#PTonICE Daily Show – Thursday, July 6th, 2023 – Artificial intelligence: SkyNet or SkyNot?

In today’s episode of the PT on ICE Daily Show, ICE COO Alan Fredendall summarizes the current state of artificial intelligence and discusses practical applications for use for physical therapists. Take a listen to today’s episode or check out the transcription below.

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Good morning everybody. Welcome to the PT on Ice Daily Show. Hope your morning is off to a great start. My name is Alan. Happy to be your host today. I currently have the pleasure of serving as the Chief Operating Officer here at ICE, an elite faculty and our fitness athlete division. We’re here on Thursdays, Leadership Thursdays. We talk all things, small business management, ownership, clinical practice for physical therapy, all that sort of fun stuff here on Thursdays. It is Leadership Thursday, which also means it is Gut Check Thursday. This week’s Gut Check Thursday, we’ve had a past couple weeks of some two-person competition workouts with our friends over at Warrior WOD for their I Got Your Six competition. That is over. So today we’re taking it, I won’t say easier, a little bit more simple with a complete bodyweight workout. This workout is called Laredo. It’s named after Staff Sergeant, Army Staff Sergeant Laredo, who died fighting in Afghanistan back in 2010. So it’s named in his honor. It is six rounds for time, 24 air squats, 24 push-ups, 24 walking lunges, and a 400-meter run, six rounds through that. So the squats move usually at a pretty steady pace. Push-ups are where most people are going to get bogged down. The lunges are the lunges. And then all of that just makes the run that much slower every time. So maybe a 30-ish minute workout, maybe a little bit longer. Great for any place, right? It’s all bodyweight. Great for the cabin, great for the park, great for the front yard, the backyard with the kids out in the evening or this weekend. So hit Laredo if you participate. Hit us up in your time lapse. Tag us, IcePhysio. Use the hashtag GutCheckThursday to play along. Some courses coming your way the next couple of weekends. The weekend of July 22nd, you can catch Jordan Berry in Milwaukee for cervical spine management. You can catch Lindsay Huey out in California. Yet again, I think she spends half of her time in California. That’ll be in Simi Valley, California for extremity management. And then Justin Dunaway will be in Knoxville, Tennessee for total spine thrust manipulation. The weekend of July 29th, you can catch Paul Clorin down in the Dallas-Fort Worth area for upper body dry needling. That course is almost full. It’s got about three spots left. That same weekend, you can catch Alexis Morgan out in Denver, Colorado for Ice Pelvic Live. Two chances at Older Adult Live that same weekend. You can join Alex Germano out in Boise, Idaho, or Christina Prevot in Watkinsville, Georgia. And then Lindsay will again be on the road for extremity management, this time in Madison, Wisconsin. And then the weekend of August 12th and 13th, we have the Older Adult Live Summit at Stronger Life Headquarters in Lexington, Kentucky. That is your chance to come learn from all of the older adult faculty and teaching assistants that are all going to be there that weekend. I’ll be there that weekend. It’s going to be a really fun weekend. So if you’ve been looking to take Older Adult Live, try to make your way to the Older Adult Live Summit the weekend of August 12th and 13th. Today, what are we talking about? We’re talking about artificial intelligence. You’ve probably heard of this by now, hopefully, unless you live under a rock. You’ve heard some sort of reference to artificial intelligence. And a lot of us have questions of what is it? Is it safe? Should I be using it? And how can I use it? How can it actually affect my practice? So we’re going to tackle all those questions today. So starting from the top, what is it? Now it has been around for a while. We’ve had chat bots and you’ve probably seen these if you’ve gone on maybe like Reebok.com and you see that chat pop up and that little virtual assistant is asking you questions. Those are kind of pre-canned responses. Not really what we would call an artificial intelligence, but we’ve seen kind of the rise of automation over the past couple years. And then in November of 2022, a company called OpenAI launched what you may have heard of chat GPT. Now what is chat GPT? It is claimed to be an artificial intelligence, but really what it is, is a generative pre-trained transformer GPT, generative pre-trained transformer. What does that mean? It’s not exactly an artificial intelligence, right? It’s not a autonomous robot. It is a system. It’s called a learning language model. It’s been pre-fed a whole bunch of information, essentially fed the entire internet from the creation of the internet up to about 2018. And what it does is cross reference all of its databases and attempt to give an answer to a response. And the more detailed you are with your question, the more detailed of a response you can get from chat GPT. So you’ve probably heard of chat