11 ms·

My Mom and Dr. DeepSeek (2025)

238 points by kieto 8mo ago

wnissen 8mo ago
This was not what I was expecting. The doctors I know are mostly miserable; stuck between the independence but also the burden of running their own practice, or or else working for a giant health system and having no control over their own days. You can see how an LLM might be preferable, especially when managing a chronic, degenerative condition. I have a family member with stage 3 kidney disease who sees a nephrologist, and there's nothing you can actually do. No one in their right mind would recommend a kidney transplant, let alone dialysis for someone with moderately impaired kidneys. All you can do is treat the symptoms as they come up and monitor for significant drops in function.
mhl47 8mo ago
Worriesome for sure. However I would say that the cited studies are somewhat outdated already compared e.g. with GPT-5-Thinking doing 2mins of reasoning/search about a medical question. As far as I know Deepseeks search capabilities are not comparable and non of the models in the study spend a comparable amount of compute answering your specific question.
- nsjdkdkdk 8mo ago
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candiddevmike 8mo ago
I think the article can basically be summed up as "GenAI sychophancy should have a health warning similar to social media". It's a helluva drug to be constantly rewarded and flattered by an algorithm.
- koshergweilo 8mo ago
  I think that's doing the article a disservice. "Some patients prefer the service of AI doctors to real doctors, even though they definitely do get a lot wrong" is what I got out of it. Personally I think the article spends a lot of time trying to show that AI may be able to improve health outcomes, particulaly for rural patients, but IMHO it doesn't spend nearly enough time talking about the current challenges
snitzr 8mo ago
A sick family member told me something along the lines of, "I know how to work with AI to get the answer." I interpret that to mean he asks it questions until it tells him what he wants to hear.
- Joel_Mckay 8mo ago
  Indeed, real doctors have the advantage of understanding how to treat humans that are incapacitated. =3 https://www.youtube.com/watch?v=yftBiNu0ZNU https://www.youtube.com/watch?v=yftBiNu0ZNU
  - wvbdmp 8mo ago
    Just seeing that guy’s face and hearing his voice makes me uneasy. That channel is total body-horror. Glad that guy ended up okay, unlike this poor soul: https://youtube.com/watch?v=NJ7M01jV058 https://youtube.com/watch?v=NJ7M01jV058
    - Joel_Mckay 8mo ago
      Indeed, the instinctual pucker factor for some things in this world are warranted. That case is famous, and still controversial to those with inflated hubris. =3
blacksmith_tb 8mo ago
The dangers are obvious (and also there are some fascinating insights into how healthcare works practically in China). I wonder if some kind of "second opinion" antagonistic approach might reduce the risks.
- torstenvl 8mo ago
  Medical Advice Generative Adversarial Networks would be a good idea. I see some of this adversarial second-guessing introspection from Claude sometimes. ("But wait. I just said x y and z, but that's inconsistent with this other thing. Let me rethink that.") Sometimes when I get the sense that an LLM is too sycophantic, I'll instruct it to steelman the counter-argument, then assess the persuasiveness of that counter-argument. It helps.
- cassepipe 8mo ago
  Can you expand on the insights into the chinese medical system ?
  - blacksmith_tb 8mo ago
    I hadn't really even seen much in the way of recent, first / second person accounts of what it's like to receive chronic care in modern China. It's sad but maybe not surprising to see that it's dysfunctional in its own special way.
philipwhiuk 8mo ago
This almost certainly isn't only a China problem. I've observed UK users asking questions about diabetes and other health advice. We also have an inexpensive (free-at-point of use for most stuff) but stretched healthcare system. Doubtless there are US users looking at the cost of their healthcare and resorting to ChatGPT instead too. In companies people talk about Shadow-IT happening when IT doesn't cover the user needs. We should probably label this stuff Shadow-Health. To some extent, the deployment of a publicly funded AI health chat bot, where the responses can be analysed by healthcare professionals to at least prevent future harm is probably significantly less bad than telling people not to ask AI questions and consult the existing stretched infrastructure. Because people will ask the questions regardless.
