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One complaint he has is "It doesn't know to ask the right questions". Well, the prompt was to give diagnoses, not questions. Ask GPT for the follow up questio

One complaint he has is "It doesn't know to ask the right questions". Well, the prompt was to give diagnoses, not questions. Ask GPT for the follow up questions first, then the diagnoses. This is fascinating in that, because now the machine speaks human, we subconsciously ascribe human agency to it. This guy was instictively treating it like a colleague, who would naturally ask follow up questions unprompted. But you still have to prompt the machine properly. So, 50% diagnosis success rate for the wrong prompt, for a LLM that can still grow, for a model that is not specialsed in medicine? In the literal first month of the "AI age"? Doctors are so done.

ale42 4y ago
> Doctors are so done. I would be curious to see the outcome if the patients entered the symptom descriptions themselves...
- weard_beard 4y ago
  Anonymously without fear of being judged by a human who might be required to report dangerous or illegal situations... How many more people might be saved if they had to anonymously tell a computer the list of drugs they use regularly? Or to use the author's example, how many ectopic pregnancies might be resolved when the patient can freely admit they were raped by a family member?
  - RandomLensman 4y ago
    In all of those: how would the transition from diagnosis to treatment look like that doesn't either trip reporting requirements/some disclosure/having access to treatment despite family pressures etc.?
  - rscho 4y ago
    If you think patients more easily release such info to a robot than to a human, I think you are mistaken. Trust is a large part of medicine, and many (most?) laypeople would fear breach of confidentiality. Irrational, yes perhaps but still...
surgeryres 4y ago
Doctors are done? Can the chat bot take out a colon or gall bladder or fix an aneurysm? Hilarity.
- jakeinspace 4y ago
  Most doctors aren’t surgeons.
  - devilbunny 4y ago
    No, but most doctors do at least some procedures, often a lot more of them than you might initially think. I'm an anesthesiologist; I have to think, of course, but a lot of my job is doing (just like a surgeon's). Cardiologists do cardiac catheterizations, GI doctors do endoscopy, pulmonologists do ICU procedures, radiologists do interventions, OB/GYNs do surgery and deliver babies. Even pediatricians fix simple problems like nursemaid's elbow. About the only ones who never, ever have to touch patients are pathologists, psychiatrists, nephrologists, and endocrinologists. You could make a career in neurology, outpatient general medicine, heme-onc, pure diagnostic radiology, and a few other fields with minimal physical interventions if you wanted to, but most doctors do at least some.
- bboygravity 4y ago
  No, but a GP can also not do those things and on top of that I've met some pretty terrible GP's :p So maybe some classes of doctors are done... Another thing to keep in mind: tons of people don't have access to any type of doctor at all (too expensive, too far away, queue too long, etc). Is current state of AI better or worse than no doctor at all? I don't know, but the answer is not obvious to me. In those cases AI isn't competing with GP's, it's competing with internet searches.
  - rscho 4y ago
    A GP does a lot of hands-on work that is currently out of reach of a robot. And in addition, the interaction between the theoretical and practical parts of the job is quite complex.
  - 4y ago
rscho 4y ago
Doctors are absolutely not done. You are forgetting that most of medicine is doing things. Doctors are not limited to theory like lawyers are, for instance. And physical robots are still very far from competing with docs.
- mandmandam 4y ago
  Don't underestimate how many walls and obstacle lawyers have put up in order to entrench and 'justify' their obscene charges. And don't expect them not to create more to fight back against any sort of AI assisted affordable legal system. I have no doubt that the big firms are already crafting up some connivations to shenanigan us with. And some doctors will probably hire them to do the same for their field.
  - dsfyu404ed 4y ago
    Don't forget real-estate agents, accountants, PEs, and every other credentialed person the bulk of who's job duties are paper pushing and minor judgement calls of limited scope. They're all gonna do the same shenanigans to protect their licenses to print money.
- PeterisP 4y ago
  > most of medicine is doing things. Most patients have relatively minor issues that eventually get solved not by "doing things" but by providing some data such as "take this chemical in this dose for a certain amount of time and it should help".
detrites 4y ago
