this post was submitted on 19 May 2025
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Could you provide references? I'm genuinely interested, and what I found seems to say differently:
AI NEJM
Also I believe you're seriously underestimating the abilities of present day LLMs. They are able to ask relevant follow up questions, as well as interpreting that information to request additional studies, and achieve accurate diagnosis.
See here a study specifically on conversational diagnosis AIs. It has some important limitations, crucially from having to work around the text interface which is not ideal, but otherwise achieved really interesting results.
Call them "idiot machines" all you want, but I feel this is going down the same path as full self driving cars - eventually they'll be doing less errors than humans, and that will save lives.
My mistake, I recalled incorrectly. It got 83% wrong. https://arstechnica.com/science/2024/01/dont-use-chatgpt-to-diagnose-your-kids-illness-study-finds-83-error-rate/
The chat interface is stupid in so many ways and I would hate using text to talk to a patient myself. There are so many non-verbal aspects of communication that are hard to teach to humans that would be impossible to teach to an AI. If you are familiar with people and know how to work with them, you can pick up on things like intonation and body language that can indicate that they didn't actually understand the question and you need to rephrase it to get the information you need, or that there's something the patient is uncomfortable about saying/asking. Or indications that they might be lying about things like sexual activity or substance use. And that's not even getting into the part where AI's can't do a physical exam which may reveal things that the interview did not. This also ignores patients that can't tell you what's wrong because they are babies or they have an altered mental status or are unconscious. There are so many situations where an LLM is just completely fucking useless in the diagnostic process, and even more when you start talking about treatments that aren't pills.
Also, the exams are only one part of your evaluation to get through medical training. As a medical student and as a resident, your performance and interactions are constantly evaluated and examined to ensure that you are actually competent as a physician before you're allowed to see patients without a supervising attending physician. For example, there was a student at my school that had almost perfect grades and passed the first board exam easily, but once he was in the room with real patients and interacting with the other medical staff, it became blatantly apparent that he had no business being in the medical field at all. He said and did things that were wildly inappropriate and was summarily expelled. If becoming a doctor was just a matter of passing the boards, he would have gotten through and likely would have been an actual danger to patients. Medicine is as much an art as it is a science, and the only way to test the art portion of it is through supervised practice until they are able to operate independently.
From the article referenced in your news source:
A couple of key points:
I don't think anyone's advocating that an AI will replace doctors, much like it won't replace white collar jobs either.
But if it helps achieve better outcomes for the patients, like the current research seems to indicate, aren't you sworn to consider it in your practice?