- threetonesun 8mo ago
  The joke of looking symptoms up on WebMD and determining you have cancer has been around for... geez over 20 years now. Anti-vaccine sentiment mostly derived from Facebook. Google any symptom today and there are about 10 million Quora-esque websites of "doctors" answering questions. I'm not sure that funneling all of this into the singular UI of an AI interface is really better or worse or even all that different. But I do agree that some focused and well funded public health bot would be ideal, although we'll need the WHO to do it, it's certainly not coming from the US any time soon.
margorczynski 8mo ago
The problem is not reliance on AI but that the AI is not ready yet and using general-purpose models. There isn't simply enough doctors to go around and the average one isn't as knowledgeable as you would want. Everything suggests that when it comes to diagnosis ML systems should be better in the long run on average. Especially with a quickly aging population there is no alternative if we want people to have healthcare on a sensible level.
- HPsquared 8mo ago
  They really have arrived just in time, I think.
guywithahat 8mo ago
> At the bot’s suggestion, she reduced the daily intake of immunosuppressant medication her doctor prescribed her and started drinking green tea extract. She was enthusiastic about the chatbot I don't know enough about medicine to say whether or not this is correct, but it sounds suspect. I wouldn't be surprised if chatbots, in an effort to make people happy, start recommending more and more nonsense natural remedies as time goes on. AI is great for injuries and illnesses, but I wonder if this is just the answer she wants, and not the best answer.
- cube00 8mo ago
  As soon as the model detects user pleasure at not needing a scary surgery (especially if you already confided that you're scared) then it'll double down on that line to please the user.
- abhisuri97 8mo ago
  med student here: Reducing immunosuppressant not something to be taken lightly for kidney transplant patients. I was shocked when I read that sentence.
kingstnap 8mo ago
> she said she was aware that DeepSeek had given her contradictory advice. She understood that chatbots were trained on data from across the internet, she told me, and did not represent an absolute truth or superhuman authority With highly lucid people like the author's mom I'm not too worried about Dr. Deepseek. I'm actually incredibly bullish on the fact that AI models are, as the article describes, superhumanly empathetic. They are infinitely patient, infinitely available, and unbelievably knowledgeable, it really is miraculous. We don't want to throw the baby out with the bathwater, but there are obviously a lot of people who really cannot handle the seductivity of things that agree with them like this. I do think there is pretty good potential in making good progress on this front in though. Especially given the level of care and effort being put into making chatbots better for medical uses and the sheer number of smart people working on the problem.
- atoav 8mo ago
  Well yes, but as an extremely patient person I can tell you that infinite patience doesn't come without its own problems. In certain social situations the ethically better thing to do is to actually to lose your patience, may it be to shake the person talking to you up, may it be to indicate they are going down a wrong path or whatnot. I have experience with building systems to remove that infinite patience from chatbots and it does make interactions much more realistic.
- HPsquared 8mo ago
  If the computer is the bicycle of the mind, GenAI is a motor vehicle. Very powerful and transformative, but it's also possible to get into trouble.
  - thewebguyd 8mo ago
    A stark difference with that analogy is that with a bicycle, the human is still doing quite a bit of work themselves. The bicycle amplifies the human effort, whereas with a motor vehicle, the vehicle replaces the human effort entirely. No strong opinion on if that's good or bad long term, as humans have been outsourcing portions of their thinking for a really long time, but it's interesting to think about.
renewiltord 8mo ago
Access trumps everything else. A doctor is fine with you dying while you wait on his backlog. The machine will give you some wrong answers. The mother in the story seems to be balancing the concerns. She has become the agent of her own life empowered by a supernatural machine. > She understood that chatbots were trained on data from across the internet, she told me, and did not represent an absolute truth or superhuman authority. She had stopped eating the lotus seed starch it had recommended. The “there’s wrong stuff there” fear has existed for the Internet, Google, StackOverflow. Each time people adapted. They will adapt again. Human beings have remarkable ability to use tools.
