blue. | PragmaticPulp wrote: | Everything about this sounds like they hired inexperienced | sales people and promised them huge payouts if they could close | certain deals. The kinds of sales people who won't hesitate to | burn a lot of customer relationships to the ground as long as | they could close a few big deals for themselves. | tekstar wrote: | That's what it felt like, yeah. Also that the tech wasn't | able to prove itself so they kept it behind a curtain. | | Multiple times they'd book a technical meeting to get us on- | boarded and when I got on the call it was all sales people | trying. | Traster wrote: | >1) To apply for Watson access you needed to show C-level | approval, so our CEO put his name and phone number on the | application (trying Watson was somewhat his idea). A few months | later, an IBM marketing team called HIS CELL and asked for ME. | Imagine how it felt to have the CEO walk up to me, deadpan hand | me his personal iphone and say "It's for you.".. | | This sounds like the biggest power move you could ever pull. | lifewallet_dev wrote: | Wow, I can't believe how accurate this story is, same thing | happened to me I think summer 2016 but I thought it was because | our execs were idiots not that IBM would treat every company | like that... CTO calling me to his office to talk to IBM on | their personal phone, he was the only one who wanted Watson | (this was a healthcare company, I was VP of Eng). And yes, they | were obsessed with putting their logo everywhere, and as soon | as we heard it was so expensive, we had to tell our CTO to | chill, we stopped, cause you know you can hire at least 2 devs | for that money. | mrtksn wrote: | The company I worked for used some Oracle tech and I was trying | to get some high level information about a product but their | website kept requesting my e-mail just to show me some | documentation. | | Once I provided them with my e-mail, I started receiving "You | must take us to your leader" messages in a tone as if I was | their employee and they were commanding me to take them to my | CEO. I can't imagine myself chasing the CEO in the building | because some sales people in Oracle told me to do so :) | | To be fair, after being in meetings with theirs sales | engineers(who wore the best shirts I've ever seen) a few times | I grew to respect their stubbornness and the way they | structured their corporate machine. It's a valuable lesson to | have an exposure to corporate dealings I believe, before that I | used to do freelance stuff and had no idea how a simple webpage | can cost millions and why a large corporation won't buy that | easily from a small company with similar or better product at | the fraction of the cost. | sjg007 wrote: | What are these shirts? I must know! | mrtksn wrote: | I don't know but my manager was a non-technical guy with | passion for fashion and even his shirts weren't as nice! | digisign wrote: | Unfortunately, still don't know what you're talking | about. Probably because I don't have expertise in the | area. Am imaging some kind of white-collar business shirt | that's... platinum plated? If the design is not | extravagant, how would anyone know? | sgt101 wrote: | These are the best ones I've ever worn : | https://turnbullandasser.co.uk/products/white-west- | indian-se... | Daneel_ wrote: | For the price you'd want them to be. | akudha wrote: | 640$, lol | | My entire wardrobe costs less than that, and no, I am not | lying. | | It must be nice to have enough money to spend on such | luxury. Is it really _that much_ better than a $10 | t-shirt? | mrtksn wrote: | Nothing exotic but extremely good quality and attention | to details that you can recognise from distance. No | button looks off the shelf, no detail is cheap out. The | cut matches the body perfectly and elegantly and the | designer and manufacturer definitely went the extra mile | even if it wasn't the easiest or cheapest thing to do. | Maybe cutting in straight lines would be the easiest way | to do it but if the design requires a slight curve, they | wouldn't shy away from it. The more you look at it the | more details you notice that someone must have agonised | over it even if it wouldn't make any functional | difference. Just because it's not visible all the time, | doesn't mean that can't have a nice design, for example | inside the collar has also a seperate design. | | I think @sgt101 is onto something. | blastonico wrote: | > You must take us to your leader. | | LOL, it sounds like General Zod in Superman II (1981). You | should have asked if they want you to kneel before them as | well. | mrtksn wrote: | It was both funny and scary as if I was reached by | demanding aliens who were watching me :) | | I didn't know what to do, so I simply start marking it as | spam and moved on. I guess they had a sales pitch based on | the stuff I looked at. | aenis wrote: | Funny, similar thing happened to me. | | IBM along a few other behemots pitched for a serious project | at a company I worked for as enterprise arch. All companies | brought their top salespeople, and all tried nasty things, | but IBM was _by far_ the worst. Their top guy started their | pitch by saying he chatted with our CEO over the christmas | holidays. He mentioned - and I am not making this up - that | he should be talking to people higher in the org. (The most | junior person in the room was me, the rest were board-2 | /-3s). It soon emerged their thing could not work, and I | killed it in the first round of pitching. What followed was | my bosses' boss, the CIO of a very large company, called me | and gave me an earfull since he himself has to explain to CEO | why we had the audacity to not choose IBM. | | I'd not touch anything IBM ever. Bunch of assholes. | sgt101 wrote: | Yup - I had the same "your guy is a problem, he's anti- | innovation." The brilliant thing was that they rang the CEO | of the business unit who was at that time +4 on me and had | never met me. He was flummoxed and invited me for lunch to | find out how I'd made such a big impression! Did me loads | of good! | elygre wrote: | It sure sounds like IBM were bad. But it sounds like your | company was even worse, the way your bosses' boss behaved. | jdkee wrote: | "Nobody ever got fired for buying IBM" was the common | phrase at our company in the 1990s. At the time, that was | certainly true. Which lead to adoption of truly awful tech, | token-ring over type-1 cable, versus ethernet over twisted | pair. | wildzzz wrote: | It's because they want to talk to the most power in the | decision but with the least information as to how the | problem could be solved without the help of | Oracle/IBM/whoever. | ethbr0 wrote: | This, 100%. Think about it another way: IBM et al. sales | only _lose_ by talking to lower-title folks. | | Best case, they lose control of the narrative as it's | reported up internally, and someone higher up still has | to approve it. | | Worst case, some engineer who actually knows their shit | very quickly outlines why this can never work for the | given problem. | | Once you're into the VP level, there's (usually) less | technical knowledge, because folks at that level have | full days crammed with higher-level decisions. So it's | more plausible for sales to pitch {insert whatever | buzzwordy, batshit crazy idea} and have it fly. | pettycashstash2 wrote: | I was involved in a small project, and we were running low | on the money runway for next phase. The IBM sales guy | literally barged into a FORTUNE 50 CIOs office, without an | appointment, asking for budget to be approved for the next | phase. project continued, but I never saw the sales guy | again. The team had a good chuckle and I never understood | what the guy was thinking he would achieve with this | tactic. | afandian wrote: | Stories like this about IBM were handed down to me by my | father. They've been doing this a long time! | raverbashing wrote: | A little psychological manipulation and marketing gimmicks | (including overdressed people and marketing directed to CXOs) | goes a long way. | prepend wrote: | My first Oracle experience was similar. Back in the 90s, I | was tasked with replacing our old mssql6.5 generic custom | built rack log server with something stronger as the product | was successful and we had money. | | Oracle put me in touch with their eval solutions people who | took all my info on number of users, transactions, size, etc | and came back with an estimate of a $2M Sun+Oracle box. I | told them that the current solution ran on like $10k of | licenses and hardware and they revised the spec down to | $250k. | | They were totally clueless but projected absolute competence. | pettycashstash2 wrote: | It used to be you can't get fired for hiring big blue. In the | end it was always a lot of sales /pre sales folks, and a lot of | substandard subcontractors milking the golden cow. I don't miss | managing their implementations/deliveries at all. | lvl100 wrote: | This reminded me of my experience with them a few years back | with MQTT. They were pushing their Bluemix/cloud hard and I | just wanted to test it out. Never again. | stathibus wrote: | IBM is famous for charging people for the privilege of talking | to them, even if you're trying to sell them something. | | This strategy makes sense if you consider that even in it's | heyday Watson was 95% data science consulting firm and 5% | actual valuable technology. | | I really think Watson is one of the biggest tech marketing | bamboozles of the 21st century. Through Jeopardy they really | had a segment of the business world and the general public | convinced that they had cracked AI, but behind the scenes it | was all one-off custom solutions under one trademark. | dpflan wrote: | Deep Blue preceded this. They had specialty equipment for | crunching chess moves. Really excellent hype machine. | | I liked the documentary about it: | https://m.imdb.com/title/tt0379296/ | indigodaddy wrote: | Was Deep Blue/Watson basically the starting point of AI/ML, | or had that already been happening earlier or concurrently? | umanwizard wrote: | Deep Blue and Watson aren't the same thing. Deep Blue was | a chess computer from the 90s -- and it was not the first | chess computer, so regardless of whether you consider | computer chess to be part of AI, the answer is no. | Kye wrote: | It's a shame we never got a cross of Deep Blue and Battle | Chess. Make those chess masters fight for their lives. | Guest42 wrote: | To me it seemed like those products were the start of the | hype train, however, I believe the algos trace their | roots to the 1960s although someone with more knowledge | or time to research can refine this comment. | cuteboy19 wrote: | Deep Blue isn't ML at all, it's just a purpose built | system for solving chess. It doesn't learn anything as | such and just a fancy brute forcing machine that | (smartly) goes through