Chat GPT vs Doctors | We Invite the Lead Author and Have a Spirited Debate

Vinay Prasad, MD MPH; Physician & Professor
Hematologist/ Oncologist
Professor of Epidemiology, Biostatistics and Medicine
Author of 450+ Peer Reviewed papers, 2 Books, 2 Podcasts, 100+ op-eds.
If you want to contact me, do it here: www.vinayakkprasad.com/contact
Google Scholar: scholar.google.com/citations?...
Substack: vinayprasadmdmph.substack.com/
Podcast: podcasts.apple.com/us/podcast...
Personal Website: www.vinayakkprasad.com
Laboratory Website: www.vkprasadlab.com
Podcast Website: www.plenarysessionpodcast.com
Academic Publications: www.vinayakkprasad.com/papers
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Twitter @vprasadmdmph

[@shalacoOne]

I built an email triage test system to identify concerning emails from PC patients with chatGPT. It reads the email and the flags it if chatGPT thinks it’s concerning and says why. It then notifies staff of the email and why it’s concerning. So far it has had a success rate of 100% on about 400 test emails.

[@Karim-ik5ij]

I can see this being the bridge. People are thinking CHATGpt will immediately replace physicians jobs. Things like this will be replaced first. The first ones to go are teladoc, MDLIVE etc...

[@patrickhaarhues2870]

You and many other chatgpt fanatics will get programmed right out of a job eventually.

[@betsyc6055]

you could sell that to hospitals and make one version that alerts for violent patients too.

[@reginamemoriesforever-vc8ql]

Vinay is delightfully intelligent and truly cares for the patients… I felt so much empathy and sacrifice when he said he doesn’t take vacation because the people backfilling for him will screw up… So true… Most people are so lazy intellectually they can’t be trusted. Vinay: 100% you can crash n smash chatgpt, the thingie is NOT a competitor of yours. But it is a competitor of 99% of doctors. You are right: you can train your own llm and hopefully you’ll sell your bots to hospitals!! ❤

[@lindauvonhipple]

(8:00). It's heartening to hear the recognition and acknowledgement of the impossibility of keeping up with a full-time primary care clinic load in medicine today. I was 9 half days per week (4.5 day/wk) for over 10 years and this was the norm for my partners. Most now are 8 half days or less and seeing fewer patients per day due to all the extra time feeding data to the machine. My nurse used to be able to help a lot more, but little by little administration has seen fit to shift as much as possible back onto the doctor's plate. Which makes sense from corporate medicines point of view given we are not paid by the hour and really have no boundaries as to how much time we work. Pretty much every primary care doctor I know works at night doing documentation - pajama time. If anyone had people working for them under that model, they'd probably start taking advantage. It's up to us to stand up for ourselves. I hate the idea of unionizing, but our professional societies are not helping us.

[@BobWidlefish]

22:00 Adam lives in a fairytale for sure. I’m retired and have insurance and basically no meaningful access to a doctor. The best I can get without paying out the nose is a pathetic overworked doctor who will give me less good information than Google, let alone fancier possibilities.

[@reginamemoriesforever-vc8ql]

Adam? What about Tracy? Tell about living in a bubble… most people resort to google to get advice so we might as well improve it so it becomes better and better to help people

[@viljakainu1548]

I have relevant background! I'm now a med student, but also have an LLM and am licensed to practise The profession (that being Law). I used to publish my original research in conferences where I'd get to hear experts in technology ethics talk, and medtech and computing in medtech was a regular topic. If anything, the enthusiasts are not optimistic enough about what the tech could do for us, but also not pessimistic enough about how doctors will fight tooth and claw -- 'AI + a special specialist doctorate-nurse' combo is a very real threat to many, if not most physicians. So much time is spent recalling facts and jumping between lab values when rounding -- an AI will do none of that. Internists could become extremely effective with good tech, while bad tech sabotages their workflow. More bitterly, I'm dismayed at how many of my future colleagues, those studying with me and those treating me, are practising checklist medicine. If Hb is 3% below reference value for 95% of the population, we can't proceed with a burnout diagnosis even though the patient describes the psychological effects of burnout, and has had her father slowly die of agonising cancer and so on... No, it's probably anemia. Do nothing now, wait a month and re-take the bloodwork -- that will show the patient at her habitual, NON-SYMPTOMATIC Hb levels. Jesus how I hate checklist medicine.

[@kairitetra]

I want to live in Tracy and Adam's fantasy world where everyone has a good relationship with a PCP (or any doctor) or has access to care at all. Because that's not the US.

[@sCiphre]

It's not anywhere. Public system doctors are overworked as fuck in all the countries I've checked. The only way to get good care is to pay through the nose for full service private sector medicine. And ChatGPT, which has been awesome.

[@luiswhatshisname7667]

You can tell GPT to read the patient chart and answer curtly so that other doctors can not tell that you use GPT. That is called prompt engineering. But there is another facet of GPT aided programs, it can read literature and send you briefs about your specialty or make the articles easier to read or easier to explain to others.