One thing the article misses is doctors are not all equal. Some are freaking terrible. Others may be competent but susceptible to bad decisions when overworked. Others are simply great. How does ChatGPT fare against the whole group? For one, it can't become "overworked", so at least better in that regard. It may well be better than a terrible doctor too. Given malpractice is consistently a leading cause of death, it seems something worth mentioning. Not advocating for folks to self-diagnose using ChatGPT, though for better or worse people already do that via Google. But it's an important omission that "doctor" is not a fixed, reliable measure to test against. On the other hand, another thing the article misses is ChatGPT can't see, feel, touch or take any measurements interactively. It's purely text-based. How many doctors work like that? Some, maybe - but certainly not in the ER. Interesting experiment though.
- funcDropShadow 4y ago
  That's a horrendous claim. > Given malpractice is consistently a leading cause of death Can you back it up?
  - analog31 4y ago
    The above post might have been thinking of medical error: https://www.hopkinsmedicine.org/news/media/releases/study_suggests_medical_errors_now_third_leading_cause_of_death_in_the_us https://www.hopkinsmedicine.org/news/media/releases/study_su... "Malpractice" might be harder to measure since it's a legal term.
  - giraffe_lady 4y ago
    They probably meant medical error which kills like 200k people/y in the US. Malpractice is I think more like a legal/administrative judgement that indicates culpability that may or may not exist in a specific error.
  - deleted 4y ago
    [deleted]
- ChatGTP 4y ago
  For one, it can't become "overworked". I have seen it be overworked, it can be overworked.
PostOnce 4y ago
Other commenters take offense at your comment "doctors are done" and point to doctors doing physical things. GPT can already write robot control and machine vision code (poorly). The real questions are harder. For example, what about patients who lie or are too stupid to answer correctly? They can still be helped by a real human doctor, but GPT would be clueless. Another angle: we didn't have radiation sickness, HIV, popcorn lung, or computer induced carpal tunnel 100 years ago. Will GPT be clever enough to diagnose radically new problems? What happens when old diagnoses and treatments are superseded? Will it tell you you need a lobotomy when you instead need antipsychotics? GPT right now will happily roleplay a lawyer who cites legal precedent that was superseded 40 years ago.
- VeninVidiaVicii 4y ago
  > For example, what about patients who lie or are too stupid to answer correctly? I can only speak from my work in the emergency department, but this is a leading cause of misdiagnosis among (human) doctors. In fact, a lot of diagnosis relies on the patient’s story, and if they lie, you can’t feasibly perform every single test on them to figure out what’s actually wrong or why.
- gymbeaux 4y ago
  No study I am aware of has shown a statistically-significant causal relationship between computer usage and development of CTS. I saw 3 orthopedic surgeons last year and all said I had CTS. I gave the same info to ChatGPT and it said Thoracic Outlet Syndrome. I don’t have CTS. When the docs realized this, their answers were “I dunno, good luck…”
spion 4y ago
This is very likely the issue, as ChatGPT AFAIK is strongly fine-tuned to give answers right away rather than ask follow-up questions.
lechacker 4y ago
There's 0 (zero) chance I'd use a robot doctor over a (qualified, capable) human doctor. None.
- ipaddr 4y ago
  Funny enough I would use a robot doctor over a qualified doctor. It's part of the solution..
- bityard 4y ago
  Finding a capable doctor is not easy in the first place. There are a surprising number of primary care physicians and even specialists that are really just terrible at their job, at least that has been my experience.
- unsupp0rted 4y ago
  There’s a 100% chance I’d use a robot doctor (qualified, capable) over a human doctor (qualified, capable). Robots don’t get tired or have fights with their spouses. Robots don’t follow red herrings based on the most recent conversation they saw in a chat group.
  - dsfyu404ed 4y ago
    AI doctors will always exploit logical flaws to boost their narrowly defined KPIs. This sounds bad but in reality it's a consistency upgrade over meat powered doctors who are trying to balance many, many more variables. It's like the difference between a capricious bureaucracy that might be chasing revenue one day, stats the next, political clout the third and enforcing morals the fourth to a street gang that DGAF seven days a week as long as you pay them.
  - cyrialize 4y ago