all possible chess moves and | selects the best possible tree of outcomes. The work on | actual ML happened independently of this. | alar44 wrote: | I don't see the problem here, that was literally the point. | To build a chess computer. | civilized wrote: | That was the last time IBM was cool. | | That and it was cool when Watson won at Jeopardy. | qaq wrote: | Kindah like Palantir | jelling wrote: | Ehh...I get why tech people are suspect of Palantir but | they're just disrupting other government contractors. | | And from my limited experience working with the government, | they absolutely need / want / rely on having companies hold | their hand as they insist on doing things the hard, slow, | and very custom way. | tsss wrote: | It doesn't take much to disrupt a fax machine. | edgyquant wrote: | Doesn't this apply to most startups though? The core | technical problems aren't "hard" it's that the industry | involve can't adapt due to inertia of entrenched | companies. | humaniania wrote: | Because of Thiel's lack of ethics and his support for the | political far right? | legerdemain wrote: | Disrupting? Their stock price has dropped by two thirds | from its peak. They're probably looking to find a buyer | at this point, such as IBM itself, while the leadership | uses them as a stock-printing machine to enrich | themselves. | Traster wrote: | To be honest, my experience of private enterprise is that | they insist on doing things hard, slow and very custom. | Almost every problem that exists is distinct enough that | you can argue it doesn't fit the existing COTS software. | It's sometimes necesary to build something yourself, but | no where near as often as it is done. | [deleted] | dr_dshiv wrote: | Can you expand? | fourthark wrote: | It's promoted as a complete system, but you end up paying | them to build out the system to do whatever you wanted to | do. | marsRoverDev wrote: | Yeah, that is patently untrue. | dr_dshiv wrote: | Right, AI is just custom software, with people in the | back to deal with edge cases? | Daneel_ wrote: | It's IF statements all the way down, baby. | goatherders wrote: | IBM, Oracle, Panatir....in a lot of cases these are pro | services companies that custom build whatever is needed. | LOTS of money in enterprise application development. | NicoJuicy wrote: | Oracle is a expensive and "popular" database, IBM does | many things ( eg. Quantum computers, ... ) | | Palantir is a consultancy body shop with a dashboard | product and a probably good pipeline for merging data. ( | Reference - https://news.ycombinator.com/item?id=11646587 | ) | | Pure consultancy is rated much lower ( eg. Thoughtworks | if you want a reference) | ethbr0 wrote: | Consultancy + adaptable software is a decent business | model. Unfortunately "adaptable software" for {insert | industry} is a _really_ hard target to architect right. | | Especially when the majority of your tech headcount bills | by the hour and gets paid to tell the customer "Yes." | pmorici wrote: | They are just a contracting company making money off | billing the government hourly for their employees time. | It's a horrible business. | civilized wrote: | Sounds like an awesome business if you're getting the | money. | NicoJuicy wrote: | Many people think palantir cracked AI. | | While they are just using tensorflow and other things | like anyone else. | | Additionally, large tech can't apply for defense | contracts because of internal ethical concerns of | employees. So the naritive remains. | chelical wrote: | Who thinks that? I've never heard this. People thought | Watson was a lot more capable than it actually was just | because of the Jeopardy PR stunt. People outside tech | were buzzing about IBM and Watson. In my experience, | people outside tech barely know Palantir exists. | NicoJuicy wrote: | A lot of retailers buying their stocks and blindly | following people like Cathy Woods and random YouTubers. | | Not me, but i see some guys trying to spread that | naritive. | teawrecks wrote: | To be fair, paying them for the privilege to sell them | something makes more sense than the inverse. | WrtCdEvrydy wrote: | > an IBM marketing team called HIS CELL and asked for ME. | | What the fuck is this? A name/email for your company when | trying something out is so that you can keep track of any | support requests we need, not for you to sell shit to me. | throwaheyy wrote: | Yeah, the whole culture there (and other places like Oracle) | is all about implanting mindshare at the decision-maker level | and driving unilateral adoption from the top down. Pursuing | such an approach is highly revealing because if the | technology _actually worked_ , that approach would not be | necessary. | | Once they're "in" at the decision-maker level, they can | continue to milk the organisation with long-duration support | and consulting contracts, feeding parasitically and gradually | becoming more and more entangled. | | One spectacular example, 7M budget but in actuality, 1.2B | down the drain and nothing to show for it | https://blog.beyondsoftware.com/the-queensland-health- | payrol... | spikej wrote: | Add this one to the list: | https://en.wikipedia.org/wiki/Phoenix_pay_system | pram wrote: | Oh yeah I worked on a similar project at Oracle. The sales | people basically sold the state on a 'stack' with a bunch | of random horseshit that was magically supposed to work | together and then dumped it on engineering. I mean that in | a totally serious way, sales seemingly just grabbed a bunch | of names of Oracle software and mashed it together. It | literally never worked at any point. | | Then Oracle sued THEM about it, lmao. | | https://en.wikipedia.org/wiki/Cover_Oregon | fphhotchips wrote: | > Pursuing such an approach is highly revealing because if | the technology actually worked, that approach would not be | necessary. | | This is, sadly, untrue. Enterprise reps do this because on | the whole, it doesn't matter if you have the best | technology - if the other guy is successful at the CxO | level, the customer will go their way. | throwaheyy wrote: | Correct - not saying that the best technology assures | success, but that without working tech, marketing to the | CxO level is the sole viable option. | rubyfan wrote: | In my experience this seems to be a theme with very senior | executives - they are very often interested in snake oil and | can't seem to discern snake oil from real medicine. | daniel-thompson wrote: | This is kind of funny to see after reading the Tech Review's | piece on Watson Health from 4 years ago (https://www.technologyre | view.com/2017/06/27/4462/a-reality-c...). They were wrong on the | outcome but right on the diagnosis - that the marketing got way | ahead of the engineering. | throwawayay02 wrote: | To the surprise of no one who ever paid attention. | sys_64738 wrote: | It might be successful if not lumbered with a dinosaur such as | the IBM tag around its neck. Nobody I know looks to IBM for | anything nowadays. | umangkeshri wrote: | back in 2016 I joined my first company as Fresher and was excited | to work in the use case of Ml and was given my first project for | making chat bots using IBM Watson Conversation :P I think that is | the worst project i have done in my life till now. | saxonww wrote: | I really expected that we'd see a change in my lifetime, that GPs | in particular would be replaced by a lower-cost Watson | descendant, with there being some other role for patient | interaction, wet work, and data entry (perhaps just nurses). | | My mom worked for a GP for about 20 years, and it seemed to me | that most of what made that guy a doctor was bedside manner + | being able to remember a lot of things. But GPs often make | astounding amounts of money while leaning heavily on their staff | to actually handle patients and keep the business running. I | thought it could help drugs get a little cheaper too, because | there wouldn't be any point in the pharma companies sending out | salespeople to do lunch seminars to convince the GPs to prescribe | this or that drug (this still happens). | | Maybe this will still happen, but it doesn't seem imminent | anymore. | diognesofsinope wrote: | American Medical Association (and other medical/pharma/health | workers associations) > IBM | jakey_bakey wrote: | The hard part is knowing what things you need to remember | wiz21c wrote: | > bedside manner + being able to remember a lot of things | | My impression is that accompanying a patient is super | important, it helps to understand illness, to have a plan in | case of more complex treatments, etc. | | Then my doctor has the ability to know me and gauge my health. | She's also very good at probabilities and detecting when | something really goes wrong. | | I'm sure that being able to do that require a lot more than | numbers. | | (I'm studying data sciences, I trust them, but my guts tell me | that diagnosis is in a whole different ballpark) | telxosser wrote: | What data is being collected on you? Once a year blood test | if that even? | | I actually suspect it would be trivial to beat my doctor | after 5 years of higher frequency full blood panel data | collection. | | 10 full blood panel samples a year, have 20 million people do | that for a data set we can do classification on. I think my | doctor is kind of out of business then. | | Will never happen in my life though with health insurance and | health bureaucracy. | [deleted] | zo1 wrote: | It won't happen primarily due to government regulation. | Medical information has "dangerous, don't touch this" | written all over it, and everyone is scared to try. | nradov wrote: | Beat your doctor on what? You can already get 10 full blood | panel tests per year if you want. You can just pay for it | and don't need insurance. But what will you do with the | data? For most people the results won't tell you anything | useful. | | https://www.ondemand.labcorp.com/lab-tests/comprehensive- | hea... | chromatin wrote: | It also helps to have a relationship with a patient (or | person). | | There are some people who will never, ever complain about | anything. When they complain of severe abdominal pain, for | example, you pull out all the stops immediately to figure out | what's wrong, because it's probably really bad. | | On the other hand, there are hypochondriacs and people will | low pain tolerance. While they can certainly also become | seriously ill -- and one must never forget this -- the tempo | and pace of workup and order of intervention is markedly | different, absent other information that shifts the pretest | probabilities. | Aeolun wrote: | > On the other hand, there are hypochondriacs | | That's me. I really, really appreciate a GP that both | understands that I'm not doing it on purpose, and can | reassure me that nothing is wrong, or figure out that we | actually do need more testing this time. | | Unfortunately it's