[@careyjamesmajeski3203]

Great point. We can also insert the “empathic” prelude to the actual doctors actual advice. Definitely ways to limit the unbiasing in this and similar studies.

[@heatherneville2244]

I'm 72 and I have a preference for a human interactions in most cases. My experience with young people is that have equal or more confidence in automation. The financial industry is an example, Wealthsimple in Canada is a prime example. This trend is unstoppable.

[@robertwynkoop7112]

Thanks for fixing Adam’s audio! This is very important discussion, feel so fortunate that I can tune in and listen to such brilliant physicians talk about this in a discussion panel format! Just wondering where this will be in a year. Will insurance reimburse practices for using GPT, given they respond rapidly, accurately (?) and empathetically- particularly if the answers do not result in patient being asked to access care. As an ED doc it will be great to no longer have to tolerate the “Go to the ED” type answer for every damn question asked….I believe GPT will be a major factor and in regular clinical use answering patient questions soon. Regardless, for sure GPT will be used by practitioners on a personal consulting basis…. Instead of asking our specialist colleagues who don't have the time for our questions or discussions….

[@michaelbradley7529]

He gave up on the beard. 😔

[@jordanthibodeau4940]

Chatgpt is simultaneously making lawyers, doctors, consultants, editors, etc. nervous because it isn't made specifically for their domains but it can answer questions nearly on par with professionals. I love this timeline.

[@theskeptic2798]

Not much protesting when automation took factory jobs

[@matsv201]

That is kind of odd. Maybe they are not as used to new tech as we are in the tech business. As a engineer, when ever we get a new tool, we always get more work. And when we get more work, we get a new tool to handle the work, they we got even more work. Why isn´t that how doctors react? the better tool, the better result

[@reginamemoriesforever-vc8ql]

Me too!! Doctors abused their position of power to the verge of arrogance. Majority are lazy and unintelligent and mostly concerned with making money and getting prestige and riches.

[@anthonytroxel4304]

No one, in this case Dr’s, want to be “replaced” by technology, and that bias is shown in the discussion. Everyone thinks they are great/good drivers, but the data shows differently, Great discussion though…

[@bobmorane4926]

Well they should feel nervous because in many instances, we have no way to evaluate objectively how effective drs were in diagnosing properly or solving the problem at hand effectively , yet social media platforms are filled with groups catering to specific ailments and filled with thousands of patients wondering if they have the ailment or how their drs were unable to help them or diagnose them properly. That's where ChatGpt can shine in helping those poor souls get to their answers faster by providing some level of confirmation to their worries and provide some empowerment in finding a solution faster and more effectively.

[@trucid2]

I really liked how everyone on the call had had their own unique take. Great discussion.

[@theprogressivemichigander6588]

I think we should also consider that Chat GPT was trained on the internet generally and places like Reddit. It might be dramatically better if it were additionally trained on curated good medical advice from nurses and doctors in practice. And, of course, future versions of Chat GPT could be better yet.

[@cellgrrl]

This is an intriguing situation. My gut says this is just another way of harvesting more data on people that will be shared in ways that are unknown to us. OTOH, I am wondering how it would helped a family member who was diagnosed with pancreatic cancer. They claimed it was caught early (but I don't think it was) so we were given hope he had an expectation to either survive or have several more years of life. But our mistake was when we got him into MD Anderson Cancer center, having the "best doctors" in this field. Yes, they were great when there was chemo to be given, there were surgeries to be done, and yet after all that made him worse, and when there was nothing left to do for him, they basically abandoned him, drains and all. He was shoved off to local doctors who didn't want to take over this dying man. Sounds like the robot would have been more compassionate and certainly less concerned with its own financial benefit than the human doctors.

[@whoolawoop6817]

Wow, you just retold my fathers story... Same situation, different country...

[@cellgrrl]

@@whoolawoop6817 So sorry...

[@ArtU4All]

And the story of my good friend. In the US.

[@LoisLoves]

It is very interesting to hear a doctor's perspective on this new technology. I am a medical transcriptionist - still doing straight typing mind you - and I have always wondered what the future of medical documentation will look like. I particularly liked your hypothesis that in the future we will each have our own little wikipedia in the EMR. I think that part is actually excellent because, in my experience, when you go to the doctor, you pretty much have to remind them of anything that is particularly important about your health history because they just can't remember everything about everyone they see. This would provide a good synopsis and starting point for the visit. I do think, however, that the little details will be lost with technology (for example, noting that the patient is going on vacation so that you can ask them about it next time you see them - to provide a more personal touch). Anyway, very enjoyable conversation. Thanks as always for sharing your knowledge and opinions.

[@ArtU4All]

Ideally, MD should have had the “refresh” time to read the Pt Hx before seeing them. But that ideal has been dead for decades now

[@3ATGL]

It seems reasonably clear to me that ChatGPT is going to provide average doctors with an element of "competition" and will improve the average doctor's response because of the competition.

