Memes

Yeah, I think we overall are on the same page in regards to the role AI is going to play in our futures and the consequences that could come with the greed of bad actors. (Though I have to say I really hate the word "normie". I feel the use of it instantly weakens an argument because it's so associated with the stereotype of a basement dwelling know-it-all.)

I am going to stand my ground somewhat on the point of medical codes, not as an attempt to be adversarial though but because I'm enjoying the conversation.

I admittedly don't know much about how it works in the human medical world because I'm in veterinary medicine. In my experience though there isn't a difference between billing codes and test order codes from a clinicians perspective. I order a test, and to do so I have to put in a code that tells the software we use both what the test is and how much it costs, and then both applies it to the bill and sends a request to clin path, which is why I just referred to them as billing codes. With our software (and all others that I've used for that matter) there are an unreasonable number of different codes that order tests that can differ very minimally, and they usually aren't named clearly. I'm pretty sure this is because the people organizing and naming the tests are not clinicians, and possibly aren't even medically trained as it's more of an IT responsibility.

For example, if I'm concerned about the function of a patients liver and kidneys, the I want a test that will tell me what their AST, ALP, GGT, Albumin, Cholesterol, Glucose, BUN, Creatinine, and SDMA are, or at least some relevant combination of those plus some others. The problem is that I don't order a panel with a drop-down list of what values I want. Instead I have to choose from a Chemistry, Chem 6, Chem 8, Chem 10, Chem 12, Senior Panel, Adult Wellness Panel, Profile, Mini Profile, Full Profile, NOVA, NOVA lytes, etc. All of those have their own codes and their own names, and the same tests can differ based on if I'm ordering in house vs ordering from any of multiple external labs. I know exactly what values I want to see, but juggling the various different non-descript names of the dozens or more possible test options is a nightmare, and that's just when dealing with lab work that I run routinely. When it comes to codes that I very rarely use, or have never had to order before, then the chances I get it wrong are much higher. The worst part is that many of the available options overlap significantly, and sometimes I can get the same diagnostic value out of several of the options, but for some reason one of the options costs $50 to run while another costs $300 and the rest fall somewhere in-between.

Bottom line, knowing what I want and knowing how to ask for what I want are often very unrelated.