[schwarzrules]

I understand all the chatter about LLMs hallucinating, or making assumptions, or not being able to understand or provide the more human/emotional element of health care.

But the question I ask myself is: is this better than the alternative? if I wasn't asking ChatGPT, where would I go to get help?

The answers I can anticipate are: questionably trustworthy web content; an overconfident friend who may have read questionably trustworthy web content; my mom who is referencing health recommendations from 1972. And as best I can imagine, LLMs are going to likely to provide health advice that's as good but likely better than any of those alternatives.

With that said, I acknowledge that people are likely more inclined to trust ChatGPT more like a licensed medical provider, at which point the comparison may become somewhat more murky, especially with higher severity health concerns.

[com2kid]

Chatgpt helped me solve a side effect I had with a medication just by suggesting a changing to dose timing. Solid improvement to my QoL just from one small change. My doctor completely agreed with the suggestion.

When I got worried about an exercise suggestion from an app I'm using (weight being used for prone dumbbell leg curls) Chatgpt confirmed there is a suggested upper limit on weight for that exercise and that I should switch it out. I appreciate not injuring myself. (Gemini gave a horrible response, heh...)

Chatgpt is dangerous because it is still too agreeable and when you do go outside what it knows the answers get wrong fast, but when it is useful it is very useful.

[quitit]

There is nothing wrong with obtaining additional, even false, information from any source that is available to you. (AI, Search, Websites/Blogs, Podcasts, influencers, word-of-mouth, etc)

It's what you do with that information that is important - the correct path is to take your questions to a medical professional. Only a medical professional can give you a diagnosis, they can also answer other questions and address incorrect information.

ChatGPT is very good for providing you with new avenues to follow-up upon, it may even help discover the correct condition which a doctor had missed. However it is not able to deliver a diagnosis, always leave that to a medical professional.

This actually differs very little from people Googling their symptoms - where the result was the same: take the new information to your medical professional, and remember to get a second opinion (or more) for any serious medical condition, or issues which do not seem to be fully resolved.

[1412312510129]

This is the same as Googling your symptoms, but on a more broad scale. I think the issue here is how many people are going to give themself self-induced health anxiety because of this result.

There is no deny on positive case of people actually being helped by ChatGPT. It's well known that Doctors can often dismiss symptoms of rare conditions, and those people specifically find way more success on the internet because the people with similar conditions tends to gather here. This effect will repeat with ChatGPT.

[timeon]

> if I wasn't asking ChatGPT, where would I go to get help?

Is this serious question? Can't you call/visit doctor?

[browningstreet]

I vibe coded an app and recorded all the things happening to my 50-something body. I shared that list with a few MDs -- they were useless. They literally can't handle anything except acute cases.

It's like telling someone to ask their doctor about nutrition. It's not in their scope any longer. They'll tell you to try things and figure it out.

The US medical industry abdicated their thing a long time ago. Doctors do something I'm sure, but discuss/advise/inquire isn't really one of them.

This was multiple doctors, in multiple locations, in various modalities, after blood tests and MRIs and CT scans. I live with literally zero of my issues resolved even a little tiny bit. And I paid a lot of money out of pocket (on top of insurance) for this experience.

[tootie]

I babbled some symptoms I did not understand to a doctor who correctly diagnosed me with a very rare condition in 30 seconds. And that's after spending weeks prodding LLMs (~2 years ago) and getting nowhere.

[browningstreet]

I think the main point is to not “of course” either side of this. Use every tool and recourse available to you, but don’t bag on people for doing or not doing one or the other. “Ask your doctor” is presumptive for people who have and need more.

[spongebobstoes]

AI is a lot better now than it was 2 years ago. There wasn't even a reasoning model until the end of 2024!

Either way, nobody is arguing that doctors aren't great. Doctors are great!

The argument is that doctors are not accessible enough and getting additional advice from AI is beneficial.

[halapro]

It can go both ways. The difference is that Dr. Chat's opinion takes 5 seconds and is free. It can be just as useless as a doctor who prescribes some med to mask your symptoms instead of understanding why you have them.