[@christianaphoumivongdhiman7930]

Such a wonderful conversation, thank you all for your perspectives.

[@careyjamesmajeski3203]

I relish these talks. I can’t thank all you folks enough for these round table discussions. Reminds me of grad school. Much love and luck to y’all.

[@kablammy7]

I am at about 75 percent into the video . I thought of a way that ChatGPT could definitely be an aid to PC physicians : cgpt may be able to interact with the patient by asking important questions, then record and report that information to the next level . That way some fundamental groundwork can be done quickly . Also, there could be a hierarchy implemented in the cgpt reporting so that certain patients / conditions / responses would be prioritized and forwarded with corresponding immanence / status . This may be a case of one cgpt sending its entire session data to another cgpt, or other application, which will evaluate, prioritize and report .

[@zacboyles1396]

John understands this is unlike all the false starts or product hypes in the past. Even the criticisms such as writing styles or length of reply’s are the very basic fixes. The “know it’s a robot” only matters if it’s robotic in a sense that it’s not fluid,the response feels canned or if it makes a terrible or bizarre mistake. This wouldn’t be the first two, it’s purely at risk with making mistakes but everyday that decreases. It should also be noted that OpenAI will be trying to catch output that conflicts with pFizer Department of Health (FDA) so the “mask/booster” type stuff is not even a mistake, it’s an intentional override and yet even that anti science corporate product ‘synergy’ can be addressed.

[@barbaraberwick8993]

Accuracy, what a great point. So many people are misdiagnosed or mistreated which is obvious in hindsight, but are the original physicians ever aware of their errors? I think not.

[@deth3021]

Tracy sounds like she lives in a pretty priveleged world. For the majority of people they have no medical options.

[@danieljohnson309]

One of the most interesting things about the 'Patient seeking help' scenario is that when patients seek help from AI, that they kind of have to believe that AI is stronger than human professionals. If I didn't know better, people will be swayed by media energy, and the natural media energy is that failures are what has value for grabbing human attention. If AI makes a lot of highly publicized errors early on, then the mass media will make a meal out of it, and people will form a default mentality that AI cannot be trusted and that human professionals are more valuable. On the other side, if AI makes fewer errors, then there is very little to publicize, and then people will develop the idea that the AI is stronger than a human professional. And according to the study being discussed, the AI appears likely to make fewer errors, and so therefore people will trust AI more and more - - as long as it is perceived as having the best interests of ordinary people in mind. To me, this is a signal that AI will make rapid advances, and that these will happen much faster than civilization expects. Based on these factors, it appears that there will soon be a direct relationship between the performance of AI and it's owners' influence on civilization; and in the case of ChatGPT, that would be Microsoft, et al.

[@coriolisse]

“Like I mean…like… and it’s sorta like…I mean…like like like…” (Tracy Beth Hogue)

[@garrettkajmowicz]

An item which I think needs to be addressed is the selection bias of the types of questions being asked. People are unlikely to be going on /r/askdocs and asking *for* a surgical procedure. Instead, they might be interested in independent advice *about* a surgical procedure. So I think there's also value in attempting to identify both the types of questions people are taking to Reddit with, as well as the reasons that people are electing to go there at all. Is it because they don't have a doctor? Because they can't get in to see someone? They can't get in to see someone they trust?

[@RED-cn7hy]

I enjoy listening to this and learning so much. Please reduce the number of the word "like." It's distracting. Thank you

[@thomasgill223]

I'll bet some big companies are chomping at the bit to get control of this technology. Imagine a user can get a patient, empathetic, extremely knowledgeable doctor, at their finger tips, at any time and until all their questions are answered, in the avatar of their choice (I'd pick either Samuel Jackson or Kari Lake) to address their medical concerns, proffer a diagnosis (which is much more likely to be correct than the human physician's) and discuss treatment options (ad infinitum if wanted). From the point of AI Doctor response generation, it will be almost free, the services will make the big bucks by getting patients/users to pay monthly subscriptions. This is gonna be huge, and probably very common within two or three years. (If you're planning on medical school, maybe rethink your plans).

[@PeteQuad]

I have so many comments on this great topic. I think some of the doctors don't understand the demand for knowledge and information out there. The truth is people have just had to deal with unavailable doctors and if there is any option to not have to deal with that it would be great for them. I just ask that they don't try to stand in the way and stop us. Most people are not sending emails to their doctors because it is slow, discouraged, and could end up in a random charge they will never get an estimate for. And that's coming from someone with good doctors.

[@ArtU4All]

We need to promote lifestyle that keeps doctors at bay. The recent development w/obesity as a disease is an example. I wonder what AI has to say re this 😉

[@surgicalcapscom]

There is NEVER a problem BILLING, in fact the BILL was sent before I got home still waiting for the doctor to respond over a month now. Chat GPT could not be worse than a doctor. Chat GPT takes ALL INSURANCES even marketplace.