theyneverlear 8mo ago
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reenorap 8mo ago
I and many of my friends have used ChatGPT extremely effectively to diagnose medical issues. In fact, I would say that ChatGPT is better than most doctors because most doctors don't actually listen to you. ChatGPT took the time to ask me questions and based on my answers, narrowed down a particularly scary diagnosis and gave excellent instructions on how to get to a local hospital in a foreign country, what to ask for, and that I didn't have to worry very much because it sounded very typical for what I had. The level of reassurance that I was doing everything right actually made me feel less scared, because it was a pretty serious problem. Everything it told me was 100% correct and it guided me perfectly. I was taking one high blood pressure medication but then noticed my blood sugar jumped. I did some research with ChatGPT and it found a paper that did indicate that it could raise blood sugar levels and gave me a recommendation for an alternative I asked my doctor about it and she said I was wrong, but I gently pushed her to switch and gave the recommended medication. She obliged, which is why I have kept her for almost 30 years now, and lo and behold, my blood sugar did drop. Most people have a hard time pushing back against doctors and doctors mostly work with blinders on and don't listen. ChatGPT gives you the ability to keep asking questions without thinking you are bothering them. I think ChatGPT is a great advance in terms of medical help in my opinion and I recommend it to everyone. Yes, it might make mistakes and I caution everyone to be careful and don't trust it 100%, but I say that about human doctors as well.
- ZhadruOmjar 8mo ago
  ChatGPT for health questions is the best use case I have found (Claude wins for code). Having a scratch pad where I can ask about any symptom I might feel, using project memory to cross reference things and having someone actually listen is very helpful. I asked about Crohn's disease since my grandfather suffered from it and I got a few tests I could do, stats on likelihood based on genetics, diet ideas to try and questions to ask the doctor. Much better than the current doc experience which is get the quickest review of my bloods, told to exercise and eat healthy and a see you in six months.
- jamespo 8mo ago
  [flagged]
Thoreandan 8mo ago
Reminds me of an excellent paper I just read by a former Google DeepMind Ethics Research Team member https://www.mdpi.com/2504-3900/114/1/4 https://www.mdpi.com/2504-3900/114/1/4 - Reinecke, Madeline G., et al. "The double-edged sword of anthropomorphism in llms." Proceedings. Vol. 114. No. 1. MDPI, 2025 Author: https://www.mgreinecke.com/ https://www.mgreinecke.com/
adzm 8mo ago
Considering how difficult it is to get patients to talk to doctors, using AI can be a great way to get some suggestions and insight _and then present that to your actual doctor_
- stronglikedan 8mo ago
  Patients talking to doctors is the easy part. Doctors actually listening to anything they don't already think is nearly impossible.
delichon 8mo ago
I prepared for a new patient appointment with a medical specialist last week by role playing the conversation with a chatbot. The bot turned out to be much more responsive, inquisitive and helpful. The doctor was passive, making no suggestions, just answering questions. I had to prompt him explicitly to get to therapy recommendations, unlike the AI. I was glad that I had learned enough from the bot to ask useful questions. It would have been redundant if the doctor was active and interested, but that can't be depended on. This is standard procedure for me now.
zzzoom 8mo ago
If you get the "You're absolutely right!" response from an LLM that screwed up on a field you're familiar with and still let them play with your health, you're...courageous to say the least.
- kristianp 8mo ago
  What you're describing is called Gell-Mann Amnesia.
heisenbit 8mo ago
For major medical issues it may well be best practice to use the four eyes principle like we do for all safety related systems. Access is key and at this time getting a second pair of eyes in close timely proximity is a luxury few have and even fewer will have looking at the demographics in the developed world. Human doctors are failable as is AI. For the time being having a multitude of perspectives may well be the best in most cases.
