Joseph Berger, MD

“Can you imagine a robot telling somebody that they had amyotrophic lateral sclerosis? Or that they had Alzheimer disease? Or that they had Creutzfeldt-Jacob disease and were destined to die? …There’s nothing formulaic about it. It’s something that you learn over the course of years, how to convey that information.”

health systems beginning to invest in the use of artificial intelligence (AI)

, the development of a physician-AI interface is an ongoing topic in healthcare. Physicians who are not already interacting with these systems will need to understand the role that AI can, and likely will, play in medicine. In neurology, however, there may be some difficulties.

As Joseph Berger, MD, pointed out in a conversation with 

2019 American Academy of Neurology (AAN) Annual Meeting

, May 4-10, in Philadelphia, the neurologist’s reliance on physical examinations and rudimentary-style tools such as reflex hammers and tuning forks will make them difficult to be replaced by AI altogether. However, the associate chief of the MS division and professor of neurology at Penn Medicine does envision some relationship between the two, with AI augmenting the ability of the physician to do their job.

He detailed how AI might be integrated into the diagnostic process, acting somewhat as a failsafe in the instance that some bit of information slips through the cracks. As well, he shared insight into some of the challenges this dyad will face, including the relaying of information to, and development of a relationship with, the patient.

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The associate chief of the MS division and professor of neurology at Penn Medicine described the ongoing relationship between artificial intelligence and neurologists, and how it may evolve in the future.

Joseph Berger, MD: The Role of Artificial Intelligence in Neurology

“We are the last physicians that are still performing detailed physical examinations…When we hear someone’s story, we generate a hypothesis…and we test that hypothesis by actually examining the patient. The examination is a critical component of what we do as neurologists and it would be extraordinarily difficult to program a robot to do the types of examinations that we do—which we do with tools that are, essentially, primitive.”

As technology has continued to make exponential gains in its capabilities, the advantages different tech has offered physicians and medicine as a whole have, in turn, allowed for practice-changing advancements. Now, debates have begun to make their way into the field about the use of 

artificial intelligence (AI) in the place of the physician

 for a number of conditions. Although, for neurologists, this may be easier said than done.

, May 4-10, in Philadelphia, there was such a debate as to whether a robot with AI could possibly, in some instance, replace the specialty care provided by neurologists. 

 sat with Joseph Berger, MD, to discuss the uniqueness within the field of neurology that would make an AI transition in neurology drastically different from several other specializations. He shares examples based on his experiences working with patients with multiple sclerosis (MS).

Specifically, the associate chief of the MS division and professor of neurology at Penn Medicine spoke to neurologist’s reliance on physical examination, and how the use of almost-rudimentary but longstanding tools—such as reflex hammers, pins, and tuning forks&mdash;allow for critical 1-on-1 time with the patient. He noted that over the years, the average time physicians are spending with patients has decreased so drastically that it has prevented that bond with the patient, which Berger noted can importantly offer key insights into their ailments and condition.

The associate chief of the MS division and professor of neurology at Penn Medicine spoke to neurologist’s reliance on physical examination, and how the use of almost-rudimentary but longstanding tools allow for critical 1-on-1 time with the patient.

Joseph Berger, MD: Can AI Replace Neurologists?

“We don’t have a sufficient number of MS specialists, nor is the distribution appropriate for the care of the number of people we have in our country. It’s now estimated that there are close to 1 million individuals with MS in the United States and with the amount of time that’s required in caring for these people—who you will often see 2, 3, or 4 times per year&mdash;it’s simply insufficient.”

The medical field is facing a shortage of physicians across all specialties, with many estimates suggesting a lack of more than 100,000 doctors in the coming years. This is compounded by rising numbers of morbidity and an overall aging population. One area which has been hit particularly hard is those specializing in the treatment of multiple sclerosis (MS).

MS is already a complex disease to treat, and adding to that complexity are more than a dozen disease-modifying treatments which require a solid understanding to properly use, as well as a number of resources and monitoring. Joseph Berger, MD, the associate director of the MS Clinic at the University of Pennsylvania, knows this all too well, and has seen the landscape evolve over the years he’s treated the disease.

At the Americas Committee for Treatment and Research in Multiple Sclerosis (ACTRIMS) 2019 Forum in Dallas, Texas, Berger spoke about the need for more resources and physicians to tackle the increasing number of patients and the complexities of doing so. To discuss these challenges, the professor of neurology spoke with 

The professor of neurology spoke about the challenges faced by MS specialists as their numbers dwindle and the number of patients surpasses 1 million in the United States.

Joseph Berger, MD

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