GPT teaching kids to make napalm and home explosives and all sorts of that dangerous stuff. But at its core, it is not really an artificial intelligence like we might think about from a movie or a book we may have read, but rather it is just cross referencing a bunch of different information in an attempt to give us the human a response. And from chat GPT have come a whole bunch of different programs and apps that use the chat GPT coding and programming to do different functions that might help us in our business. So that’s what it is. That’s what we are calling these days artificial intelligence is. What is it not? It’s not actually an independent intelligence, right? It has a limit and its limit is the information that it has in its databases. The upper limit of the computing power of something like chat GPT is well below the lowest limits of human intelligence. So if you’ve ever used chat GPT, just to maybe ask it some fun, goofy questions, you know that its responses are a little bit canned, a little bit corny, sometimes grammatically incorrect. And it you just immediately know that you’re talking to computer code and not a person. So despite the term artificial intelligence, it is not really intelligence. It is artificial, but it’s not what we would think of as an equal level intelligence of our we have something called the Turing test of can we really tell if the computer program that we’re interacting with is a computer or a human? If we’re not sure or we think it is a human, we know that that program has passed the Turing test and that it is a true artificial intelligence and chat GPT has not done that. What we know when we use programs based off chat GPT is that often the output that we get is really impressive sounding nonsense and sometimes completely wrong. So what we need to understand when we work with these artificial intelligence programs and think about using them in our personal life or our professional life and our practice is the information that comes out isn’t guaranteed to be correct and it isn’t guaranteed to be usable. So two things when we’re talking about what artificial intelligence is not that we need to be concerned about is a term called AI hallucination. And this is where the generated content is completely just nonsense, just words that don’t make any sense. If you were to read them, you would think this is just literally random words thrown together. What’s interesting with the rise of artificial intelligence these past couple months is that artificial intelligence created books have taken over the Amazon bestseller list. The top 81 of the 100 current top seller books on Amazon, on Amazon Candle specifically, are artificial intelligence generated books. And that is to say that they are books written by computer programs based off chat GPT and they’re complete nonsense. My favorite title is Apricot Barcode Architecture. The journey to becoming enlightened is arduous, right? And if you buy that book and read the pages, it’s literally just grammatically correct nonsense thrown together in a book. So that’s the first downfall of artificial intelligence is the output we get might not be useful. It looks like a whole bunch of words. It looks like a whole bunch of work has been completed without us doing anything. And very fast, sometimes an almost instantaneous response when we ask these programs questions, but ultimately the output is totally worthless to us. It would spend us an almost equal amount of time of editing that content as if we had just made it ourself. So that’s the first thing to be concerned about of this term of AI hallucination. The second is that artificial intelligence has often been described as an eager to please intern that says everything you want to hear and nothing that you don’t and is sometimes completely wrong or lies that because these programs reference the internet, they are referencing things like Wikipedia pages. They’re referencing things like opinion blog articles, which we know may not be factually correct, could be wrong on purpose on purpose, such as satire pieces. So if they are opinion-based in nature, they’re not necessarily factual. Nonetheless, that program is going to reference that material and may give it to you as a response. And it may be something that’s completely untrue, something that is not scientifically sound, something that maybe doesn’t have any references and could just be basically a summary of a bunch of blog articles. So we need to understand that the outputs that we get from these programs are maybe things that are completely worthless that we either need to edit heavily or discard. So that’s what it is and that’s what it is not. Now let’s talk about how can we actually use these in practice. A lot of us are concerned that these are going to take over our job. I don’t think so. At least the current iteration of artificial intelligence, it’s not like a chat GPT powered robot is going to take over your job at your clinic and start treating patients. These programs simply don’t have the context. They don’t have the ability to interact with humans on a level that a human recognizes it as a human, right? It’s very