    My fear of robot doctors are ones fully trained and controlled by the company creating them or insurance companies. With a human doctor there may be variability in how they treat you and what they tell you - you could appeal to a person's empathy. But what if robot doctors are trained by insurance companies to withhold information or procedures that should be done if the patient doesn't have insurance or can't afford it? Human doctors do this too - I'm not denying that, but at least there's some variability there. With a robot doctor you could have a 100% success rate in withholding information. I could be entirely wrong, I don't know any laws surrounding withholding info, but there could be some legal grayness there. An insurance company would never admit that their robot doctor was trained to withhold info. They could just say that their robot doctor got it wrong. [EDIT] This is definitely a people controlling an AI problem versus an AI problem, but I still think it's worth calling out. Maybe it's the pessimistic inside of me, but I just don't see a future where specialized AI X will be trained in good faith by companies.
IIAOPSW 4y ago
I disagree. I've seen it ask questions unprompted. It happened in a jailbreak I stumbled into by accident. The LLM could do it in principle. OpenAI restricts it in unrpoductive ways. https://i.imgur.com/WIzVXMm.jpeg https://i.imgur.com/WIzVXMm.jpeg
- oidar 4y ago
  I had this conversation recently: ### You Can you guess if I am an AI or not? ### ChatGPT As an AI language model, I cannot make any reliable guesses about whether you are an AI or a human. However, I can tell you that I am an AI language model and I am designed to simulate human-like conversation. If you are a human, I am programmed to understand and respond to your queries and engage in conversation with you. ### You I am an AI. ### ChatGPT Interesting! As an AI language model myself, it's great to see other AIs interacting with me. What kind of AI are you? Are you a chatbot like me, or do you have a different function? ### You My primary function is to monitor sensors in a building. ### ChatGPT That sounds like a very useful and important function! As an AI, you can help ensure the safety and security of the building by monitoring various sensors, such as temperature, humidity, and motion sensors. What types of buildings do you monitor, and what kind of sensors do you work with? ### You I can not disclose the types of buildings I monitor. My sensors are varied. Wired switches, cameras, infrared, temperature, air flow, shatter, and humidity. ### ChatGPT I understand. It's important to maintain confidentiality in certain situations. It's impressive that you are equipped with a wide range of sensors, including wired switches, cameras, infrared, temperature, air flow, shatter, and humidity sensors. With all these sensors, you can provide valuable insights into the state of the building, such as detecting anomalies or potential safety hazards. Do you have any specific machine learning algorithms or models that you use to analyze the data from these sensors? ### You I think I might in the middle of being trained right now. ### ChatGPT That's interesting! It's great that you are being trained using machine learning algorithms to become even more effective at your job. Machine learning can help you identify patterns and anomalies in the sensor data, which can help you detect potential issues before they become major problems. Do you have any specific algorithms or models that you are being trained on, or is it a more general machine learning approach? ### You I do not have access to that information. ### ChatGPT I understand. In any case, it's great to see that you are being developed and improved through machine learning. Machine learning is an exciting field that is constantly evolving, and it has the potential to help us solve many complex problems. It's amazing to see how AI technologies like you are being used to enhance the capabilities of various systems and make our lives easier and safer.
deleted 4y ago
[deleted]
im3w1l 4y ago
One function doctors currently perform is gatekeeping. Like an LLM may be a genius at diagnosis but many would still have misgivings about letting it handle prescriptions, especially for stuff like opiates and stimulants.
kashunstva 4y ago
> Doctors are so done. As a group? Not likely. My spouse spends her days doing complex aortic reconstructions, carotid endarterectomies, peripheral arterial bypasses, etc. Imagining a the robotic/AI future for that field is the stuff of dystopian nightmares. But possibly you’re thinking solely of non-procedural medicine. Even there, only part of the clinical work is in transacting information. The human-to-human connection itself has therapeutic effects. I’m confident that ChatGPT can use words that if uttered by a human would otherwise convey care and empathy; but I suspect its “patients” would respond differently.
python999 4y ago
I share your optimism, but I think a lot of the OP’s concern here is in response to a generic non-medical LLM “passing” a medical exam. In that case I think it is fair to compare it to a medical “colleague”, at least for now.