- th0ma5 8mo ago
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- alexpotato 8mo ago
  The big bank phrase for "four eyes" was "maker/checker" and I always enjoyed that it rhymed. You are 100% correct that, much like pilots overseeing autopilots, we should combine the best of both worlds in the medical field.
Jhater 8mo ago
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repiret 8mo ago
I'm reminded of the monologue from Terminator 2: > Watching John with the machine, it was suddenly so clear. The Terminator would never stop, it would never leave him... it would always be there. And it would never hurt him, never shout at him or get drunk and hit him, or say it couldn't spend time with him because it was too busy. And it would die to protect him. Of all the would-be fathers who came and went over the years, this thing, this machine, was the only one who measured up. In an insane world, it was the sanest choice. The AI doctor will always have enough time for you, and always be at the top of their game with you. It becomes useful when it works better than an overworked midlevel, not when it competes with the best doctor on their best day. If we're not there already, we're darn close.
- magarnicle 8mo ago
  But the top of their game includes them make things up and getting things wrong. They always give their best, but they always include mistakes. It's a different trust proposition to a human.
  - TeMPOraL 8mo ago
    All doctors make things up and get things wrong occasionally. The less experienced and more overworked they are, the more often this happens. Again, LLMs aren't competing with the best human doctors. They're competing with doctors you actually have access to.
  - terribleperson 8mo ago
    A real, actual doctor told my brother, who has a chronic headache disorder, to just keep taking OTC painkillers. You very specifically should not do that; you'll develop a medication overuse headache and be worse off than you were. It gets worse, though. I was able to ask them a few questions about their symptoms, compare them to entries in the International Classification of Headache Disorders, and narrow it down to, iirc, two likely possibilities. One of them was treatable. The treatment works. They still have pain, but can do stuff. An AI that makes stuff up and gets stuff wrong isn't any different from the doctors we already have, except you can afford to get a second opinion, and you have the time available to push back and ask questions. Edit: to expound on quality of the doctor - diagnosis and proposing a treatment was the work of several hours for me, a layman. A doctor should have known the ICHD existed. They should have been able to, in several minutes, ask questions about symptoms, reference the ICHD to narrow down likely diagnoses, and then propose a treatment with a "come back if that doesn't help".
alexpotato 8mo ago
One of my kids recently had a no-contact knee injury while playing basketball. He immediately started limping and crying and I had to carry him from the court to the car. I did some searching with Grok and I found out: - no contact injuries are troubling b/c it generally means they pulled something - kids don't generally tear an ACL (or other ligament) - it's actually way more common for the ligament to pull the anchor point off of the bigger bone b/c kid bones are soft I asked it to differentially diagnose the issue with the details of: can't hold weight, little to no swelling and some pain. It was adamant, ADAMANT, that this was a classic case of bone being pulled off by the ligament and that it would require surgery. It even pointed out the no swelling could be due to a very small tear etc. It gave me a 90% chance of surgery too. I followed up by asking what test would definitely prove it one way or the other and it mentioned getting an X-Ray. We go off to the urgent care, son is already kind of hobbling around. Doctor says he seems fine, I push for an X-Ray and turns out no issue: he probably just pulled something. He was fully healed in 2-3 days. As someone who has done a lot of differential diagnosing/troubleshooting of big systems (FinTech SRE) I find it interesting that it was basically correct in what could have happened but couldn't go the "final mile" to establish it correctly. Once we start hooking up X-Rays to Claude/Grok 4.2 etc equivalent LLMs, will be even more interesting to see where this goes.
- WarmWash 8mo ago
  >I did some searching with Grok Grok is...not most people's first choice. At least both OpenAI and Deep Mind do medical fine tuning, and both are almost certainly paying doctors to do it.