clear when you get these responses from these programs, if you played with them of, okay, a computer wrote this, right? It’s, this is not correct. This is not how a real person talks. Immediately in our head, we’re thinking, I’m working with some sort of computer system. This is not a real person. And so because of that, it would be really hard for some sort of artificial intelligence software or robot to treat patients like we treat them in person in the clinic. Especially, we don’t like to say it, but our work is really a part algorithm of when we’re ruling and ruling, ruling in, ruling out competing hypotheses in our exams, but it’s also a lot of soft context skills of having a lot of soft skills of interacting with the person of knowing when to push that person, knowing when to back off. And it’s not entirely objective or subjective. It’s a combination of both. When we’re working with patients in the clinic that is of right now, really only a human can do well. Furthermore, we do have a lot of research that says when people follow computer guided exercise programs, their pain, their range of motion improves very similar to if they come to in-person physical therapy with a human being. But we know that’s not for everybody, right? That’s probably actually for a very small set of the population. So being concerned that physical therapy is just going to turn into some sort of artificial intelligence, virtual reality program where patients treat themselves through computer program is unlikely to happen because it already exists. And if people interacted that way, if people use technology like that to get better, then we would already be unemployed, right? That technology has been out for many, many, many, many years, app based exercise. If it was that easy, everybody would download the app and fix their own knee pain, fix their own back pain, start an exercise program, whatever. And we know that’s simply not the case. Yes, there is a subset of the population who learns like that, who enjoys interacting with healthcare and exercise like that. But we know that it is a small minority of the population and we shouldn’t be worried about AI taking over our jobs anytime soon. Now, where can we use it? We’re probably going to see more and more artificial intelligence in the backend of your traditional physical therapy clinic, of using artificial intelligence and automation for practice management. We have a whole bunch of different programs. I’m going to name off a couple, but just know there are literally dozens and dozens and now hundreds of programs, just like the ones I’m about to name that perform all sorts of functions for your business. So right off the top, the one that sticks out, that’s probably going to be the most powerful to those of us, especially those of us that own and operate our own clinic is a program called Amelia. Amelia is an artificial intelligence that will answer your phone, will answer your text messages and help patients get scheduled. So it’s already in place with some clinics, both physical therapy, primary care physician offices, optometrists, dentists, if it’s a kind of traditional brick and mortar healthcare clinic. Some clinics are using programs like Amelia to work their scheduling, to work their communication, answer their phone, reply to text messages that get sent into the clinic using chat GPT as their backbone. Other programs that can be helpful specifically for marketing, we have a bunch of different ones to help with things like podcasts and blog articles. So there’s a program called Swell that will take an audio file like a podcast file, it will do a complete transcription for you, it will give you some example summaries, it will give you some captions if you wanted to make a social media post, it will give you some hashtags and things to use. And we’ll also write a five paragraph blog article based off your transcription. Stuff like that is very powerful for us to help run the back end of our clinic, because it’s taking content that we already have if we were to record ourselves, and it makes a bunch of content off of that. And it does it quite cheap, it does it for about eight cents a minute. That’s a tremendous time and cost savings when we look at what does it cost to pay a human to do transcription. It costs about $4 a minute for a human to do your transcription. So about $250 an hour. So eight cents a minute, a couple dollars an hour versus $250 an hour, big time savings, big cost savings. So just know that even if you don’t have a podcast, you could record yourself for example, on a voice memo on your phone, talking about an idea for social media post, get home, upload it to Swell, have it transcribe it, make you some captions, some blog articles, some content for you to put on your website and social media that you just maybe need to edit a little bit to make sure that it looks and sounds okay, and then push it out to the internet. Similar programs, we have Okoya, which is a program that helps with writing captions for your social media posts. If you’re like me, and you’re not particularly creative, this can be very helpful. And then there’s a program called