been years since I had one like that :/ | KerrAvon wrote: | Sometimes a relationship is bad. If you think someone's a | hypochondriac, but in fact they're unusually sensitive, | you'll dismiss a lot of what they say and that can be quite | damaging over time. (Especially if they're female | https://www.health.harvard.edu/blog/women-and-pain- | dispariti...). | | I wouldn't eliminate GPs from the process, but many people | actually would like to hear what the robots have to say | about their medical conditions. Having second opinions of | this sort available might lead to better patient outcomes. | Spooky23 wrote: | Lol. Maybe people who don't have any medical problems. | | There isn't enough humanity in healthcare to begin with. | Replacement of doctors with AI sounds pretty horrific. | General practice isn't where healthcare costs are going | bonkers, and it seems weird to want to cost-cut something | that actually kind of works in favor of bullshit. | | Know what would be a great use of AI? Something real like | analyzing all of the telemetry in EMRs to provide better | guidance to doctors to proactively guide people. Some | CVSHealth chatbot telling me whatever is a waste of time. | Elof wrote: | I think the person was suggesting using the results of | the AI to inform the doctors, not replacing them. Which | is something I would like as well | nradov wrote: | Automated diagnosis applications have existed for | decades. They have proven useful in limited circumstances | for certain specialties and rare conditions but for | routine medical care they're more hassle than they're | worth. | nradov wrote: | There is no evidence that diagnostic robots would | actually produce better outcomes. The hypochondriacs are | already able to Google their symptoms and make themselves | sick with anxiety. | derefr wrote: | "Super important" -- more like "super nice-to-have." | Hospitals don't have any single person on staff who stays | attached to particular in-patients. Who knows you? Your | chart. | | Yes, of course, hospital care would be _better_ in many ways | if we did have somebody who statefully understood particular | patients' needs. | | But what I'm saying is, the GPs in hospitals could be | replaced with stateless diagnostic AI without making hospital | care any _worse_ than it is now. And hospital care is a large | part of the medical system, so only replacing diagnostics | there (while leaving primary-care GPs alone) would still be a | major optimization, freeing many doctors to provide better | care, go into specialties, etc. | nradov wrote: | That's simply false. You obviously have no idea how | hospital care is actually delivered. To start with, every | admitted patient has an assigned attending physician who is | responsible for coordinating the care team. Some things can | be documented in the patient chart but there are always | gaps. Clinical decision support systems for partially | automating diagnosis could potentially be helpful in some | limited circumstances but the ones built so far mostly | don't work very well. | robbiep wrote: | I'll second how misguided that view of hospital care is. | There is ALWAYS a treating team, always an admitting | consultant/attending | HaZeust wrote: | Knowing the ontology of your patients and their risk is also | a tenet of a doctor's job, but we can do it with AI too. | Hell, ontological engineering had a revamp specifically so | that we could have a standardized model to describe any and | all "parts" of a "whole" in a way that machines could | understand. | nradov wrote: | No we really can't do that with AI yet. Current AI | technology is nowhere near that level. | kilburn wrote: | What many people don't realize is that medicine as a whole is | already some sort of expert system (i.e.: a flavor of AI). | | There are researchers that conduct experiments to produce | meaningful data and extract conclusions from that data. Then | there are expert panels that produce guidelines from the | results of that research. Most diagnostics and treatments are | prescribed following decision diagrams that doctors | themselves call... algorithms! | | There are several limitations that prevent us from applying | other AI techniques to the problem. Off the top of my head: | | - We do not have the technology for machines to capture the | contextual and communication nuances that doctors pick up on. | There can be a world of difference between the exact same | statement given by two different patients or even the same | patient in two different situations. Likewise, the effect of | a doctors' statement can be quite literally the opposite | depending on who the patient is and their state of mind. One | of the most important aspects of the GP's job is to handle | these differences to achieve the best possible outcomes for | their patients. | | - Society at large is not ready to trust machines to make | such intimately relevant decisions. It is not uncommon for | patients to hide relevant information from their doctors, and | to blatantly ignore the recommendations from them. This would | be many times worse if the doctor part wasn't human. | | - We cannot apply modern inference techniques (e.g.: deep | learning) to the global problem because we have strict rules | that prevent medical data collection and analysis without a | clear purpose. Furthermore, these techniques tend to produce | unexplainable results -which is unacceptable in this field-. | As a result, there's not enough political capital to relax | those rules. | sjg007 wrote: | > We cannot apply modern inference techniques (e.g.: deep | learning) to the global problem because we have strict | rules that prevent medical data collection and analysis | without a clear purpose. | | I mean, China will likely do it, as long as they can | capture high quality data, so there's that. | shadowofneptune wrote: | The attending physician in a modern hospital system is | primarily a manager. Their main concern is treatment of the | patient's medical issue, but their role isn't limited to | that. This patient is refusing care but also refuses to | leave, what do we do? How should we schedule care around a | patient who requires the entire floor to assist in daily | activities of living? They may not get the last word on | matters outside of their responsibilities, but being the | physician their words carry weight. This role has remained | pretty much constant through the modern medical system, | even as medicines change and nurses and technicians gain | more responsibilities. | | A computer cannot perform that role with the current | paradigm of AI, even the worst and most arrogant doctor is | more qualified leader than any computer. | [deleted] | oblio wrote: | I assume that you're from the US? | | Those are both people problems. Tech can't solve many people | problems, especially something as entrenched as healthcare. | Isn't it huge, something like 10% of the US economy? | tomrod wrote: | Yes, due to massively inflated prices. | cycomanic wrote: | It's funny how on these forums people who actually do | something good and useful like GPs are considered | overpriced, but at the same time many here work for FANGs | or other webad businesses often making more than GPs. I | know that if it comes to decide between the health industry | and Facebook, Google, Apple or MS I sure know which I'd | rather keep. | kortilla wrote: | FAANG doesn't cost 15% of the GDP though. Not sure why | you're comparing those. | JshWright wrote: | Interestingly, I assumed they were outside the US. Primary | care docs (especially independent primary care docs) are one | of the lowest paid medical doctors. Most specialists make | significantly more money (and have a significantly better | workload/schedule). | FredPret wrote: | I thought to myself: no way can this be true. The US | generates $21tr a year[1]. How can medical be $2.1tr a year? | | ...turns out, it's $2.7tr!!! [2] | | [1]www.tradingeconomics.com | [2]https://www.statista.com/study/15826/health-care-and- | social-... | vasco wrote: | 20% https://www.cms.gov/Research-Statistics-Data-and- | Systems/Sta.... | FredPret wrote: | Absolutely bonkers. One of every five dollars goes to | healthcare. | | To put this further into perspective: the US military | budget is immense, as we know... and it clocks in at 3.7% | of GDP [1] | | [1] https://www.statista.com/statistics/266892/military- | expendit... | philjohn wrote: | To put it even further into perspective, that's 2x as | much as comparable western nations with single-payer, who | have similar or better outcomes in most cases. | oblio wrote: | Why do you think nobody important (politicians, primarily) | is really trying to solve those major healthcare problems? | | If politicians are willing to pork and barrel over a random | soy farm employing 2000 people, for sure they're not going | to throw away, say, 5% of the US GDP and possibly 5% of all | employment in the US. | | I don't know how you're going to get out of it... | | [1] "There were 22 million workers in the health care | industry, one of the largest and fastest-growing sectors in | the United States that accounts for 14% of all U.S. | workers, according to the Census Bureau's 2019 American | Community Survey (ACS)." | | https://www.census.gov/library/stories/2021/04/who-are- | our-h... | Spooky23 wrote: | We have this health system to avoid taxes, but this crazy | US system probably costs 97-98% of Americans pay more for | health stuff than all of their actual taxes combined. | lotsofpulp wrote: | >that GPs in particular would be replaced by a lower-cost | Watson descendant | | It is happening. They are called physician assistants and nurse | practitioners, "supervised" by a doctor. I assume going | forward, they will take more and more of the usual pink eye/ear | infection/flu and other common work that does not require 6 to | 8 years of post bachelor education. | tryptophan wrote: | It's happening because hospital corporations love them. | | Corps can pay less, and since they have a tenth of the | education, they order tons of profitable tests, consults, and | scans because they don't know otherwise. | colinmhayes wrote: | This is why insurances are moving toward capitated plans. | Instead of paying for services provided health care | providers get paid per patient they care for. That way the | perverse incentive created by asymmetric information is | removed. | lotsofpulp wrote: | I thought it was the opposite, that everything is moving | towards value based payment, or at least it seems to be | for government funded healthcare: | | https://www.chcs.org/its-not-just-risk-why-the-shift-to- | valu... | colinmhayes wrote: | Well implemented capitated plans are value based. Value | based just means there are incentives for better than | expected health outcomes and disincentives for bad | outcomes. If you have a non-value based capitated