  - code_biologist 8mo ago
    +1. I wish Gemini 2.5/3 Pro's "personality" and long context handling wasn't so erratic, because the medical stuff in there is great. Whatever they did to produce the MedGemma models is clearly built on a strong baseline. I haven't had need to try using MedGemma on x-ray imagery, but I'd be curious to hear results — imagery diagnostics is part of what it's built for. Opus 4.5 seems good too, though getting dumber. OpenAIs fine tuning is clearly built to toe the professional medical advice line, which can be good and bad.
scuff3d 8mo ago
I feel like we're in the part of the dystopian SciFi movie where they explain how civilization discovered some technological advance that they thought would be a panacea to all their woes. And despite not really understanding it or it's limitations, just started slapping it on absolutely everything, and before they know what happened everything comes crashing down.
- q3k 8mo ago
  We are witnessing the Great Filter in action. (and not just with the AI stuff)
tgtweak 8mo ago
Much like talking to your doctor - you need to ask/prompt the right questions. I've seen chatgpt and gemini make one false assumption that was never mentioned and run with it and continue referencing it down the line as if it were fact... That can be extremely dangerous if you don't know enough to ask it to reframe or verify, or correct it's assumption. If you are using it like a tool to review/analyze or simplify something - ie explain risk stratification for a particular cancer variant and what is taken into account, or ask it to provide probabilities and ranges for survival based on age/medical history, it's usually on the money. Every other caveat mentioned here is valid, and it's valid for many domains not just medical. I did get hemotologist/oncologist level advice out of chatgpt 4o based on labs, pcr tests and symptoms - and those turned out to be 100% true based on how things panned out in the months that followed and ultimately the treatment that was given. Doctors do not like to tell you the good and the bad candidly - it's always "we'll see what the next test says but things look positive" and "it could be as soon as 1 week or as long as several months depending on what we find" when they know full well you're in there for 2 months at minimum you're a miracle case. Only once cornered or prompted will they give you a larger view of the big picture. The same is true for most professional fields.
- wildzzz 8mo ago
  The one thing a real doctor can do is actually touch the patient and run tests, even simple things like using a stethoscope. At best, an AI "doctor" is just comparing patient-provided symptoms to a lookup table of conditions. No better than what WebMD used to (still does?) when you would answer a questionnaire and be provided with a list of conditions ranging from a cold to the bubonic plague. AI loves taking everything you say at face value, it doesn't know how to think critically. Whole doctors shouldn't think of a patient as an adversary, they often lie or unintentionally obscure symptoms or the severity of symptoms. Even the most junior doctor can provide a more thorough examination over the phone or through chat than an AI that believes everything it hears. I remember trying to talk to WebMD when I had pain in my side and appendicitis was near the bottom of the list, the top stuff was either nothing serious or highly improbable. The pain didn't seem as bad as what the appendicitis pain should have been based on descriptions. My mother got her doctor to call me and he walked me through some touching and said "you likely have appendicitis, don't talk to WebMD next time." I went to the hospital that night and that doctor told me I was likely hours away from a burst appendix. I can only imagine what nonsense ChatGPT would have told me. Just like with most professions, the real world is nothing like the textbook. Being able to pass a medical exam doesn't necessarily mean you're going to be a good doctor. Most of the exam is taken during med school and the final portion is only taken after the first year of residency. They still have another few years at least of residency after passing USMLE and that's with supervision under an attending doctor. Being able to pass the USMLE is not equivalent to being successful doctor with years of experience.
Kuyawa 8mo ago
"Doctors are more like machines" "Machines are more like humans" I love the future...
rramadass 8mo ago
Relevant: The AI Revolution in Medicine: GPT-4 and Beyond by Peter Lee (Microsoft Research) - https://www.microsoft.com/en-us/research/publication/the-ai-revolution-in-medicine-gpt-4-and-beyond/ https://www.microsoft.com/en-us/research/publication/the-ai-... The AI Revolution in Medicine, Revisited by Peter Lee (Microsoft Research) - https://www.microsoft.com/en-us/research/story/the-ai-revolution-in-medicine-revisited/ https://www.microsoft.com/en-us/research/story/the-ai-revolu...