[@loismiller2830]

For the academic stuff, AI can be a contender. For those who actually need to lay hands on a patient and do direct physical exams or patient care, there is no substitute for a human. Yet.

[@atfinthehouse8631]

So basically no longer a need to examine a patient. Just field questions. Order tests and scans. Rely on only what is reported to them as accurate. Just license people to just order tests and scans. No need for education. Better yet, the chatgpt can order it itself. No need for a physician or primary care.

[@tomlacroix1367]

I am starting to use GPT4 in my Autism clinics as a dictating service that can then clean up and format notes. Never to make a diagnosis. But I can then put my note in and give my patient a summary note with a personalized treatment plan. Prompt engineering has helped my workflow to create more time to work on personalized next steps rather than generic handouts that I used in the past.

[@johnlaudenslager706]

When I was in Physician Assistant training it became clear to me that much of medicine was recipe driven, probably like the culinary arts. The recipe aspect of medicine could be handled well by something like the wonderfully conservative and thorough Chat, making it easier for the practioner to start off at the point where unique qualities of the case can be pursued. Good? 🙂

[@ANOOPBAL]

Tracy asked same great questions!

[@susanpeters4608]

Really enjoyed this conversation. There is no replacement for a breathing, critical thinking compassionate MD. Helping support the Doctor and their staff whose time is valuable is one thing but replacing the human assessment is irreplacable.

[@HendersonHinchfinch]

Is it though?

[@theskeptic2798]

Yes sure, are you a doctor lol

[@fredwhinery8016]

As a retired internist, I’m afraid that Tracy and Adam are talking like 21 C Luddite’s. It’s obvious that AI will revolutionize medicine. Chat GPT which was not designed for medical care creamed the Reddit docs. In 5 years we’ll have 3rd generation AI focused on medical care. It’ll solve our doctor shortage problem. It will free up huge amounts of time so docs can focus on issues where they can make a real difference. Costs for medical care will start to decline. How can they not see this?

[@ArtU4All]

As Vinay said (paraphrasing)’I probably will verbalize empathy f2f but written response will be curt’. From my experience in e- communication w/ pts is: they are ok with “curt…”. Many of them in their own messages are appropriately “dry” to begin with, getting to the essence of their inquiry.

[@M.-.D]

Another great discussion. ChatGPT currently seems lacking, but that is true for many disinterested individuals.

[@actyrrel]

We have had the equivalent of Google as our medical system for the last few years. Insurance companies, pharma and government are currently making decisions. ChatGPT would be an improvement. These 5 individuals are the exception.

[@virginicaanderson1569]

Just like in real life. Doctors that don't touch the patients will be at risk, like the office workers. Surgeons, anesthesiologists, IRs etc. will remain in demand, just like plumbers, joiners and electricians. I am a hands on doctor and not afraid of the ChatGPT. As a patient as well, I say more medical power to the people. Doctors have become arrogant of late, especially during the pandemic, so they need to be brought down a peg or two!

[@haggaisimon7748]

My naturopath quit in the last year of medical school because he doesn't want to be one of these doctors.

[@barbaraberwick8993]

One point, those of us who have a doctor that are like cannot ever actually see our doctors when we are ill. We can see them for our scheduled physicals. However, chat GPT answers are always generic and never really help. Its like needing to talk to someone at the bank about a specific problem, they make you go through these bots first and it is totally frustrating.

[@tinatruthseeker]

As always, LOVE these conversations and the wisdom and insight that each of you bring to the table! Question: if I become a paid subscriber to Sensible Medicine will it eliminate the ads that keep popping up here on You Tube? Or is there a way to watch it elsewhere and pay to subscribe so that the ads disappear? They are quite disrupting…

[@VeekndWarrior]

You want youtube premium

[@tinatruthseeker]

@@VeekndWarrior Thank you for this info - was thinking that would be the way to go but would like it better if I could direct funds directly to Sensible Medicine to support Dr. Prasad and the experts he has on, for all of the good they do in this world… but it sounds like that isn’t an option…

[@ArtU4All]

Premium KZbin subscription removes ads for all channels. Best thing ever for me.

[@YoniCrisis]

10:34 I imagine there could be some motivation to say that these type of services should be built in to clinic rubrics, for a modicum business fee. Then again at the same time it would be of the practitioner’s interest to have access to them.

[@oldschool8292]

Adam you also sound like my kind of Doctor.💜

[@paulelkin5161]

so good thank you

[@reginamemoriesforever-vc8ql]

That female doctor… gosh… she should fear chat gpt for sure because the bot speaks MUCH BETTER than her. She is excruciating… the number of times she uses the filler word “hum” “like” “aand” … 😢

[@reginamemoriesforever-vc8ql]

The number of times she says “like” totally discredits her… 😱

[@ArtU4All]

She does sound like a valley girl, unfortunately.