[bawana]

Medical training is designed to produce operators who will add value to corporate health systems - prescribe pills, do procedures, or anything that can generate 'billable hours'. Actually educating patients to be healthy will only reduce corporate health system profits. Why do you think we have been fighting the 'war on cancer' since the 60s? Now 'personalized medicine' and synthetic peptide and complex immunotherapies are the latest twist with costs into 5 figures (orders of magnitude greater than standard therapies)and efficacy only better by a factor of 2 at best. Many treatments promise improved 'partial response rate' increases from 10 % to 50% yet a partial response is not a significant improvement.

AI is a disaster waiting to happen. As it is simply a regurgitation of what has been already said by real scientists, researchers,and physicians, it will be the 'entry drug' to advertise expensive therapies.

Thank goodness our corporations have not stooped to providing healthcare in exchange for blood donation, skin donation, or other organ donation. But I can imagine United HEalthcare merging with Blackstone so that people who need healthcare can get 'health care loans'.

[dash2]

> Why do you think we have been fighting the 'war on cancer' since the 60s?

Actually, we have made huge progress in the war on cancer, so this example doesn’t seem to support your narrative.

[zeryx]

Actual access to reliable healthcare is a massive assumption to make, not everyone has incredible health insurance or lives in a country with sufficient doctors/med staff. Most places are in crisis for lack of resources, I'd rather ask chatgpt or Gemini for something urgent rather than wait 5+ hours in ER for the doctor to say "just take some aspirin and go to a walk-in tomorrow"

[TeMPOraL]

Not to mention, going to an ER for something that doesn't turn out to be an emergency carries a high risk of coming back home with something significantly worse.

Last time I was in ER, I accompanied my wife; we got bounced due to lack of appropriate doctor on site, she ended up getting help in another hospital, and I came back home with severe case of COVID-19.

Related: every pediatrician I've been to with my kids during the flu season says the same thing: if you can't get an appointment in a local clinic, stay home; avoid hospitals unless the kid develops life-threatening symptoms, as visiting such places carry high risk of the kid catching something even worse (usually RSV).

[dgacmu]

There are only two places I still routinely wear a mask (n95) these days: Airplanes from waiting at the gate until about 10 minutes after takeoff when the air handling system has had time to clear things out (and the same after landing), and hospital/doctors visits. It's such a high ROI.

We used to observe that our kid(s) got sick every time we flew over the winter break to visit family. We no longer have this problem. (we do still have kids.) Not getting sick turns out to be really quite nice. :-) Hanging out in the pediatrician's office surrounded by snotty, coughing children who are not mine...

[jofzar]

I'm Australian, but from what I understand from my friends in America, no.

They only go when it's urgent/very worrying.

[zdragnar]

If you don't need to be physically seen to make a determination, most hospitals and networks operate phone lines where you can speak with a nurse who will triage symptoms and either recommend home remedies or an appointment as needed.

I'm not sure if this has switched entirely to video calls or not, but when it became popular it was a great way to avoid overloading urgent care and general physicians with non-urgent help requests.

[beaugunderson]

As someone who was recently injured and waited three months to see a specialist in Seattle, these lines were not helpful ("yes, you should make an appointment"). The only way I was able to see someone was to write a script that blew up my phone when I got a cancellation window email (the first two I missed even though I responded within 30 seconds).

[zdragnar]

Yeah, those lines are for triage, not specialty care. It's nice when you've got an infant and are a new parent and everything is terrifying, or a fever and want to know if it is bad enough to warrant going in somewhere.

[beaugunderson]

Exactly, they're not an alternative to a doctor, which is the point... it's nearly impossible to see a provider these days if you don't have a pre-existing relationship. I moved recently and finding a PCP who is accepting new patients is also maddening.

[furyofantares]

I'm not fond of the fact that it's owned by Amazon but I use OneMedical and I can get a call to a doctor ~immediately, or to my regular doctor within a day or so.

[rainonmoon]

I'm also Australian and some of these comments have really made me re-appreciate what we have in Medicare. Damn, it's got its issues, but the American attitudes towards their healthcare system are downright bleak. Deeply worrying that the prevailing attitude seems to be "But ChatGPT is so good" rather than "Our healthcare system is so bad." Remind me to visit my GP next week to thank them.

[wincy]

I took an at home flu test, messaged my doctor at no cost telling him I’d tested positive (he didn’t even ask for a picture) and paid $25 from a tax free the same day. My doctor is part of a large hospital system too, he didn’t want me to come in just sent the rx.

[8bitsrule]

People with public health care may have a hard time understanding the costs of medical advice and pharma here in the US. We're in deep doo-doo.

