[abeindoria]

That is surprising. My primary care provider had a different response. Basically he said something in line of

"You wouldn't believe how much of a relief it has been. In your last visit, you saw me typing everything you were saying, right? I don't have to. I can listen to you and take very specific notes as necessary as opposed to focusing on both typing and listening to you at the same time. It has bought my stress levels down to here." (Indicated by his hand lowering)

[terminal-bloom]

I’d be more willing to consent to these tools if I had confidence that the underlying software truly was built to honor my privacy.

Too many AI tools are built hastily for me to give my doctor’s (visibly awful) software the trust.

[rkagerer]

Indeed, I always turn this down as I don't consent. If you had a thorough read of the major providers' Terms of Service, you wouldn't either.

It's a shame, if they had an AI transcription tool that kept everything in-house I'd be much more comfortable with it. Or perhaps some kind of zero-knowledge cloud-based product where I hold the keys.

[BeetleB]

This is a challenge for me.

On the one hand, pre-LLM there was plenty of software out there for medical use, and they had to be HIPPA compliant, etc. I've worked with people who used to write that SW (they hated the job because HIPPA was so strict). The rational side of me is saying I shouldn't be biased against these, and that there's no way they would relax the requirements.

On the other hand, the emotional side of me screams: It's LLMs! Huge privacy concern!

I try to let the rational side win. I've always given consent. Especially because I liked my doctor pre-LLMs, and it seems silly to suddenly mistrust him and go to a doctor I don't know at all.

[axus]

I use Kaiser, recently their webpage asked nicely if I would sign a HIPAA waiver to share my data with third parties for marketing purposes. The default was Deny and they made that easy, but it was concerning.

[sensanaty]

Having seen the type of insane shit these LLM transcription tools shit out on the regular, I wouldn't trust these tools for even the most mundane note taking in a medical setting, especially if there's a summarization feature.

I've seen summaries that implied the opposite of what was actually said, and even the transcripts themselves often contain egregious errors. I can so easily imagine these tools summarizing "I drink coke often" to "I use cocaine often", as a random simple example. All nuance gets lost, all context gets lost and unless you're vigilant and looking out for these types of errors it's so easy to slip by the cracks.

[elric]

I've seen the quality of transcriptions, and it's awful. I wouldn't trust it for something as trivial as meeting notes, let alone medical transcripts. Either this doctor is going over the notes later to summarize them for your records anyway (which will cost them just as much time as the old way), or they're relying on the LLM to summarize, which is even more irresponsible.

[xmprt]

Nursing and PCP are very different jobs. Ones a lot more cognitive than the other whereas the other involves actually doing/executing on a plan. I can see how AI would help reduce the cognitive burden while actually increase stress on the execution side.

[Loughla]

Do you still get doctors for primary care? Our local hospital is hiring nothing but nurse practitioners now.

They're amazing in a support role, but not equipped as well for primary care roles.

[soared]

I’d rather have an NP 10 times out of ten for primary care

[Loughla]

While they definitely serve a purpose, primary care is not that.

If you present with anything other than healthy and fine, the ones I have had to see are less than helpful.

They simply do not have the depth or breath of training as a doctor. They're very good at executing a plan as part of a care team, and even making changes to that plan based on patient need. But they just simply aren't as good as doctors.

There's a reason they're replacing doctors. . . They're cheaper. That's it.

[TylerE]

If you're more or less healthy they're fine. When things start to go sideways my experience is that they get out of their depth pretty quick.

[abeindoria]

Eh. There's a reason the entire noctor subreddit exists. NPs have their places. Replacing doctors with them isn't it.

[ballon_monkey]

NZ uses AI dictation and according to doctors who were apprehensive at first, they now love it because they feel they spend less time note taking, more time listening to the patient, and can deal with patients better.

[jmye]

Similarly, I think anything we can do to help take the burden off the mundane parts of the job has helped clinicians focus on the actual hard parts. Where we get... bristling, is when there's any suggestion of "legislating" (operationally, not like, governmentally) care patterns and telling clinicians how to care for their patients.

Which is great, because anyone suggesting AI should replace clinical judgment and work is an idiot.

[dqv]

You're seriously saying it's surprising that your PCP had a different response to AI that is presumably not mandatory for him to use? Cmon dude.

[abeindoria]

you're frowning on a verbatim experience, considering it a presumption _while_ making another presumption? Come on, dude.

[dqv]

I'm frowning upon your use of a good experience that one person had in a completely different context to overshadow a bad use of AI that affects hundreds of thousands of people. They both happened in healthcare, but other than that, they are different situations with different outcomes.

I made a single presumption: that the PCP's use of AI for this situation is not mandatory. Is it mandatory or is it not?

In 2024 when the AI empathy snakeoil machine was inflicted on the nurses, the nurses had no choice in the matter. And management has already established that they may do something like this again.

Your situation is completely different. It's a doctor overseeing their own tool. If the AI makes a mistake, the doctor is responsible and would presumably take responsibility. Who is responsible if an AI tool makes a mistake in a performance evaluation of an employee? The employee! The employee is guilty until proven innocent. But the employee gets no choice in whether that AI tool is used against them (absent a union agreement which dictates how AI tools can be used).

The reason I fear the misuse of AI is because it is so useful.