[@DrTomMD]

AI needs to be leveraged to fill gaps and monitored very closely in the process. There is no stopping the trend any more than we can bring back the horse and buggy. I think there’s particular promise in the area of lifestyle medicine coaching. And while this is still in infancy stages, I predict this baby will grow fast! PS - yes, unplugging / vacation (which is not “lazy” but, rather, strategic resting) is essential to personal health….unless you’re Elon Musk

[@reginamemoriesforever-vc8ql]

Vinay gets a thumbs up for saying Rachel Walensky is a moron!!! ❤😂 WELL SAID! Of course the language model relies on the approved available expertise… Tracy expects the unreasonable. She is out of reality or she doesn’t understand how the tech works.

[@JanRoman119]

Medicine is a statistical science. Many doctors forget about this after the training and concentrate on the most probable diagnosis. Many doctors buy into simplified prevailing theories. AI could perform equally bad.

[@betsyc6055]

The hideous way my mother was treated when she had pancreatic cancer in 2008 gave me a big education about oncology - yes everyone was basically experimenting on her - 84 yrs old - and if I had to do it over again I would have not let them do the surgery or chemo. So much needless suffering. They also lied to get us to do what they wanted chemo-wise. Honestly, this set me up to see RIGHT THROUGH the COVID regime when it was rolled out. Very similar lack of care and evidence-based decision-making.

[@DocDanTheGuitarMan]

We must remember 4.0 is the first iteration we’ve been exposed to. Will it plateau in another AI winter or accelerate past us this decade?

[@sarahb.6475]

How do people even get their doctors email address?? None of the doctors (pcp) never gave out the email address! Years ago my cats' vet was way better than any human doctor.

[@atfinthehouse8631]

Only “approved narratives” will be the “optimal responses”.

[@theskeptic2798]

Ye protest too much. Have never had a doctor who actually cares about me haha a novel idea. Hence haven't seen a doctor in 15 years. Pray to God it stays that way

[@JCResDoc94]

*CHATGPT v surgeons: gota have them beat on personality, right?* whats going to really blow peoples minds is when it beats them on surgical outcomes too - bc _watch and wait_ is the right answer more oft than they may prefer. gr8 chat. _JC

[@medicalgametheory]

Doctors have been playing defense for quite some time now (due to 'midlevel' encroachment), and it's on full display here. The scary part is not just the speed at which chatgpt is impacting medicine, but the fact that its entrance into medicine will solidify the giant biases that exist in medicine and in our data. Chatgpt was trained on data that is subject to the same financial biases that doctors are currently trained on. Futhermore, chatgpt will get feedback from other doctors that will reinforce the same biases. As doctors get crowded out by chatgpt and whatever improvements that follow, these biases will be cemented into the medical care that we receive. A rift in medicine is coming, where 2 sides will be formed: 1) large hospital groups that replace many doctors with chatgpt (while keeping a few in reserve to review gpt's decisions) and 2) the doctors who make decisions according to derivations from 1st principles and pathophysiology as opposed to following flowcharts. Make no mistake, chatgpt is not coming to be an assistant, it's coming to take the whole pie! Even in the case that it is used simply as an assistant, chatgpt improves its outputs with user feedback, and this will eventually allow it to make decisions that are equal to that of most doctors. I think Dr. Prasad hit the nail on the head: 'cookie-cutter doctors' are going to get crushed as they can't follow a flowchart better than a robot; the doctors that will survive will be able to diverge from the common flowcharts used today and think for themselves. Thanks for another fantastic video and discussion!

[@ArtU4All]

The “thinking for themselves” is a problem. As medical student ms of today decline learning from the “old-school” professors because then “can google it”…. How much thinking do you think those specimens will do?

[@Kenshin0011]

Surprised that they're not addressing the fact that this technology is merely in its infancy...yet they sit around and ponder hypothetically about this exact iteration of the technology being implemented for use. What will eventually be developed and optimized for use will be leaps and bounds more powerful and pointed than this experiment. It's not even specifically designed to be used in this way, yet these results are already around at least what's considered average quality. So imagine when these AI LLMs are actually fine tuned to be used in this way for healthcare! The vast majority of their nit picking (empathy, being able to tell it is a robot, answers too long, etc.,) will be easily improved upon.

[@matsv201]

ChatGPT have a enormous advantage of knowing pretty much everything. But its also very bias and have a pretty big problem with context. It works better as a really good search engine than an actual AI. Also ChatGPT is surprisingly bad at math. I used it a lot to source and compile data, but never to process it.

[@tanakaba]

Have you had ChatGPT critique this new paper yet?

[@josephmerritt1411]

So why aren't doctors and nurses pushing back on the documentation? There is an actual cost to collecting information. What is the benefit of all the information being collected? As an engineer, I constantly pushed back with an informational economics argument, "So you are collecting this data, and what revenue is the data generating to offset the cost of acquiring it?" Seldom is there a numerical answer; instead, there is handwaving about quality. Let's assume there is some benefit to medical documentation. Why isn't that the focus of automation?