plan | health care providers would reduce the quality of care, | so value based strategies were implemented to ensure | patients receive good care even though providing it costs | money. | lotsofpulp wrote: | Oh, thanks for the clarification. I thought they were not | compatible. | plucas wrote: | This is a mischaracterization of P.A.s (well, not the | being-paid-less bit). Do you know any personally? | jac241 wrote: | It's a mischaracterization for PAs because doctors only | have ~7.5x minimum more clinical training and not 10x, | 15000 clinical hours (for med school + family medicine, | the shortest residency program) vs 2000hrs. Ask any | radiologist you know what they think about the imaging | orders from NPs and PAs and that will give you your | answer. | SkyPuncher wrote: | He's exaggerating significantly, but the core point is | true. pAs and NPs will be the future of hospital care. | RHSeeger wrote: | It's worth noting that the higher tiers of nurses have at | least a masters degree, and like more time working than a | doctor spends in residency. They are highly trained/skilled | professionals. | jac241 wrote: | I would guess that most people entering NP programs at | this point have less than 3 years of work experience as a | nurse, a job where you are not diagnosing, coming up with | treatment plans, performing procedures or doing any other | physician tasks. | | I don't know if 500hrs of shadowing after a 2yr part-time | online only program that you don't need any nursing | degree or experience to enter would count as highly | trained or skilled. Here's a list of direct entry nursing | masters programs - https://nursinglicensemap.com/nursing- | degrees/masters-in-nur... | | Here's Johns Hopkins doctor of nursing practice program's | curriculum - | https://nursing.jhu.edu/academics/programs/doctoral/msn- | dnp/... - where more than half of your classes are not | medicine related and which requires an astounding 1000 | clinical hours and less than 10 credits a semester before | you can call yourself "doctor". Most medical students | will have 1000hrs after 3 months in 3rd year, where they | will be expected to diagnose and come up with treatment | plans vs just shadowing, and they still have 9 more | months of 3rd year, 4th year, and a minimum of 3 more | years in residency. Doctors will likely end up with a | minimum of 15000 hours of training. The difference really | is that large, and I feel bad for the patients and for | the NPs who have no idea how deficient their education | is. PAs have 2000hrs of clinical experience. Here's a | chart - https://i.imgur.com/Cj5z4f8.jpg | RHSeeger wrote: | I didn't say that nurses have the same medical training | as a doctor of medicine; just that they are highly | trained professionals with a fair amount of experience. | If you match the 3 years of residency with 3 years of | working as a nurse (they're clearly not the same thing, | but both are "experience" for the purposes of this | discussion), a starting medical doctor has 2.5-3 more | years of training/school/experience than a nurse | practitioner. That's a lot; but it doesn't reduce the | fact that the NP has a lot of training. The post I was | replying too sounded like it was dismissing the amount of | training/experience being a NP takes, and it bothered me. | morpheuskafka wrote: | Why are all the universities on board for this? All these | midlevel degrees are devaluing their own medical schools. | nradov wrote: | Is there any evidence that patients of NPs actually have | worse outcomes? Given the current physician shortage | would it be better to wait to see one, or get an | appointment with a NP right away? | jac241 wrote: | Many studies comparing NP and physician outcomes will | have the NPs under supervision by physicians, which is | ideally how they would be used, but in practice the true | supervision level varies widely. I wouldn't see an NP for | my care personally, and I doubt there are many physicians | who would. The wait time to see primary care physicians | is typically less than a week in most places and would be | worth it. If you're experiencing something you feel is | too serious to wait a week I would visit the ER (and make | sure to ask to be seen by the physician also). It's your | health. Personally I would only trust mine to the people | who are the experts in their subjects, and not those who | have less training and can switch between specialties | without any additional training. | | I don't have anything against NPs when the supervision is | close, but more and more doctors are put into positions | where they are acting as liability sponges for de-facto | independent NPs/PAs. | | Here are a few studies - (CRNA) We found an increased | risk of adverse disposition in cases where the anesthesia | provider was a nonanesthesiology professional. | https://www.ncbi.nlm.nih.gov/pubmed/22305625 | | Comparing urgent care visits between MD/DOs and | Midlevels. Doctors saw more complicated patients, | addressed more complaints and deprescribed more. https:// | link.springer.com/article/10.1007/s11606-021-06669-w | | NPs/PAs practicing in states with independent | prescription authority were > 20 times more likely to | overprescribe opioids than NPs/PAs in prescription- | restricted states. | https://pubmed.ncbi.nlm.nih.gov/32333312/ | | Both 30-day mortality rate and mortality rate after | complications (failure-to-rescue) were lower when | anesthesiologists directed anesthesia care. | https://pubmed.ncbi.nlm.nih.gov/10861159/ | | Compared with dermatologists, PAs performed more skin | biopsies per case of skin cancer diagnosed and diagnosed | fewer melanomas in situ, suggesting that the diagnostic | accuracy of PAs may be lower than that of dermatologists. | https://www.ncbi.nlm.nih.gov/pubmed/29710082 | | Advanced practice clinicians are associated with more | imaging services than PCPs for similar patients during | E&M office visits. https://jamanetwork.com/journals/jamai | nternalmedicine/fullar... | | Nonphysician clinicians were more likely to prescribe | antibiotics than practicing physicians in outpatient | settings, and resident physicians were less likely to | prescribe antibiotics. | https://www.ncbi.nlm.nih.gov/pubmed/15922696 | | The quality of referrals to an academic medical center | was higher for physicians than for NPs and PAs regarding | the clarity of the referral question, understanding of | pathophysiology, and adequate prereferral evaluation and | documentation. https://www.mayoclinicproceedings.org/arti | cle/S0025-6196(13)... | | Resident teams are economically more efficient than MLP | teams and have higher patient satisfaction. | https://www.ncbi.nlm.nih.gov/m/pubmed/26217425/ | RHSeeger wrote: | My expectation is that the outcomes would be similar for | the common issues, and would start to deviate as you got | into more uncommon problems. A doctor will have a lot | more "background knowledge" to be able to consider things | that are outside the every day. At least in my mind, it's | not unlike someone in software development with a degree | in it vs not. For most things, the person without a | degree will do a fine job; but for some things, they | won't be able to consider many of the possible | options/tools, because they just haven't been exposed to | them. | lotsofpulp wrote: | >Corps can pay less, and since they have a tenth of the | education, they order tons of profitable tests, consults, | and scans because they don't know otherwise. | | Hence the purpose of managed care organizations (MCOs, | health insurance companies) employing people to approve and | deny (or design systems that approve or deny) payment for | unnecessary tests, consults, and scans. And in a taxpayer | funded system, the government employs people to performs | the same roles. | goodells wrote: | Yep. The midlevels are supported by automatic protocols in | Epic (e.g. sepsis, DKA -> put these dozens of orders in with | 5 clicks) that physicians decide on and approve. They also | rely more heavily on imaging instead of a physical exam and | history. When unsure, they can consult a physician, even a | specialist. | | It's a very polarizing topic in medicine that patients | generally aren't privy to. Especially for resident physicians | who often make half as much as these midlevels yet have more | education, there's a lot of bitterness. The federal | government is ultimately to blame... having a fixed number of | residency spots to artificially limit the supply of new | physicians is terrible, and this is the predictable result. | | I think hospitals support inefficient midlevels because they | can bill patients for the increased resource usage, but it's | not good for the system overall when unnecessary scans and | consults are done, and more complex patients don't get | comprehensive care. Many foresee a two-tiered system | developing, where the rich see physicians, and the poor see | midlevels. | nradov wrote: | A two tiered system might actually be better for improving | access to affordable health. Mid-level providers seem to | achieve equivalent outcomes for routine cases at lower | cost. | | I agree that Congress should increase funding for residency | programs. | | https://www.ama-assn.org/education/gme-funding/ama-seeks- | mor... | goodells wrote: | I generally dismiss these "equivalent outcome" studies. | Any midlevel will (and should) bounce the more | complicated cases to their supervising physicians. | Outcomes at that point are meaningless. | | There's definitely a trade off between resources devoted | to education vs. acceptable risks from failed procedures, | missed/delayed diagnoses, and increased utilization of | imaging and referrals (and the physician radiologists and | others who participate in that - it goes full circle). | Physicians now are probably on one extreme end of that, | and midlevels on the other. | | On the topic of servicing rural areas... the problem is | that nobody with better options (which includes | midlevels) wants to live in these places. These educated, | high-earning people want to live in urban areas, and they | can. CMS has tried to incentivize this with billing by | offering higher reimbursement rates to rural places that | have a midlevel on staff. That's about it, though. | mlyle wrote: | > I generally dismiss these "equivalent outcome" studies. | Any midlevel will (and should) bounce the more | complicated cases to their supervising physicians. | Outcomes at that point are meaningless. | | If midlevels can successfully detect complicated cases to | a supervising physician, and handle a whole lot of other | care independently... and the net result is equivalent | outcomes... this isn't a massive win? You've conserved | the really expensive and contended resource for where | it's needed and not made anything worse... | goodells wrote: | It's not so clear cut for a few reasons. | | #1 - Funky/misleading statistics - Generally they claim | that these NPs with uncomplicated patients do as well as | physicians with complicated patients. It's not claiming | that of any randomly selected patient, regardless of who | they see, the outcome is the same. Therefore, if | uncomplicated patients saw physicians, outcomes for the | physicians could improve. In primary care managing | hypertension or diabetes, this isn't as pertinent. For | something like anesthesiology, it's more so counting how | many times shit hits the fan, and brain cells die when | the anesthesiologist takes time to be summoned. | | #2 - They're not conserving expensive resources. Imagine | a patient comes in with a lump on their hand. An NP might | see a weird lump, order an MRI which gets read by a | radiologist, refer to an orthopedic surgeon who | specializes in the hand, who removes tissue to send to a | pathologist, who determines it's a common benign tumor of | the fascia. That's three physicians who spent much more | time here! The patient no longer has use of their | interphalangeal joints. The physician would probably try | to shine a light through it, note the patient's | Scandinavian ancestry and family history of plantar | fasciitis, and tell them to live with it and come back if | it changes. | | No resources were saved here, but the patient's DASH | score (disability of the arm, shoulder, and hand) is | still 0 so the outcomes are the same. | | This happens all the time. | | #3 - Bad incentives - Medicaid would not in a million | years cover this, but the game of medical pinball where | patients bounce around through in-network referrals can | funnel those with decent insurance into procedures. | Especially when most people have poor health literacy. A | hospital executive probably just splooged in his pants | seeing how much money their loss-leader of primary care | is driving to radiology and the surgical specialties | where they actually make money. | | #4 - It's insincere. All of this can be viewed as | possibly successful when the midlevels are part of the | healthcare _team_ and know their limitations. But the NP | groups are increasingly pushing for independent practice | and prescribing rights in state legislatures across the | country. CRNAs require a physician supervisor... in many | places, that doesn't necessarily need to be an | anesthesiologist, and the surgeon performing the | procedure can suffice. The AANA recently changed its name | to the "American Association of Nurse Anesthesiology"... | It used to be "Anesthetists". The CEO and president (two | different people) of the American Nurses Association both | refer to themselves as "Doctor" in a healthcare setting | even though one holds a DNP and the other a PhD. It's | pervasive. | lotsofpulp wrote: | > the problem is that nobody with better options (which | includes midlevels) wants to live in these places. | | Or the problem is that people are not offered enough | money to make the sacrifices they would make by living in | rural places. | itg wrote: | I'm having a hard time understanding why they would be | bitter. Residency is temporary and a part of the training | process. Once completed, doctors will make 2x-3x+ compared | to midlevels for the rest of their careers. | goodells wrote: | Residency has a lot of problems. The match is stressful | enough. Medical school graduates carry a huge amount of | debt, but must complete residency before earning enough | to meaningfully pay it off. Residencies pay 40-85k and | most resident physicians are expected to work 80+ hours | per week. 80 is the theoretical maximum, but that doesn't | count time arranging work, studying, taking board exams, | etc. | | All this, and if you don't complete your residency, you | have no prosperous future as a doctor. You might re-match | to another residency if you're very lucky. The hospitals | know this and act accordingly. Residents and even medical | students paying tuition (!) were assigned to treat COVID | patients and couldn't really decline without risking the | future they're heavily invested in. | | Keep in mind, the federal government pays ~150k per year | to the hospital for having the resident. Yet the | residents are often more indentured workhorses than | trainees. It's not uncommon for entire departments to run | overnight with only residents, but no attending | physicians. | | Now imagine being in this situation, and not being | allowed into the "providers lounge" because you're a | resident. Or using a broad-spectrum antibiotic instead of | something more specific and being scolded for poor | antibiotic stewardship, while the NP who has "completed | their training" can't even properly decide antibiotics | are indicated some of the time. And if that NP were ever | treated the way a resident is, they could go get a job at | the hospital on the other side of town and start in a | week. | rcpt wrote: | You can read r/noctor if you want examples | lotsofpulp wrote: | Because the future is for doctors to not make 3x compared | to them. The mid levels are being used to increase supply | of healthcare, using the doctor's license for liability, | in order to reduce the price doctors collect (per unit of | time and effort). | | Basically, they are watching their expected wealth / | purchasing power be reduced. | jac241 wrote: | If someone was making more than twice as much as you, | working half as many hours as you, seeing half as many | patients as you, and were less qualified for their | similar role, you would be upset too. | lotsofpulp wrote: | >Many foresee a two-tiered system developing, where the | rich see physicians, and the poor see midlevels. | | There already was a tiered system, with rich people being | able to buy concierge medicine and getting preferred | treatment based on who knows who on the hospital's board or | if their name is on a wing of the hospital. | | The change now is a more visible and more granular price | segmentation. | jac241 wrote: | There's no price segmentation. You pay the same for a | visit with a PA or NP as for one with a physician, so why | see someone with less than a tenth the experience who may | have gone to an online only school with 100% acceptance | rate and shadowed for 500hrs of "clinical experience" | right out of nursing school? | lotsofpulp wrote: | It will happen via in network and out of network | agreements. | | Healthcare providers with greater proportion of NP/PA | will be selling for cheaper, so MCO will sell access to | only them in their lower price plans, and healthcare | providers where you get to see doctors will be in higher | price plans. | | This already happens, especially with many healthcare | providers not accepting lower reimbursed Medicaid | patients. | cube00 wrote: | _> But GPs often make astounding amounts of money while leaning | heavily on their staff to actually handle patients and keep the | business running._ | | The private ones might the ones in the public system at least | in my country need to see a patient every 10 minutes to keep | their heads above water. | james-redwood wrote: | This is more or less the case in many European countries. | Less so here in the UK, but approaching there rather quickly | due to astoundingly poor management by various successive | governments. It's tough back in South Africa as well, and | they pay their doctors extraordinarily well. | nradclif wrote: | What country are you from, if you don't mind me asking? | InvertedRhodium wrote: | I'm in New Zealand and it's not too far from what was | described. | kilburn wrote: | I'm from Spain and my wife is a family doctor. It really is | like that here too. | flipchart wrote: | I've heard Canada is like that. I've had similar experience | in South Africa, even in private health care, but I | definitely had the impression that my doctor somewhat cared | about me, especially after going to them for a few years | herval wrote: | > what made that guy a doctor was bedside manner + being able | to remember a lot of things | | That sounds like a lot of professions, engineering management | included :-) | dukeofdoom wrote: | Bribing politicians is far more profitable. Never thought my | own prime minster would become a pfizer sales rep...but here we | are. | Brybry wrote: | The American medical system is truly bizarre. | | I've been to private practices where every day at lunch or near | end of day there would be some drug rep with food for all the | staff. | | And a psychiatrist that had stacks of free samples of drugs. | | Even contact lenses are marketed with free samples. | Scoundreller wrote: | > Even contact lenses are marketed with free samples. | | I mean, yeah? If a shoe company required you to buy a shoe | before trying it on without free returns, the shoe may as | well not exist. | listenallyall wrote: | Everyone talks about the relationship between drug reps and | doctors like it's the most incestuous, evil, corrupt thing. | How else are doctors, especially those who are 10, 20 years | removed from their residency, supposed to learn about new | treatments and medicines? Alexa, what is best current | treatment for a duodenal ulcer? You think a doctor is going | to spend his limited downtime perusing the PDR (which no | longer exists, and was always heavily influenced by the drug | manufacturers anyway)? | | Sure, there may be some excesses (although the truly major | perks like entire vacations dressed up as a "conference" no | longer exist), but I would _much_ rather have doctors be | aware of new drugs and yes, subject to marketing pitches, | than have these drugs languish (eventually leading to drugs | not being created) because nobody knows about them. | afandian wrote: | Is there no continuing training throughout the career of a | doctor? And if not, how are they qualified to evaluate the | claims of a sales rep? | Jabbles wrote: | Scrubs covers this: | https://www.youtube.com/watch?v=JVTWoPeMWSQ | rafale wrote: | It's their responsibility to stay up-to-date. If a dev can | keep up with front end tech stacks, doctors, who are much | more elite in their education, should keep track of latest | treatment breakthroughs in their domain of expertise. | divbzero wrote: | Continuing medical education not only a responsibility | but also a requirement to maintain a medical license in | many states ( _e.g._ California [1]). | | [1]: https://www.mbc.ca.gov/Licensing/Physicians-and- | Surgeons/Ren... | listenallyall wrote: | Take a look at what that actually entails. Inexpensive | online courses with guaranteed passing exams, many of | which have zero to do with actually treating sick people | -- Secondhand Smoke. Medical Ethics. Herbal Medicine | Review. | | Even if a practitioner took it seriously and wanted to | get a real education about actual medical issues, they | aren't going to find coverage of brand new drugs in an | educational setting