Predis, where you basically tell it an idea you have for a picture and or video. It pulls from a library of stock photos and videos and gives you what you’re asking for and gives you a caption. So maybe you want to have some text over a picture or video for social media posts with a caption. Predis can create that for you and it can create it for you at volume. You can maybe give it an idea for a three-part series for your Instagram, get some pictures or videos, get some captions, and schedule out maybe a month of social media posts from just writing a paragraph into the program and having the program go to work. So there’s a lot of different ways in the back end that artificial intelligence can help us save some time and some money. What does that look like in the future? I don’t know. It’s too early to say. Are we going to have clinics that are powered entirely by artificial intelligence where all of the back end is automated and the only in-person real people are the therapists? Maybe. Maybe for some clinics. Maybe not. We’ll see. But the main thing I want you to keep in mind is what we’ve already talked about, to really be mindful of the time and cost investment with these programs. They sound great. They sound like they’re going to do all your work for you and you can just move to the Caribbean and retire. And it’s really not the case of a lot of them have a monthly fee. It’s kind of a Netflix model of you might think, wow, if I just had these eight programs, it would really save me a lot of time. And before you know it, you might be spending hundreds or thousands of dollars a month on all these artificial intelligence programs. So the costs can add up very quickly. As of right now, there’s not one central practice management artificial intelligence. It may be coming, but as of right now, you would need to piecemeal a bunch of these different programs together, which is going to add up cost-wise. It’s also going to add up time-wise. Like we talked about, the output that you get from these programs is nowhere near perfect, nowhere near complete. We’ve all got an email or maybe a voicemail or a phone call from something generated from artificial intelligence at this point in our life. We immediately recognize it as computer-generated and nonsense. We can tell that it’s just not correct. And that is the output of these programs. So whatever we’re doing, we do need to have the time available to spot check these, to proofread them, to edit them, and make sure that they look and feel and read and flow how we would say it if we were to do it, which adds a time investment to these programs as well. So be mindful of both the financial cost and the time cost of using these programs. It’s not like you’re suddenly going to free up 100% of your time using artificial intelligence programs. You still need to have some time to spot check their work. What I love is when we get artificial intelligence-generated emails here at ICE that say, hello PTO, like parent-teacher organization, hello PTO NICE or PT in ICE, which is the European Nuclear International Safety Commission acronym. Right? The artificial intelligence is trying to guess what our name is and it just doesn’t know, versus if you are a human being who listened to our podcasts, who followed our social media, you would know it is PT on ICE. So that’s the kind of caliber of work we can expect from an artificial intelligence program. And we need to be prepared that we ultimately will probably have to sit down and do a lot of proofreading of whatever content or work that these programs do create for us. So artificial intelligence, is it worth the buzz? Eh, maybe. The jury’s still out. It’s probably not going to replace their traditional in-person physical therapist anytime soon. And it’s probably unlikely to significantly save us any time or money in the back end the way that they currently work because they just still are too much computer, not enough human. That may change as they get more smart. And of course, that’s the worry with artificial intelligence is that they will actually become an independent intelligence and take over the world or something like we’ve seen in the Terminator movies. But as of right now, we’re not there yet. But that doesn’t mean they don’t have value, especially if you’re looking to make social media content, especially if you already have content created and maybe you’re just looking to repurpose it. You’re looking to turn a podcast episode into a blog article, or you’re looking to put a facelift on a post maybe you that’s still relevant, that artificial intelligence can do a lot of the legwork for you, provided you have the time to pay for the program, the money to pay for the program, and the time to proofread the work. So artificial intelligence. Would love to hear what you all are using artificial intelligence for. If you’re using it already, you can leave those comments here on Instagram or shoot us an email info at ice.physio. I hope you all have a fantastic Thursday. Thank you for joining us. We’ll see you all next time. Have a great weekend. Bye, everybody.

18:44 OUTRO
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