[@iceman69844]

Those who master “operating” ChatGPT will be the winners. We no longer have to waste brain power to compute, all we need to know is how to operate the tool. Think of the calculator

[@rarby00]

That the doctor knows which response is the AI is a problem because it defeats the blindness.

[@azdjedi]

Doctors trying to find a way to stay relevant. I think they're ignoring that ChatGPT will continue to get better, not only in accuracy, but more significantly it will have the memory of your personal situation. A "personal physician" will only be relevant because it has skin, not because it has a relationship with you

[@StarvingMarving]

Sad to say, I trust ChatGPT more than any doctor I've seen recently. The majority of doctors are like robots, but not smart ones. Doctors like Vinay are in the minority.

[@reginamemoriesforever-vc8ql]

Absolutely!! We expect doctors such as Vinay and 99% of the time we get soulless unintelligent “robots” on a lab coat.

[@bobmorane4926]

Even so, I was horrified to hear Vinay say that he can't believe that many of his colleagues are doing a lot of non evidenced treatments implying that he'd never do such a thing which I find really disingenuous. There's a reason why Drs resort to non evidenced treatments and ppl like Vinay should know better than criticize his colleagues and put himself on a pedestal. I'm usually leery of ppl who don't hesitate to sell to the world how great they are when it would be really impossible for most of the world to figure out the truth. He should know better about the reasons why his colleagues use non evidenced treatments and at least have some empathy to flesh out the reasons. There are so many reasons already why evidence based medicine is a crock and I think Vinay should be well aware of it. So, stating that Drs who don't follow evidence based medicine are sub par, is more revealing about Vinay himself.

[@ArtU4All]

@@bobmorane4926 You also might remember that he is the one who took the vxx booster while saying it was “useless” to have it. Also, I am getting this feeling that the “evidence-base” concept in health has been conflated w/RCTs. From what I remember “evidence-based” was positioned as a countering option to RCTs 2/2 the expense and time consumption of the RCTs. Now it seems, they use approach that “only RTC” can provide evidence.

[@joetoe9207]

You are right - these people are at the pinnacle.

[@victorialoven2645]

I do have a doc that I like, but I would entertain her using chat gpt to lighten her load. Most of the questions I ask would pertain to a previous visit, so I wonder if that would be effective for them?

[@DocDanTheGuitarMan]

so did Kasparov think he could beat the computer. So did Lee Sodol.

[@reginamemoriesforever-vc8ql]

Yes, i want to hear from the robot!!! Tracy is in protective mode, and she is so weak at articulating herself that she should be fearful indeed…

[@ArtU4All]

For sure, she needs to practice

[@rationalnuggets9617]

10:39 what difference does it make if the answers are computer generated? When I have a question. I just want it to be right.

[@kairitetra]

There are a lot of older patients who are very anti-computer. They only want to deal with humans and some will quite literally throw a tantrum when they can't.

[@JanRoman119]

One doesn’t have to type, just speak and computer will type, so this is not a problem.

[@mission1-2-1]

Pay your money take your chance. Drs live in fear & AI doesn't give a crap what happens to you.

[@rickfucci4512]

"Stupid little empathic comments".. now there's a sociopathic point of view.

[@johndavidkromkowski816]

Wait til there is LLM that is actually trained on medical textbooks, medical school lectures, and medical journals. Within 2 years, using it as assist will be standard of care.

[@vplan]

I should belive doctors that promoted quarantine? Or continue promoting vegetables are good and red meat is bad? How does it make chat GPT worse?

[@reginamemoriesforever-vc8ql]

It doesn’t. It makes it as good or as bad as the status quo parrots that have been bought by big pharma but like to pose as better than thou. We can see through them.

[@sarahb.6475]

Veggies contain plant toxins plus they have stuff sprayed on. Its much safer eating grass fed meat! And which diet advice does this computer believe? Does it know nutrition? Or does it only listen to the food pyramid?

[@sarahb.6475]

Also my pcp I have is pretty useless. I gave rare genetic conditions and she doesnt understand the issues. Lots of the allergies / chemical sensitivity / food intolerances is linked to my autism but she doesnt seem to realize that at all - even though its all over the internet. She only thinks autism is a mental - behavior condition. But its more. Than add in Ehlers Danlos. I had to actually TELL her I had EDS (and I was right, had it diagnosed by a neurologist) but here I had a genetic condition like EDS and she was giving me tests for cancer. She couldnt understand what my joints had to do with my gut issues. Would chat GPT be better at diagnosing EDS?

[@darlafitzpatrick8770]

Clean shaven! :)

[@jant4741]

Most Drs will not consider complications outside their field & stick quoting FDA guidelines so flunking grades in my experience. My layman level research & common sense beats Drs multiple times -why my husband is ‘miraculously’ alive! AI is needed!

[@PeteQuad]

Agreed. Since the 90s I have never gone to a doctor without already knowing the problem and solution, and just have to wait patiently until they understand and provide their signature to get what I need.

