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Ya, internist here. For some context, the USMLE is taken during medical school. The amount I have learned about actually practicing medicine since graduating i

Ya, internist here. For some context, the USMLE is taken during medical school. The amount I have learned about actually practicing medicine since graduating is probably an order of magnitude more than everything I learned in medical school! I still learn stuff, all the time, and I’m not just talking about new research. So, while impressive and clearly part of the future world, we shouldn’t get too far ahead of ourselves with the current models. Edit: oh I should add that there are more clinically relevant exams that would be more likely to reveal d clinical usefulness, for example “board” exams. These are taken after training, usually before practice. Not knocking LLMs, just ensuring that people don’t misunderstand passing the USMLE as being clinically useful.

capableweb 4y ago
I agree that we shouldn't get ahead of ourselves with the current technology, but what you said earlier applies to practically every industry and science. What you learn at the actual job is always far more up to date than what you learn in school, no matter if it's being a engineer, doctor or just a lowly programmer.
- notch898a 4y ago
  Yes but the difference is most engineers, and pretty much all lowly programmers are unlicensed. AI or some non-human accessible in the countryside so you don't have to order questionable "fish" antibiotics or "cat" anti-parasitic would be a nice step up from the current gatekeeping of medicine from people with limited access.
  - wbl 4y ago
    There are much simpler ways to provide access to those areas.
    - notch898a 4y ago
      The only significant ways I'm aware of that people get needed rx medications outside of physicians and mid-level practitioners is to leave the country or use "vet"/"animal" drugs. What are the simpler other alternatives currently available?
      - wbl 4y ago
        Make more physicians and pay them to work in rural areas. Congress can just do this.
        goldenkey 4y ago
        American Medical Association is basically a union that artificially caps the number of doctors of each speciality.
        notch898a 4y ago
        The medical cartel loves to cloak their policies under the auspices of safety. In the end you'll find their policies magically result in massive profits for bureaucrats and chokepoints that constrain the supply of gatekeepers. This is not accidental.
        hoseja 4y ago
        Advanced healthcare is also one of major incentives the state has to keep people in line, obedient and participating.
        BurningFrog 4y ago
        How does Congress make physicians?
        cguess 4y ago
        Incentives. Plenty of people would go into rural medicine if it wasn't paying crap and dealing with nothing but elderly Medicare patients because of the lack of health insurance for people just marginally above the Medicaid line. Of course this means there's basically no support currently for the hospitals and more than half are being bought up by private equity anyways and shipping it all to the smallest bottom line. Congress can do a lot.
Madmallard 4y ago
Ive never experienced anything in my care with doctors that I couldn’t understand with a days worth of research into things like UpToDate. It isn’t complicated. It is largely memorization and application of an algorithm which is just borderline useless for complex conditions that are emerging more modernly.
- cguess 4y ago
  Have you ever had anything besides a bad cold? Tell me you understand every acronym in this article, and the ability to explain it succinctly to a patient much less to be able to hand off a case to "another" physician https://www.nejm.org/doi/full/10.1056/NEJMoa2206714 https://www.nejm.org/doi/full/10.1056/NEJMoa2206714 Doctors and nurses have saved me many times from some very close calls because of decades of experience, training and intuition. That is of course not to mention the friend who beat a deep brain tumor on their brain stem that everyone else told them was inoperable, and now are in medical school themselves for neurology. No LLM is going to pull that out of itself, possibly ever, and certainly not GPT-4 (no one else had ever had the surgery done before, it was novel).
  - Madmallard 4y ago
    I have an extremely large amount of experience in this context.
- deleted 4y ago
  [deleted]
- Veen 4y ago
  How do you know that you actually understand a topic as well as a doctor? How do you verify that? It's not unusual for people to think they comprehend a topic at expert level, when in fact they do not. The correlation between confidence and understanding is not a reliable measure. That's why doctors are trained by more expert colleagues who can judge their true understanding, have to take exams, etc.
  - Madmallard 4y ago
sizzle 4y ago
What if the AI is trained on board exams and other high signal testing/examination materials? Surely it will become superhuman in its medical abilities?

capableweb 4y ago

I agree that we shouldn't get ahead of ourselves with the current technology, but what you said earlier applies to practically every industry and science. What you learn at the actual job is always far more up to date than what you learn in school, no matter if it's being a engineer, doctor or just a lowly programmer.

notch898a 4y ago
Yes but the difference is most engineers, and pretty much all lowly programmers are unlicensed. AI or some non-human accessible in the countryside so you don't have to order questionable "fish" antibiotics or "cat" anti-parasitic would be a nice step up from the current gatekeeping of medicine from people with limited access.
- wbl 4y ago
  There are much simpler ways to provide access to those areas.
  - notch898a 4y ago
    The only significant ways I'm aware of that people get needed rx medications outside of physicians and mid-level practitioners is to leave the country or use "vet"/"animal" drugs. What are the simpler other alternatives currently available?
    - wbl 4y ago
      Make more physicians and pay them to work in rural areas. Congress can just do this.
      - goldenkey 4y ago
        American Medical Association is basically a union that artificially caps the number of doctors of each speciality.
        notch898a 4y ago
        The medical cartel loves to cloak their policies under the auspices of safety. In the end you'll find their policies magically result in massive profits for bureaucrats and chokepoints that constrain the supply of gatekeepers. This is not accidental.
        hoseja 4y ago
        Advanced healthcare is also one of major incentives the state has to keep people in line, obedient and participating.
      - BurningFrog 4y ago
        How does Congress make physicians?
        cguess 4y ago
        Incentives. Plenty of people would go into rural medicine if it wasn't paying crap and dealing with nothing but elderly Medicare patients because of the lack of health insurance for people just marginally above the Medicaid line. Of course this means there's basically no support currently for the hospitals and more than half are being bought up by private equity anyways and shipping it all to the smallest bottom line. Congress can do a lot.

Madmallard 4y ago

Ive never experienced anything in my care with doctors that I couldn’t understand with a days worth of research into things like UpToDate. It isn’t complicated. It is largely memorization and application of an algorithm which is just borderline useless for complex conditions that are emerging more modernly.

cguess 4y ago
Have you ever had anything besides a bad cold? Tell me you understand every acronym in this article, and the ability to explain it succinctly to a patient much less to be able to hand off a case to "another" physician https://www.nejm.org/doi/full/10.1056/NEJMoa2206714 https://www.nejm.org/doi/full/10.1056/NEJMoa2206714 Doctors and nurses have saved me many times from some very close calls because of decades of experience, training and intuition. That is of course not to mention the friend who beat a deep brain tumor on their brain stem that everyone else told them was inoperable, and now are in medical school themselves for neurology. No LLM is going to pull that out of itself, possibly ever, and certainly not GPT-4 (no one else had ever had the surgery done before, it was novel).
- Madmallard 4y ago
  I have an extremely large amount of experience in this context.
deleted 4y ago
[deleted]
Veen 4y ago
How do you know that you actually understand a topic as well as a doctor? How do you verify that? It's not unusual for people to think they comprehend a topic at expert level, when in fact they do not. The correlation between confidence and understanding is not a reliable measure. That's why doctors are trained by more expert colleagues who can judge their true understanding, have to take exams, etc.
- Madmallard 4y ago

sizzle 4y ago

What if the AI is trained on board exams and other high signal testing/examination materials? Surely it will become superhuman in its medical abilities?