[Imme_Play_5550]

I have no job and no health insurance. After crafting my prompt correctly (I have W symptoms, X blood markers, have Y lifestyle, and Z demography) ChatGPT accurately diagnosed my problem. (You have REDS and need to eat more food, dumbass.)

Or, I could've gone to a doctor and overloaded our healthcare system even more.

ChatGPT serves as a good sanity check.

[gck1]

It depends on where you live and what the issue is.

Where I live, doctors are only good for life threatening stuff - the things you probably wouldn't be asking ChatGPT anyway. But for general health, you either:

1. Have to book in advance, wait, and during the visit doctor just says that it's not a big deal, because they really don't have time or capacity for this.

2. You go private, doctor goes on a wild hunt with you, you spend a ton of time and money, and then 3 months later you get the answer ChatGPT could have told you in a few minuites for $20/mo (and probably with better backed, more recent research).

If anything, the only time ChatGPT answers wrong on health related matters is when it tries to be careful and omits details because "be advised, I'm not a doctor, I can't give you this information" bullshit.

[mountainriver]

A lot of doctors also give bad and incorrect advice. I actually find that to be the norm

[ihuman]

Until very recently, it took a week to get an appointment with my primary care doctor, and calls weren't an option. Now that video calls are an option, I get get one in a day or two. I could always go to urgent care to get an answer faster, but that costs more.

[NuclearPM]

With what money?

[hermanzegerman]

> if I wasn't asking ChatGPT, where would I go to get help?

To an MD?

[drusepth]

This isn't feasible for a huge swathe of the USA, often because of costs/insurance but sometimes literally just accessibility/availability. A few years ago it took me nearly 8 months to find a PCP in my city that was accepting new patients (and, wee, they dropped my insurance less than a year after).

[lm28469]

> often because of costs/insurance but sometimes literally just accessibility/availability.

These are self inflicted problems, we should work on these and improve them, not give up and rely on llms for everything

[ogogmad]

Is there a proven and guaranteed way to do this? Because otherwise it sounds very idealistic, almost like "if everything were somehow better, then things would be less bad". Doctor time will always be scarce. It sounds like it delays helping people in the here and now in order to solve some very complicated system-wide problem.

LLMs might make doctors cheaper (and reduce their pay) by lowering demand for them. The law of supply and demand then implies that care will be cheaper. Do we not want cheaper care? Similarly, LLMs reduce the backlog, so patients who do need to see a doctor can be seen faster, and they don't need as many visits.

LLMs can also break the stranglehold of medical schools: It's easier to become an auto-didact using an LLM since an LLM can act like a personal tutor, by answering questions about the medical field directly.

LLMs might be one of the most important technologies in medicine.

[lm28469]

What do you do when we're finally under the critical mass of doctors needed to make new discoveries ?

Who's responsible when the llm fucks up ?

&c.

All of your points sound like the classic junior "I can code that in 2 days" naive take on a problem.

[hermanzegerman]

Every other industrialised nation on the planet has figured this out, still some idiots play dumb and ask if the problem is really solvable

[drusepth]

I think the "we" that can work on these systemic problems and actually improve them are a very different "we" than those of us who just need basic health care right now and will take anything "we" can get.

[blipvert]

Maybe time to ask AI why you’re looking for a technical solution rather than addressing the gaslighting that has left you with such piss-poor medical care in the richest country on earth?

[AstroBen]

Everyone knows this is a problem. No-one it effects has enough power to change it

[thunky]

Already know the answer, don't need AI for that one.

[simianwords]

Maybe time to use a genuinely useful tech instead of trying to solve an actual hard problem by handwaving difficult problems?

[ndsipa_pomu]

Seems to me like the "difficult problem" is solved in pretty much every other rich country in the world.

[simianwords]

if its not solved in the richest country maybe its not so easy to solve unless you want to hand wave the diffuclt parts and just describe it as "rich people being greedy"

[silotis]

Unless you're paying for a concierge doctor, MDs frequently will not spend the time to give you useful advice. Especially for relatively minor issues.

[hermanzegerman]

I've googled what a "concierge doctor" is, and it just sounds like a fancy term for a family doctor.

[vanc_cefepime]

It’s a physician who gets paid a subscription by a small panel of patients.