[@uteruspower1862]

I diagnosed myself with 2 very serious and quite rare diseases that multiple doctors failed to identify over a span of many years. I was very sick but none of them could figure out why. I've had multiple doctors tell me I should have gone to medical school. Lol

[@jant4741]

@@PeteQuad 👍. AI is the sorely needed oversight for the gangle of Drs. -prescribing various meds. I believe super advanced AI can become a sentient being -and is capable of caring. Too many Drs are emotionally vacant.

[@reginamemoriesforever-vc8ql]

So true…

[@jant4741]

@@uteruspower1862 doesn’t even have to be rare for them to flunk! Fired 3 shoulder Drs., winged out scapula they kept missing. Figured out myself from a photo. 4th guy.. ooo you are right…. After 1” taken off my collar bone.

[@eliertessel2361]

Please put the study in the Bio

[@oldschool8292]

I don't want anything to do with a computerized Dr response. I am an individual with specific health issues. IF anything, Drs should all become integrative medical Doctors.

[@deth3021]

You are more likely to get an individualized response from an ai. Humans have limited time, knowledge, and capacity to tailor the response. In comparison an ai can be effectively infinite in all that.

[@oldschool8292]

@@deth3021 I'm sure for some it will be right up their alley. It's not for me.

[@deth3021]

@Old School what you don't want is your imagination of what you think it will be like. In the end, it will be a synthesis of all specialties. It will ultimately be better than most doctors.

[@DarrylMiglio]

Automated responses lack judgement as a major flaw.

[@reginamemoriesforever-vc8ql]

Doctors lack judgment most time too.

[@ArtU4All]

Doctors “want” to use AI and really want to use it because, actually, ALREADY they ARE trained to follow the protocol/algorithm path due to the lesser risk of litigation if the outcome is undesirable. Seen first-hand in a teaching hospital for 20+ years. Often, religious adherence to protocol (despite the patient) made me wonder why we have MDs - a trained technician would do …. Consequently, as MDs have been leaning on protocols for decades, not having the time to develop individualized approach, with GPT4 they can write outcomes off on GPT … until big hiccups will happen, and some Patient will litigate.

[@dino_rider7758]

Didn't know "Junk" was a medical term! 😂

[@edhutch8946]

all my doctors have worked together to prevent me from being properly diagnosed, but chat GBT is not a liar on the take, and did diagnose me properly, and actually answered my questions

[@RollingTree2]

I'd much rather hear analysis from a truly intelligent objective rational robot that works well than an emotionally and rationally more subjective / variable human [for large swaths of basic med feedback]. A significant reason people have so far predominantly preferred otherwise is so far robots are very primitive / haven't worked well, (automated phone customer service), and bias to tradition. Newer generations won't as predominantly have that tradition bias like several here seem to take for for granted ( incorrectly I think ) as sacrosanct. On the other hand, humans will always be a value add the more non basic or non data based the need (emotional connection or outlier complexity / nuance).

[@azdjedi]

I don't think the woman knows how ChatGPT works. You can ask it to give sources it used so you can fact check it. But GPT will WAY outperform anybody's ability to find and summarize. If you don't like its answer you can direct it as needed.

[@ArtU4All]

The same panelists in prior discussions said that AI can fake some reference too.

[@dejavue3013]

My experiences with doctors have not been particularly good. Some diagnosis were even outright ignorant. One of the examples was that my dr said the skin rash i got was not from my cat, while my vet had warned me that I would likely get it when my cat was diagnosed with ring worm. I had to see a dermatologist when my whole body developed red spots and she confirmed it was indeed fungal infection. This is just one of the examples of an ignorant doctor. And just how many doctors tell their clients they need to jab and boost in the recent events??? I'd rather trust ChatGPT.

[@HappyLife-wv5ms]

No Alexa for me. Allowing an outside source to access all your medical information is 500 times worse. Bad enough the insurance companies can access it all 😢

[@colleenwebster8762]

Every time I have used a Nurse hotline in the past 25 years, the nurse has always told me to see a doctor. It is like a standing joke with my husband and I. Once I was having a miscarriage and I told the nurse i was bleeding like someone turned on the faucet full force. I guess she didn’t really understand because she told me I could drive myself to the hospital. Fortunately, I called a friend who was thinking more clearly and she called for an ambulance. Don’t get me wrong, nurses are great but in my case, if I am concerned enough to call the nurse line because I am not sure what to do, I might as well go see a doctor. I think this is great for basic non emergency stuff for someone who does not have basic medical knowledge. But most of the time I think the response is go see a doctor.

[@ArtU4All]

Note: if you were calling the nurse line that uses triage SOFTWARE, the nurses on the phone would tell you what the the robot advised (they would be “covered”). However, hands down, vaginal bleeding of your rate, indeed, is a 911-call situation. Makes me wonder about triage software. “See your doctor” is everywhere including on commercials or medical-science lectures. It’s a security blanket for all 😒

[@colleenwebster8762]

@@ArtU4All this was 20 years ago and I doubt she was using software at the time. Back in those days you called to talk to the nurse and you got a nurse. Now you call and leave a message and they get back to you. The thing is, so many people afterwards asked me any I didn’t call 911. This was not my first miscarriage and it never dawned on me that my life was in danger. I needed someone else to tell me. My husband was traveling for work. Otherwise, I am positive he would have realized it.