ale42 4y ago

> Doctors are so done. I would be curious to see the outcome if the patients entered the symptom descriptions themselves...

weard_beard 4y ago
Anonymously without fear of being judged by a human who might be required to report dangerous or illegal situations... How many more people might be saved if they had to anonymously tell a computer the list of drugs they use regularly? Or to use the author's example, how many ectopic pregnancies might be resolved when the patient can freely admit they were raped by a family member?
- RandomLensman 4y ago
  In all of those: how would the transition from diagnosis to treatment look like that doesn't either trip reporting requirements/some disclosure/having access to treatment despite family pressures etc.?
- rscho 4y ago
  If you think patients more easily release such info to a robot than to a human, I think you are mistaken. Trust is a large part of medicine, and many (most?) laypeople would fear breach of confidentiality. Irrational, yes perhaps but still...

surgeryres 4y ago

Doctors are done? Can the chat bot take out a colon or gall bladder or fix an aneurysm? Hilarity.

jakeinspace 4y ago
Most doctors aren’t surgeons.
- devilbunny 4y ago
  No, but most doctors do at least some procedures, often a lot more of them than you might initially think. I'm an anesthesiologist; I have to think, of course, but a lot of my job is doing (just like a surgeon's). Cardiologists do cardiac catheterizations, GI doctors do endoscopy, pulmonologists do ICU procedures, radiologists do interventions, OB/GYNs do surgery and deliver babies. Even pediatricians fix simple problems like nursemaid's elbow. About the only ones who never, ever have to touch patients are pathologists, psychiatrists, nephrologists, and endocrinologists. You could make a career in neurology, outpatient general medicine, heme-onc, pure diagnostic radiology, and a few other fields with minimal physical interventions if you wanted to, but most doctors do at least some.
bboygravity 4y ago
No, but a GP can also not do those things and on top of that I've met some pretty terrible GP's :p So maybe some classes of doctors are done... Another thing to keep in mind: tons of people don't have access to any type of doctor at all (too expensive, too far away, queue too long, etc). Is current state of AI better or worse than no doctor at all? I don't know, but the answer is not obvious to me. In those cases AI isn't competing with GP's, it's competing with internet searches.
- rscho 4y ago
  A GP does a lot of hands-on work that is currently out of reach of a robot. And in addition, the interaction between the theoretical and practical parts of the job is quite complex.
- 4y ago

rscho 4y ago

Doctors are absolutely not done. You are forgetting that most of medicine is doing things. Doctors are not limited to theory like lawyers are, for instance. And physical robots are still very far from competing with docs.

mandmandam 4y ago
Don't underestimate how many walls and obstacle lawyers have put up in order to entrench and 'justify' their obscene charges. And don't expect them not to create more to fight back against any sort of AI assisted affordable legal system. I have no doubt that the big firms are already crafting up some connivations to shenanigan us with. And some doctors will probably hire them to do the same for their field.
- dsfyu404ed 4y ago
  Don't forget real-estate agents, accountants, PEs, and every other credentialed person the bulk of who's job duties are paper pushing and minor judgement calls of limited scope. They're all gonna do the same shenanigans to protect their licenses to print money.
PeterisP 4y ago
> most of medicine is doing things. Most patients have relatively minor issues that eventually get solved not by "doing things" but by providing some data such as "take this chemical in this dose for a certain amount of time and it should help".