unless it was arranged by the drug | companies themselves. | | https://www.netce.com/specials.php?productid=MD22X,MDSUB | listenallyall wrote: | First of all, the vast majority of devs do NOT stay "up | to date." Most know one language or even just one | platform... i.e. "WordPress developer" or "Oracle admin". | Secondly, how do you think YOU hear about new | technologies... usually due to marketing. Did React just | come out of nowhere? No, Facebook marketed it | relentlessly. Did people discover Kotlin on their own? | No, JetBrains and Google hit people over the head with | it. Etc, etc | nextaccountic wrote: | > How else are doctors, especially those who are 10, 20 | years removed from their residency, supposed to learn about | new treatments and medicines? | | With some other mechanism that doesn't have major conflicts | of interest? Like, I don't know, attending to actual | courses, like any other profession that requires continuing | training. | colinmhayes wrote: | In Illinois Doctors have to go to a one week conference | every year that is supposed to talk about this stuff. They | also have to take board exams every few years that make | sure they're staying caught up on new advances. | listenallyall wrote: | It's 60 hours every 3 years, of which webinars are | acceptable, and no records need to be submitted with the | renewal application. There are no tests or exams. The | "new advances" they must keep up on include Sexual | Harassment Prevention and Implicit Bias. | | https://www.isms.org/CME/Medical-License/License- | Requirement... | [deleted] | austinjp wrote: | Part of the job, as stipulated by medical regulators around | the world, is keeping up-to-date with evidence. This can be | achieved by reading journals and attending conferences, in | theory. | | But.... journal publishers exploit their monopolies, and | conferences are funded by corporate sponsors. So perhaps | they're not so different. | listenallyall wrote: | Medical conferences basically would not exist if it | wasn't for suppliers and drug companies paying for | sponsorships, trade show booths, opportunities to speak, | etc. Not really any different than any industry's trade | conferences. | throwawayboise wrote: | Sounds just like every technology conference I've ever | been to. A bunch of software and hardware vendor booths, | and most of the speakers being authors hawking their | latest books. | cosmodisk wrote: | I used to see this in our country, where 10 people are | queueing outside doc's office ( this is public health system) | when some well dressed man goes straight into the office not | even bothering to ask if there's anyone in there and fast | forward a few min and the doctor is 'on break', whilst | drinking coffee with the sales rep, while all those people | sit and wait. Eventually it got outlawed. | PragmaticPulp wrote: | > My mom worked for a GP for about 20 years, and it seemed to | me that most of what made that guy a doctor was bedside manner | + being able to remember a lot of things. | | That's exactly right, but there's nothing wrong with that. | | A good doctor's memory of patients spanning decades of a career | and all of the various treatments that they did or did not | respond to is very valuable. It's a good thing that they | offload as much as possible to other people so they can focus | on doing what they do best. | geofft wrote: | I think the comment above, most charitably read, is that a | lot more people would have access to high-quality healthcare | if you could put this work on robots instead of people, | because computers excel at storing data and looking it up | accurately and following predetermined rules. There would be | fewer cases of people going to their doctor and being told | "oh, it's nothing" when it actually is a specific, rare, and | urgent problem. And then they would end up going to a human | specialist to figure out how to fix that problem. | kijin wrote: | > _there wouldn 't be any point in the pharma companies sending | out salespeople to do lunch seminars to convince the GPs to | prescribe this or that drug_ | | Right, but there would be a lot of point in making deals with | whoever builds Watson-like devices, to turn them ever-so- | slightly more likely to prescribe one drug over another or make | one diagnosis over another. It might even be cheaper than | hiring and sending out a bunch of salespeople. | Aeolun wrote: | > GPs often make astounding amounts of money while leaning | heavily on their staff to actually handle patients and keep the | business running | | I've seen this in Japan (ish), but in the Netherlands it's | definitely the GP's doing most of the job. The assistant just | does bookings and waves me in when it's my turn. | 0xbadcafebee wrote: | Medicine is a business. Its incentive is profit, not patient | outcome. Everybody knows the problems with medicine and the | solutions are straightforward. But they don't result in more | profits, only better patient outcomes. So you only get advances | when it increases profit. | | Come up with a way for better patient outcomes to result in | higher profits and you'll see advances in patient care real | damn fast. | jac241 wrote: | Please list some of the solutions, because from where I am | (actually in a hospital) all I see are people who care about | patient outcomes. | 0xbadcafebee wrote: | 1. Stop charging so much. People aren't seeking treatment | because they're afraid of the bills. | | I have other solutions, but there's no point in listing | them because nobody will implement them (for the same | reason that one won't be: profits over patients) | snarf21 wrote: | There is no need to market to Doctors now when they market | directly to consumers who go demand they get the new medicine. | | If we want to reduce costs, we need to move to lower level | providers like a LPN or CRNP. Most people coming into a GP have | the flu or an ear infection or .... and that can be handled by | them. There will be one MD and to handle complicated cases and | to supervise. We've already switched so that intake is done by | CNA making $15/hour. In the US at least working at FAANG pays | far more than being a GP. | chromatin wrote: | _> In the US at least working at FAANG pays far more than | being a GP._ | | Not just FAANG, either. | | The assertion by grandparent poster that GPs are | "astoundingly" well paid is bonkers. | jbullock35 wrote: | "Astoundingly" is vague. | | According to the Bureau of Labor Statistics, the mean | salary of "family and general practitioners" in May 2020 | was $214,370 [1]. This figure includes salaries from GPs | throughout the country (i.e., not just in the Bay Area). | | You can also look at median salaries. According to the BLS, | all ten of the occupations with the highest median incomes | in the U.S. are medical occupations [2]. "Family medicine | physicians" are 10th on this list. | | [1] https://www.bls.gov/ooh/healthcare/physicians-and- | surgeons.h... | | [2] https://www.bls.gov/ooh/highest-paying.htm | snarf21 wrote: | Additionally, a GP has med school plus residency. A | Stanford CS grad will start higher than most GPs with only | a bachelors degree. | erosenbe0 wrote: | Mediocre GP makes 200k cash in Omaha or any average city | and has choice among many employers and systems. Stanford | CS represents top talent and moreover does not make 200k | cash in Omaha, and can only make the big bucks at a fixed | number of entities in fixed locations with fixed | hierarchies and systems. | ako wrote: | A freelance GP (waarnemend huisarts) in the Netherlands | makes on average 65 euros per hour... It pays better to | be a freelance software engineer. Less education | required, less responsibilities, impact of mistakes is | also usually less. | erosenbe0 wrote: | USA has an extremely inefficient system of training for | doctors which wastes literally years of human potential. | First you go to university from 18-22 but not even 2/3rds | of the year. The rest of the year is some level of waste | for most students. You often purposefully dumb down and | study less rigorous subjects than an engineer because you | need all top grades to be get into medical school and | can't risk it. Then medical school is an excessively long | four years which has further periods of time waste and a | lack of integral training until late in the process. Then | there is a highly unfocused three year residency with | what are widely understood as illegal discriminatory | labor requirements holding on to their anachronistic 1910 | white-male origins by a proverbial thread. So at age 29 | you can finally be a GP after many unnecessary years of | wasteful, repetitive, unfocused study, vacations and | debt. This exclusivity and opportunity hoarding results | in a reasonably high skill at a very very unnecessary | level of cost and personnel shortages. | ako wrote: | Dutch system is quite similar: 3 years bachelor, 3 years | masters, including 18 months coschappen (residency), and | then 3 years of specialization to GP (other | specializations take longer). | (https://universitaire.bachelors.nl/faq/ik-wil-dokter- | worden/) | | Many specializations come with very low job | opportunities, being a GP is very stressfull: low paid | assembly line type of work, a GP is expected to see 6 | patient per hour, do home visits, follow up with patients | and hospitals, and run a practice, manage employees, | follow lots of trainings, etc. Having your own practice | as a GP is not very popular any more, a lot of GP just | want to freelance part time, not having the additional | stress of running a practice. | erosenbe0 wrote: | Reimbursement for GP services in the USA runs | $150-$300/hour depending on whether you are seeing | elderly patients or people on employment plans, and a | doctor will see about half that, plus or minus depending | on the setup. Hence $200k per year if a doctor sees about | 6 or 7 hours of patients plus a few hours of paperwork, | calls, and emails 5 days a week. | vasili111 wrote: | AI cannot replace doctors. It can help doctors a lot but not | replace. | colinmhayes wrote: | Of course AI could replace doctors. Some people will always | prefer the bedside manner a person provides, but many others | won't care, and AI will eventually do a good job at imitating | a good doctor's bedside manner. | Firmwarrior wrote: | The only way AI is going to replace doctors is if medical | technology advances to the point where you can repair a | human as well as you can repair a machine (or someone | invents AGI, I guess) | | There are just too many unknowns and fiddly things going on | with human bodies | | edit: Haha, I guess Tex's sibling comment makes a good | point though.. | telxosser wrote: | Machine learning could beat my doctor right now. "Using | Random Forest Algorithm for Breast Cancer Diagnosis" | https://ieeexplore.ieee.org/document/8644835 | | Most of what