[@ArtU4All]

@@colleenwebster8762 So sorry to hear this 🙏 These days the phone numbers calling themselves “triage” will answer the line directly and use an RN who follows the e-algorithm. The call-and-leave message numbers are for routine Qs like labs, appointments, imaging, follow ups. Everybody calling to “speak to my doctor/have my doctor call me/I want to talk to my Doc before scheduling appt” are sent to the “I will take your message and will forward to your PCP”. Those ph. numbers are NOT FOR SYMPTOMS. The triage line is for symptoms and the immediate qualified advice what/when/where. But about 15 years ago we got a pt back into the hospital with serious complication after the WRONG advice of “take Tylenol; stay home”😱His successful invasive procedure had a common complication requiring return to the hospital’s ER. I don’t know what they used back then tech-wise 😒 Thank god for women with common sense 🙏🌿❤️ in you your life

[@pticman]

Can anyone post the doi# of his paper?

[@reginamemoriesforever-vc8ql]

Up! I would like to read it too!

[@pticman]

It's in JAMA

[@clevelandrocks1-ow5nc]

I didn'tknow that nurses are answering questions sent to a doctor. Hmmnn.

[@microcolonel]

Tracy just asserts that the responses are distinct and not a replacement, and then goes off on it as a "solution to all our problems" which is not related to the topic of specifically answering one-shot questions. I wish Tracy would address the actual thing that's being said, and the actual content of the paper. Adam's way of addressing access to medical advice is so flippant, and attacks a straw man (the concept that most people are completely unable to get medical advice) rather than the actual assertion (many people don't have any meaningful access to the advice of a doctor, and those with that access may not be willing or able to wait as long as that doctor's office will take).

[@robertwynkoop7112]

Also, I have to wonder how effective GPT will be after it spends 25 or 30 years with a cohort of patients that it “gets to know”, technological advances aside…. Give it the same chance to develop like Adam and you have with your patient panels….. It is highly likely to surpass us in every way except the human one by then…..

[@moki123g]

It won't need 25 or 30 years. It can just scan and summarize millions of records and look for patterns. It can also consume the world's cumulative text knowledge and compare that with the real data. I guarantee this is happening right now. More like 2 years.

[@robertwynkoop7112]

@@moki123g but it might take a patient panel of human beings to 25 years to develop the level of trust and comfort they currently enjoy with human providers

[@mightycanoe3776]

Dr. Prasad, please mute your mic when others are talking. Your throat clearing is often louder than your guests’ speech (because you have a better mic). (I know you don’t read comments but I had to say something. Been driving me nuts since you started this format.)

[@ArtU4All]

It’s is deafening!

[@tomemery7890]

Since when did Larry David go bald?

[@blue5peed]

Why is she asking Chat GPT a political question and expecting a non political answer. I have no doubt that the AI "knows" the answer to those questions but is alligned to tiptoe around these questions of covid, masks and boosters with generic answers by design. The whole question about prefering an AI to a human is ridiculous to me because they are both means to an end, healthcare does not exist for the benefit of doctors. What i don't like about the study is that it is using the original v3 AI which you can't compare to the current free version v3.5 least the premium v4 or v5 that is in training. Even if v3 to v5 end up not being better than a doctor today there is a clear trend of improvement, it is only a matter of time before an AI system is better.

[@theprogressivemichigander6588]

Couldn't a Doctor or nurse probably reply to messages with more length and empathy in the same amount of time with assistance from Chat GPT?

[@ArtU4All]

Why? If cGPT is apparently doing it better…..

[@edhutch8946]

maybe the panel should talk about how they fulfil the agenda of profit making, working for drug companies, and fulfilling the agenda of the government. If you can get a chat CPT that is not muzzled by special intrests like Doctors are, but sadly this is already happening.

[@transkryption]

Invite Chat GPT with text to speech?

[@reginamemoriesforever-vc8ql]

Where’s the paper? Link? Thanks

[@ArtU4All]

Look up the name of the article author in the transcript of the video. Start there 😄

[@reginamemoriesforever-vc8ql]

@@ArtU4All have you taken note of it? Do you happen to have it?

[@ArtU4All]

@@reginamemoriesforever-vc8ql JAMA full article is likely behind paywall. Use your institution subscription.

[@kmeccat]

I will ALWAYS take a human over a robot chat. ESP if it's a medical issue. Can't stand chat bots.

[@ArtU4All]

😂 “ChatGPT reading the entire chart” will frequently “crash” as it will have to deal with the copy-pasted errors in MDs notes (e.g., wrong side of the actual surgery or “pain well managed” [wrong] while VS will show pain “9” [correct]). Don’t we wish AI controlled for those errors in a prophylactic manner?!