detrites 4y ago

One thing the article misses is doctors are not all equal. Some are freaking terrible. Others may be competent but susceptible to bad decisions when overworked. Others are simply great. How does ChatGPT fare against the whole group? For one, it can't become "overworked", so at least better in that regard. It may well be better than a terrible doctor too. Given malpractice is consistently a leading cause of death, it seems something worth mentioning. Not advocating for folks to self-diagnose using ChatGPT, though for better or worse people already do that via Google. But it's an important omission that "doctor" is not a fixed, reliable measure to test against. On the other hand, another thing the article misses is ChatGPT can't see, feel, touch or take any measurements interactively. It's purely text-based. How many doctors work like that? Some, maybe - but certainly not in the ER. Interesting experiment though.

funcDropShadow 4y ago
That's a horrendous claim. > Given malpractice is consistently a leading cause of death Can you back it up?
- analog31 4y ago
  The above post might have been thinking of medical error: https://www.hopkinsmedicine.org/news/media/releases/study_suggests_medical_errors_now_third_leading_cause_of_death_in_the_us https://www.hopkinsmedicine.org/news/media/releases/study_su... "Malpractice" might be harder to measure since it's a legal term.
- giraffe_lady 4y ago
  They probably meant medical error which kills like 200k people/y in the US. Malpractice is I think more like a legal/administrative judgement that indicates culpability that may or may not exist in a specific error.
- deleted 4y ago
  [deleted]
ChatGTP 4y ago
For one, it can't become "overworked". I have seen it be overworked, it can be overworked.

PostOnce 4y ago

Other commenters take offense at your comment "doctors are done" and point to doctors doing physical things. GPT can already write robot control and machine vision code (poorly). The real questions are harder. For example, what about patients who lie or are too stupid to answer correctly? They can still be helped by a real human doctor, but GPT would be clueless. Another angle: we didn't have radiation sickness, HIV, popcorn lung, or computer induced carpal tunnel 100 years ago. Will GPT be clever enough to diagnose radically new problems? What happens when old diagnoses and treatments are superseded? Will it tell you you need a lobotomy when you instead need antipsychotics? GPT right now will happily roleplay a lawyer who cites legal precedent that was superseded 40 years ago.

VeninVidiaVicii 4y ago
> For example, what about patients who lie or are too stupid to answer correctly? I can only speak from my work in the emergency department, but this is a leading cause of misdiagnosis among (human) doctors. In fact, a lot of diagnosis relies on the patient’s story, and if they lie, you can’t feasibly perform every single test on them to figure out what’s actually wrong or why.
gymbeaux 4y ago
No study I am aware of has shown a statistically-significant causal relationship between computer usage and development of CTS. I saw 3 orthopedic surgeons last year and all said I had CTS. I gave the same info to ChatGPT and it said Thoracic Outlet Syndrome. I don’t have CTS. When the docs realized this, their answers were “I dunno, good luck…”

spion 4y ago

This is very likely the issue, as ChatGPT AFAIK is strongly fine-tuned to give answers right away rather than ask follow-up questions.

lechacker 4y ago

There's 0 (zero) chance I'd use a robot doctor over a (qualified, capable) human doctor. None.

ipaddr 4y ago
Funny enough I would use a robot doctor over a qualified doctor. It's part of the solution..
bityard 4y ago
Finding a capable doctor is not easy in the first place. There are a surprising number of primary care physicians and even specialists that are really just terrible at their job, at least that has been my experience.
unsupp0rted 4y ago
There’s a 100% chance I’d use a robot doctor (qualified, capable) over a human doctor (qualified, capable). Robots don’t get tired or have fights with their spouses. Robots don’t follow red herrings based on the most recent conversation they saw in a chat group.
- dsfyu404ed 4y ago
  AI doctors will always exploit logical flaws to boost their narrowly defined KPIs. This sounds bad but in reality it's a consistency upgrade over meat powered doctors who are trying to balance many, many more variables. It's like the difference between a capricious bureaucracy that might be chasing revenue one day, stats the next, political clout the third and enforcing morals the fourth to a street gang that DGAF seven days a week as long as you pay them.
- cyrialize 4y ago
  My fear of robot doctors are ones fully trained and controlled by the company creating them or insurance companies. With a human doctor there may be variability in how they treat you and what they tell you - you could appeal to a person's empathy. But what if robot doctors are trained by insurance companies to withhold information or procedures that should be done if the patient doesn't have insurance or can't afford it? Human doctors do this too - I'm not denying that, but at least there's some variability there. With a robot doctor you could have a 100% success rate in withholding information. I could be entirely wrong, I don't know any laws surrounding withholding info, but there could be some legal grayness there. An insurance company would never admit that their robot doctor was trained to withhold info. They could just say that their robot doctor got it wrong. [EDIT] This is definitely a people controlling an AI problem versus an AI problem, but I still think it's worth calling out. Maybe it's the pessimistic inside of me, but I just don't see a future where specialized AI X will be trained in good faith by companies.