the doctor is doing is a type of modern | shamanism though. Person doesn't feel good, so the doctor | orders a useless test, test comes back negative so the | person feels better. Then we complain health care cost too | much. | | 10 full blood panel samples a year with other bio-metric | data and a data set of 20 million people to do | classification on would crush the doctor over time. | | This bullshit health system though makes it impossible to | have any real innovation at a mass scale. We will never | have personal higher frequency medical data in my lifetime | that would actually hugely improve the system and cut most | of the cost out. | jac241 wrote: | The hard part in medicine isn't diagnosis and it's not | performing the surgeries, it's disease prevention, it's | working with patients to find treatment plans they can | tolerate, and it's coordinating all of the moving parts | (skilled nursing facilities, pharmacies, inpatient rehab | facilities, outpatient rehab facilities, durable medical | equipment, home health care, insurance companies) to | deliver care that results in a good outcome. Where | hospital care falls apart is when labs/tests don't get | performed in a timely manner and when | protocols/standardized treatments aren't followed. You | don't need AI to make that work, you need wider adoption | of checklists with workflows that are efficient enough to | continue to deliver care to the same amount of people | while they're being implemented so that hospitals are | willing to adopt them. The diseases that can be | effectively caught with screening tests - colon cancer, | cervical cancer, breast cancer, lung cancer in high risk | patients, abdominal aortic aneurysms, hyperlipidemia, | hypertension, depression, etc. - already have screening | programs in place. | | Every dollar spent coming up with the next automated | imaging diagnosis model would be better spent on a model | that encourages people to get up and exercise 5x/week, | quit smoking (or never start), and get their colonoscopy. | Once the patient is presenting to the doctor with heart | failure, coronary artery disease, carotid stenosis, COPD, | colon cancer, etc. the battle is already lost. | | Complain all you want about the healthcare system holding | data back. You don't need the healthcare system to make | the biggest impact on people's health. | | --- I'll add that your shamanism comment sounds like the | typical bs that the 20-something software engineer, who | thinks they know everything because they make more than | 100k a year and have never had to go to a doctor for | anything other than strep throat or generalized anxiety | disorder let alone spent anytime in a hospital other than | to visit family members, that are everywhere on this site | loves to say about physicians or other healthcare workers | to shit on them. | Aeolun wrote: | That just means we need a general artificial intelligence to | do it. We don't have those now, but I wouldn't say never. | throwthere wrote: | Yeah like most businesses the owner his staff to help out. I'm | curious what you think GPs actually make, because in the US | it's not astronomical. Watson went after the wrong problem-- | doctors don't comprise huge amounts of healthcare spending. | It's a recurring issue, tech thinks they have a solution and in | reality the devs don't have a good grasp on the actual | landscape they're playing in. | ricardobayes wrote: | I thought the same, but as I grow older, I believe people would | reject this. Even a subpar human GP would be much more accepted | than a computer. That's not necessarily true in some societies | though, e.g. Japan probably would accept it. That said, I would | probably focus on fixing the system first in a way that a | significant percent of population doesn't need to order fish | medicine off amazon to get treatment. | Bombthecat wrote: | I'm not so sure, sure the first generation might throw a | tantrum, but the next generation will a accept it... Much | like cars or trains.. | Scoundreller wrote: | > I thought the same, but as I grow older, I believe people | would reject this. | | At some point, the (possibly subpar) GP will be a costlier | decision (whether in dollars/time/frustration). | | Just like grocery stores having 10 self-checkouts and 1 | cashier. | CodeGlitch wrote: | I wouldn't mind seeing a computer first before a GP. A lot of | the time a GP will say something like "here try these tablets | and come back in a week". The true worth of a GP is the | follow-up appointments and understanding conditions over | time. | throwawayboise wrote: | I mean, I won't even use the self-service kiosk at McDonald's. | I sure as hell am not going to interact with a computer for my | medical care. | chromatin wrote: | _> I really expected that we 'd see a change in my lifetime, | that GPs in particular would be replaced by a lower-cost Watson | descendant, with there being some other role for patient | interaction, wet work, and data entry (perhaps just nurses)._ | | Perhaps this indicates a major gap in your visibility into and | understanding of modern medical practice? | | _> My mom worked for a GP for about 20 years, and it seemed to | me that most of what made that guy a doctor was bedside manner | + being able to remember a lot of things._ | | "being able to remember a lot of things" -- Yes, absolutely. | This is an area where AI-assisted decision support (like | Watson) could be, and I hope will be, extremely valuable. | | OTOH, you also rightly recognize bedside manner -- as anyone | who has been a patient or a patient's family caregiver will | attest, this is an essential component of core, and I think | likely also the healing process. We won't get this from a | machine until there is a true general purpose AI, at which | point I expect an AI singularity anyway. | | But consider that there are other factors of the practice of | general medicine that you haven't even touched upon. For | example, liability: In the office you envision, where Watson/AI | makes medical decisions and these are executed by other roles | like nursing, where does ultimate responsibility (and legal | liability) lie? Remember that Watson outputs probabilities -- | suppose the following: | | Chance of disease X: 89% Chance of disease Y: 10% Chance of | disease Z: 1% | | If disease X, intervention A has an 80% probability of success. | However, if disease Y, intervention A has an 80% probability of | harm. | | (before you object that this is contrived, this represents a | realistic situation I encountered recently, where intervention | A is high dose steroids) | | Now, will we put the onus on the patient to select an | intervention? I don't think that would be very popular. While I | certainly do not advocate paternalism, when faced with | difficult decisions quite many people openly defer to their | physician. | | _> But GPs often make astounding amounts of money_ | | I suppose this could be true for some definitions of | "astounding," but it's generally accepted that GP/"primary care | physician" pay is essentially the lowest of all specialties , | which is a major contributor to lack of access to primary care | in industrialized countries (while you'll not have a hard time | finding a private pay dermatologist, for instance) | | ANd on top of this, we are posting on HN where a mid level | software engineer total comp can EASILY outpace the average US | primary care physician salary. | | _> while leaning heavily on their staff to actually handle | patients and keep the business running._ | | Do not all professionals and business executives rely on highly | trained staff as force multipliers? This is a fundamental | principle of the advancement of human economies. It is grossly | inefficient to operate with individuals as "jack of all trades" | when they can instead each become specialized to support a | bigger or broader goal. | | By "leaning heavily on their staff to actually handle patients | and keep the business running" are you suggesting that the | primary care physician should be performing check-in, insurance | verification, rooming, vitals measurement, blood draw, | medication administration etc? That is a certain recipe for | massively decreased throughput and shortages/decreased access | to primary care. | | _> I thought it could help drugs get a little cheaper too, | because there wouldn 't be any point in the pharma companies | sending out salespeople to do lunch seminars to convince the | GPs to prescribe this or that drug (this still happens)._ | | This has been massively curtailed for 20+ years, at least in | the US. I am not sure about other countries. But overall I | think this is a seriously minor portion of the (exorbitant) | price of medications in industrialized countries. | | In any case, I doubt it would make much of an impact on | utilization in most contexts, as insurance/health | plans/prescription benefits have already implemented fairly | strict guidelines-based formularies and coverage tiers (again, | at least in the US -- I can't speak to other industrialized | countries, although I expect they are similar or even more | strict) | | (edit: another poster points out all the direct to consumder | drug advertising -- I agree - this probably has a much bigger | influence in 2022; ad budgets are absolutely insance) | | _> Maybe this will still happen, but it doesn 't seem imminent | anymore._ | | Here we agree. I am certain we'll see AI-assisted physician | decision support, but (a) the physician won't go away and (b) I | think it'll be an unfortunately long ways in the future. | crispyambulance wrote: | > most of what made that guy a doctor was bedside manner + | being able to remember a lot of things. | | Sure, that, and recognizing patterns and adjusting medication | and being able to use good judgement for when to escalate to a | referral for a specialist. But that's a lot! | | I actually go to a teaching hospital for my primary care. It | means I get seen by residents, and almost always also by very | experienced teaching doctors. It ends up meaning that I get | more time and attention by people who are actively learning and | trying hard to do the right thing. The trade-off is there's no | long-term trust relationship, but I am OK with that. I've also | experienced care from elderly family doctors who run a "one- | man-band" with a nurse and a receptionist, they're nice but I | think I get better care at a teaching hospital. | hiptobecubic wrote: | I thought we'd have banned Dr lobbying by now, even without a | technological revolution. | jac241 wrote: | I thought we'd have banned software engineer lobbying by now, | look how much harm they're causing - | https://www.healthline.com/health-news/social-media-use- | incr... | bigbillheck wrote: | We haven't banned other kinds of lobbying, why would doctors | be different? | robotresearcher wrote: | Someone