Pros: more time spent with patients, access to a physician basically 24/7, sometimes included are other amenities (labs, imaging, sometimes access to rx at doctors office for simple generics, gym discounts, eye doctor discounts, etc)

Cons: it’s an extra cost to get access to that physician yearly ranging from a few hundred US dollars per year to sometimes thousands $1.5k-3k (or tens of thousands or more), those who aren’t financially lucky to be that well off don’t get such access.

—-

That said, some of us do this on the side to augment our salary a bit as medicine has become too much of a business based on quantity and not quality. Sad that I hear from patients that said a simple small town family doc like myself can spent 20-30mins with a patient when other providers barely spend 3 mins. My regular patients get usually 20-30mins with me on a visit unless it’s a quick one for refills and I don’t leave until they are done and have no questions. My concierge patients get 1 hour minimum and longer if they like. I offer free in-depth medical record review where I get sometimes boxes of old records to review someone’s med history if they are a new concierge patient. Had a lady recently deal with neuropathy and paresthesias for years. Normal blood counts. Long story short. She had moderate iron deficiency and vitamin b 6 deficiency from history of taking isoniazid in a different country for TB and biopsy proven celiac disease. Neuropathy basically gone with iron and b6 supplements and a celiac diet after I recommended a GI eval for endoscopy. It takes time to dig into charts like this and CMS doesn’t pay the bills to keep the clinic lights open to see patients like that all the time and this is why we are in such a bad place healthcare wise in the USA were we have chosen quality than quantity and the powers that be are number crunchers and not actual health care providers. It serves us right for let’s admins take over and we are all paying the price.

So much more I want to say but I don’t think many will read this. But if you read this and don’t like your doctor, please look around. There are still some of us out there that care about quality medicine and do try our best to spend time with the patient. If you got one of those “3 minute doctors” look for one or consider establishing care with a resident clinic at an academic center were you can be seen by resident doctors and their attending physicians. It’s not the most efficient but can almost guarantee those resident physicians will spend a good chunk of time with you to help you as much as they can.

[hermanzegerman]

> It’s a physician who gets paid a subscription by a small panel of patients

That's how it works here too, in PCP-Centric plans. The PCP gets paid, regardless if the patient shows up or not. But is also responsible to be the primary contact point for the patient with the health system, and referrals to specialists.

[cyral]

Getting a potential answer right away is certainly temping over waiting weeks to get an appointment

[hermanzegerman]

You have to wait weeks to be seen by a family doctor?

[hephaes7us]

If the GP can handle my problem, I probably didn't need to go to the doctor anyway. A lot of care is done by specialists, and it can _easily_ take weeks or months to get an appointment with one. This is strongly dependent on one's insurance network though.

[hermanzegerman]

That's just a very arrogant take, from many patients that couldn't be more wrong.

Obviously a GP refers to specialists when necessary, but he is qualified to triage issues and perform initial treatment in many cases.

[hephaes7us]

Ok, to be fair, they _can_ probably handle my problems better than I can.

But, presumably for liability and out of a genuine attempt to get me the best care possible, they _prefer_ to send me off to a specialist. Either way I'm not being treated until the specialist has time, which take a couple months at least.

[Flere-Imsaho]

In the uk, yes.

And then 6⁺ months to be seen be a specialist.

[cyral]

Yes, in my area if you need to find a new doctor you literally can't. This is a major city. The online booking for any major hospital network literally shows no results because the next appointment would be 90+ days out. If you have an existing relationship maybe you can get in in two weeks.

[davidmurdoch]

In the US, yes.

[vasusen]

Under non-urgent cases this sometimes takes 3-4 months in the US every time I experience the need to "ask an MD"

[tnel77]

While you are technically correct, we live in the real world. People are busy and/or broke. Many cannot afford to go to the doctor every time they get the sniffles or have a question. Doing some preliminary research is fine and, I’d argue, responsible.

[tombert]

If the symptoms are severe enough, sure.

For better worse, even before the advent of LLMs, people were simply Googling whatever their symptoms were and finding a WebMD or MayoClinic page. Well, if they were lucky. If they weren't lucky, they would find some idiotic blog post by someone who claimed that they cured their sleep apnea by drinking cabbage juice.

[tgma]

soon(?) mostly a proxy for LLM

[throwaway132448]

Reach further in to your local community? You need to look outside the screens. Your life will be better for it.