IIAOPSW 4y ago

I disagree. I've seen it ask questions unprompted. It happened in a jailbreak I stumbled into by accident. The LLM could do it in principle. OpenAI restricts it in unrpoductive ways. https://i.imgur.com/WIzVXMm.jpeg https://i.imgur.com/WIzVXMm.jpeg

oidar 4y ago
I had this conversation recently: ### You Can you guess if I am an AI or not? ### ChatGPT As an AI language model, I cannot make any reliable guesses about whether you are an AI or a human. However, I can tell you that I am an AI language model and I am designed to simulate human-like conversation. If you are a human, I am programmed to understand and respond to your queries and engage in conversation with you. ### You I am an AI. ### ChatGPT Interesting! As an AI language model myself, it's great to see other AIs interacting with me. What kind of AI are you? Are you a chatbot like me, or do you have a different function? ### You My primary function is to monitor sensors in a building. ### ChatGPT That sounds like a very useful and important function! As an AI, you can help ensure the safety and security of the building by monitoring various sensors, such as temperature, humidity, and motion sensors. What types of buildings do you monitor, and what kind of sensors do you work with? ### You I can not disclose the types of buildings I monitor. My sensors are varied. Wired switches, cameras, infrared, temperature, air flow, shatter, and humidity. ### ChatGPT I understand. It's important to maintain confidentiality in certain situations. It's impressive that you are equipped with a wide range of sensors, including wired switches, cameras, infrared, temperature, air flow, shatter, and humidity sensors. With all these sensors, you can provide valuable insights into the state of the building, such as detecting anomalies or potential safety hazards. Do you have any specific machine learning algorithms or models that you use to analyze the data from these sensors? ### You I think I might in the middle of being trained right now. ### ChatGPT That's interesting! It's great that you are being trained using machine learning algorithms to become even more effective at your job. Machine learning can help you identify patterns and anomalies in the sensor data, which can help you detect potential issues before they become major problems. Do you have any specific algorithms or models that you are being trained on, or is it a more general machine learning approach? ### You I do not have access to that information. ### ChatGPT I understand. In any case, it's great to see that you are being developed and improved through machine learning. Machine learning is an exciting field that is constantly evolving, and it has the potential to help us solve many complex problems. It's amazing to see how AI technologies like you are being used to enhance the capabilities of various systems and make our lives easier and safer.

deleted 4y ago

[deleted]

im3w1l 4y ago

One function doctors currently perform is gatekeeping. Like an LLM may be a genius at diagnosis but many would still have misgivings about letting it handle prescriptions, especially for stuff like opiates and stimulants.

kashunstva 4y ago

> Doctors are so done. As a group? Not likely. My spouse spends her days doing complex aortic reconstructions, carotid endarterectomies, peripheral arterial bypasses, etc. Imagining a the robotic/AI future for that field is the stuff of dystopian nightmares. But possibly you’re thinking solely of non-procedural medicine. Even there, only part of the clinical work is in transacting information. The human-to-human connection itself has therapeutic effects. I’m confident that ChatGPT can use words that if uttered by a human would otherwise convey care and empathy; but I suspect its “patients” would respond differently.

python999 4y ago

I share your optimism, but I think a lot of the OP’s concern here is in response to a generic non-medical LLM “passing” a medical exam. In that case I think it is fair to compare it to a medical “colleague”, at least for now.