[yieldcrv]

Multimodal language models have already been good at accepting imaging input and noticing things that professionals overlook

I don't see how a meeting patient in person requirement is an issue. They can listen to the patient, have a context window large enough to analyze their medical history and environmental factors, look at charts, and diagnostics of tissues

and still have a much greater EQ, ability to affirm, and have empathy more than the dismissive high IQ doctor ever will

humans are going to chose that because smart humans don't have those attributes

[rscho]

It is said that "90% of diagnosis is made on patient history". That's the whole problem for machines. We'll need machines able to converse and integrate patient appearance, behaviour etc. as well as humans, and reliably derive the appropriate conclusions from that before we get efficient medical AI. We'll see how fast progress can be made, but from what I see from chatGPT and the like, I seriously doubt the current AI wave will achieve acceptable results in real, everyday medicine. IMO, procedural medicine where lots of multimodal info is always available and the environment relatively fixed, such as (simple) surgery, is a better candidate for (reliable) automation in the near term. Something like prosthetic orthopedics, maybe ?

[mquander]

Isn't it dramatically easier to provide more useful history to machines?

If I'm providing history to a doctor I am pretty much trying to jam the history into a two minute explanation, and they are trying to remember our previous interactions based on short summarized notes that they made without my help.

If I'm providing history to a machine I can take my time to tell the machine as much as I want every time. I can send it whole spreadsheets of symptom logging and tell it my whole life story.

[rscho]

Maybe for you, but not for most people. Because most people do not behave the way you are describing. Most people express themselves in vague, sometimes incomprehensible ways linked to their cultural and personal background. Their priorities might not be aligned with their best interests at all. Some will even think it clever to hide info from the doc, because they are prejudiced against docs or fear being reported, etc. That's why a skilled clinician is first of all a skilled interrogator, and second an accurate observer. The way you look, behave, walk and talk is very often of more value than lab tests. That's what a good GP is actually: someone good at extracting information from people. An unfortunate consequence of that is that every doc you'll meet will want to hear your story again, which gets old fast for patients.

[yieldcrv]

but almost nobody has a skilled clinician or a good GP

or a skilled/good one at that point in time because their clinician is hungry, or has random bias against that person’s communication style, or insurer

or, in the US, you changed jobs and your insurer changed and you need a new doctor in an applicable network

I’m amused how all of your explanations and rebuttals reinforce the path to irrelevancy

[rscho]

> I’m amused how all of your explanations and rebuttals reinforce the path to irrelevancy

As I said, one day certainly. But if you think current tech is up to par, then I'm sorry but you are being delusional. Also, you assume I'm trying to defend the statu quo. That's not the case. I'm all for progress.

[JumpCrisscross]

> We'll need machines able to converse and integrate patient appearance, behaviour etc. as well as humans, and reliably derive the appropriate conclusions from that before we get efficient medical AI

This presupposes the problem of medical records having been solved.

[rscho]

No, this presupposes that the machine won't interact solely with the medical record, but mostly directly with the patient. At least, that's my understanding. In this view, medical records won't be just text records anymore, but records of the whole system 'sensorium' for lack of a better term.

[yieldcrv]

relevant today

https://www.nytimes.com/2024/11/17/health/chatgpt-ai-doctors...