should persuade governments to ban lobbying. But who? | lumost wrote: | Anecdotally, the main business value I've seen from ML/AI tech | has been in cases where | | 1. A basic solution shipped and made a ton of money e.g. Ads, | Search, recommendations etc. | | 2. It is financially feasible to have a dedicated team(s) make | small incremental progress on these solutions. Even very small | gains are beneficial. | | 3. The business perceives a threat if they fall behind in this | area. | | The thing is that the gains on the basic solution (heuristics, | off the shelf pre-trained CV model, open voice recognition) are | pretty small, and if the threat of others making progress goes | away - the inferred value of further investment will probably | vanish as well. | | Other applications which put the AI in the driver's seat | (sometimes literally) seem far from production - or if they do | work, then they work reasonably well using an alternate approach | from what you might expect. | wslh wrote: | I am aware that a friend's very small company related to | NLP/NLU[1] beat IBM in a sale because the algorithms worked | better than the Watson ones what seems incredible in two things: | beating them at sales and technologically. | | [1] https://natural.do/en/ | boboche wrote: | IBM is such a shadow of what it used to be. Hopefully newer | health+genomic+ai startups or initiatives at less dinosauresques | companies will make the next leap happen in our lifetime. | shane_b wrote: | Currently they have one of the only if not the only enterprise | permissioned blockchain project called fabric and it's open | source. | | I could see them making a comeback with crypto but not the way | we think about it today. Instead, inter-enterprise operations | infrastructure. | lotsofpulp wrote: | Based on their lack of competitive pay, I assume IBM does or | will end up competing with TCS, Cognizant, Infosys, etc. | sadwings wrote: | > one of the only if not the only enterprise "permissioned" | blockchain projects | | Not quite, check out Corda's R3 project - it's already being | widely used in enterprise and projects are being built on top | of it. | shane_b wrote: | Good to know, thank you. | beckingz wrote: | I attended a talk a few years ago given by one of the | blockchain VPs at IBM. | | It turned out that under the hood they were just using | conventional distributed database technology. All marketing | in order to get multiple companies to work together on shared | systems. | shane_b wrote: | I believe it. There's value in shared systems but not | necessarily a special data store. | spookthesunset wrote: | The problem with "blockchain" is it is a textbook example of | a solution in search of a problem. | shane_b wrote: | I agree when thinking about building software in one org | where there is coordination. When expanding to multi org | and international, the problems to solve become much | clearer imo. | AlexandrB wrote: | What is the use case for this technology? If it's | permissioned, it might as well be a normal database with the | "append-only" setting enabled. | shane_b wrote: | HyperLedger Fabric docs have an example of a manufacturer, | vendor and short term finance provider all on the same | network with transactions happening instantaneously. Then | when you look into case studies, Honeywell has an airplane | parts marketplace that's apparently streamlined their sales | process. I've seen some Upwork contractors demoing medical | data platforms. I didn't understand that one as much. | tomrod wrote: | Federated, hashed data stores in zero-trust environments is | one (though this isn't the best or only way to approach it, | and blockchain is almost always unneeded), where you don't | want to share the underlying data but want to provide | enough information to support reporting requirements. | Public health, taxation, etc. come to mind. | funstuff007 wrote: | What happens to all the people they paid up for the hire at the | slick Astor Place office? | | https://www.businessinsider.com/ibm-watson-office-tour-2016-... | draw_down wrote: | pb060 wrote: | Wish they had resumed IBM Chef Watson, it was completely useless | and the exotic ingredients made the recipes impossible to | prepare, but for a while it was my favorite procrastination | activity | amelius wrote: | Did they sell their contracts for collecting patient data as | well? | transfire wrote: | The only real business problem is they didn't program Watson to | do what the Healthcare industry actually wants -- make more | $$$$$. The last thing they want is a computer that can actually | diagnose people and provide effective solutions. | tomrod wrote: | > The last thing they want is a computer that can actually | diagnose people and provide effective solutions. | | Intimately knowing the non-profit side of the healthcare system | as well as the construction and operation of data science | systems, I wholeheartedly disagree with your assertion and your | conclusion as being a general takeaway. | stillworks wrote: | Can you possibly provide some objective comments on why that | comment may be incorrect ? | tomrod wrote: | Here is a submarine Wired article on what Watson promoters | expected it to do -- which supports what the parent | commenter thought, the focus being on "bottom-line": | https://www.wired.com/insights/2015/02/what-can-watson-do- | fo... | | Here is insight into how non-profit and community health | programs are funded: | https://www.parklandhospital.com/financial-summary | | Here is a section of Healthcare new dedicated to AI/ML | implementations and other related events: | https://www.healthcareitnews.com/topics/artificial- | intellige... | | Here is CMS's directive for hospital price transparency: | https://www.cms.gov/hospital-price-transparency | | The parent comment assumed that everything in healthcare is | profit-motive driven. However, there are large portions of | the healthcare industry that are non-profit, that are | transparent in their funding and their costs, and that are | looking to implement AI to improve healthcare outcomes. | Parkland Health and Hospital System, Harris Health System, | University Health System are some that I am more familiar | with that run with this (PHHS recently achieved HIMMS Level | 7 certification, for example). These are social safety-net | hospitals and healthcare systems -- they care for everyone | regardless of ability to pay. They focus not only on | emergency and inpatient care, but also ambulatory care, | primary care, and even fund (at arm's length) community | (non-profit) medicaid insurers. | | On a more subjective side, I've seen a lot of folks out to | make a buck, but the non-profit healthcare side has been | much more focused on patient outcomes. | sklargh wrote: | Turns out advertising at every tennis major can't make you a | leader in analytics, ML and basic managed services. | mnd999 wrote: | They're good at scoreboards though. Although the Wimbledon one | did break down during Isner vs Mahut. | telxosser wrote: | What data was it using again? The blood panel your doctor | orders every one to two years? | | Medical diagnosis is a trivial problem for machine learning to | beat humans. Humans are terrible at this. | | The problem is there is not even the concept of high frequency | medical data. Imagine machine learning in quant stock trading | with samples once a year. Of course it isn't going to work. | | The problem is all in the externalities. Doctors don't want AI. | They can see the automation path and their bank account change | down the line quite clearly. Not to mention most doctors don't | know anything about data science so how can you have any faith | in the algorithm prediction? No one wants to be the test case | and then get a law suit. "I was just following what the | computer said was correct". Wrong answer, pay up. | | The real irony to me is in a 100 years people look at the | current medical system as complete quakery. Literally have | everything right now to build medical super intelligence but | stuck with the human doctors doing the exact same things from | 50 years ago. | rurp wrote: | I agree with this so strongly. The medical gatekeeping is | absolutely absurd. I can't remember the last time I learned | something from a doctor that I hadn't already learned myself | with a quick online search. For every visit in the past | decade or longer they either told me what I already knew or | we were both stumped. | | If drives me crazy that I can't make my own decisions about | my own health, even for trivial cases. I've spent countless | hours and dollars going to pointless doctor visits just to | get a routine refill. Literally the conversation at most of | these visits is as simple as me telling the doc that | everything is fine with $medA, lets just keep it the same; | followed by the doctor saying sure and writing me a new | script. Such a massive inefficient waste of time. | Spivak wrote: | Yep. Rank and file MDs don't provide a whole lot of value | except to people who are totally ignorant of common | illnesses, health issues, or injuries. | | If I had the ability to order my own tests, blood work, and | adjust the dosages of my meds I could do it a hell of a lot | better than the doctor I see every 6-12 months. Antibiotics | are the some of the worst with this. The doc literally | doesn't even look at me, I just describe my symptoms and | they go "yep sounds like an infection" -- like Gods | almighty you could be a web form. And it would would | actually cost my insurance less which is even more | infuriating. | | Specialists I have found are actually useful and so I can't | really bring myself to hate that Tier 1 MDs act as a screen | for people whose time is valuable. | BlueTemplar wrote: | I'm not sure that it would be necessarily the doctor that | would actually gets condemned in this case. Could as well / | instead be the programmer(s) that made the AI. | | But this is why the current crop of AIs (which Watson itself | might NOT be part of) is problematic : they're too much black | boxes. | | So they directly clash with the laws that assume on one hand | perfect transparency of the tools used, and on the other | perfect responsibility of the people using them. | | How long before the use itself of a neural network is deemed | to have been illegal because it broke one of the laws | mandating the explanation of the algorithm that has been used | to make a decision to the person that this decision targeted | ? | | Eventually, way down the line, this might involve giving some | kind of civil status to computer programs so they can | actually be made responsible. | 1270018080 wrote: | You can only market to upper level execs who are out of touch | with technology for so long before it catches up to you. ___________________________________________________________________ (page generated 2022-01-23 23:00 UTC)