djoldman 8mo ago
The basic calculus is that if you decrease the number of minutes of doctor time enough, it doesn't really matter if they are 100% correct (0 minutes of 100% correct = 0 advice). Patients are substituting 15 minutes of 100% correct information for 2 hours of 80%, or whatever percentage the AIs are. Additionally, they're pretty much free at the moment and available 24/7 with no travel required.
swordsith 8mo ago
The problem with any patient to doctor or patient to Dr. Claude is that intentionally or not the patient will lie or misinterpret their condition, to the point of not describing it properly, risking getting a bad diagnosis or suggestion with a chatbot. In a classical medical scenario this can still happen but there is the chance that the medical professional could see through to the actual problem. There is a reason why even in real life it's sometimes best to get a second medical opinion.
fwipsy 8mo ago
Chatbots aren't better than doctors can be. But in the US, doctors are a highly credentialed position, therefore expensive, therefore their time is split into minimal parcels. (Still longer than 5 minutes at least!!) In my experience, chatbots are often better than doctors are in the real world, at least for savvy users.
deleted 8mo ago
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haritha-j 8mo ago
It really hit me when she said the chatbot was more human, the doctor was like a machine. I heard the same complaint from my mother about her doctor, and about being afraid to ask a question because he might snap at her.
emsign 8mo ago
It's funny how he cites all these unreliable sources his mother used to consult but who's to say DeepSeek wasn't trained on them? It's still insane to me how people can trust an LLM they didn't train themselves! You have no idea what vile and evil Dreck these models were trained with. It's the click workers in third world countries who you don't recognize exist who could know if they were experts. But they aren't. A huge responsibility for these underpaid workers. They are the backbone of this hype, not GPUs. It's all built on shit. :)
serious_angel 8mo ago
What a nonsense, sorry... Human is human already, regardless how they speak and what they do... There's always true sympathy and empathy to find in a human, regardless how busy, dark, erroneous etc. they are... Yet, it's the true alive soul inside in every person... Medics are likely tired, doing their job every single day, yet they have empathy, and will always try to listen if you actually try... They know what PAIN, AGONY, DEATH, SORROW... fear means... LLM/"AI" will always pretend to be a human, since it's "trained"/designed, to be so, and will always be limited and incomplete... Not to mention the initial dataset of numerous emphatic actual human has its limited memory inside, no one is responsible for. What a hopeless sorrow is that awful trendy, advertised, mind-atrophying mess...
meroes 8mo ago
Not a single response how the doctors got her all this data to be able to be fed into DeepSeek? AI is doing the last mile and all these posters are saying it’s replacing doctors. Scary stuff.
District5524 8mo ago
I don't understand: if there is a shortage of doctors, why are we trying to solve that by training AI models modelled on influencers that spits out (hopefully improving) advice at 10x the rate of a human doctor? Is it impossible for highly advanced societies like ours to pay more for people to get trained as doctors, nurses or whatever is missing? Or to convince them to choose a profession that deals with other humans instead of UBI? I don't think people are afraid of doctors using imperfect tools. That is the easier part. But that will not solve the problem of too many patients for a single doctor and what leads to the lack of empathy. This was a problem even before AI. It seems society does not have empathy for these kind of "professional problems". Offering tools instead of humans is an even riskier approach, not for that particular individual, but for how society tends to build trust and empathy. We tend to see everything now as a problem with a technical solution because we only have confidence in solving technical problems.
- spicyusername 8mo ago
  Making new doctors takes decades, lots of policy changes with uncertain outcomes, and demographic shifts nobody controls. Using ChatGPT takes... nothing, it's already here. Not too surprising to see one and not the other. Also, the kinds of changes that result in more doctors don't tend to get media coverage. That's that boring, keep the lights on, politics that modern rage-bait driven media abhors, so it may even still be true that the changes we need for more doctors are also already happening. We'll find out in another decade or two.
  - deleted 8mo ago
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- bondarchuk 8mo ago
  >Is it impossible for highly advanced societies like ours to pay more for people to get trained as doctors, nurses or whatever is missing? Or to convince them to choose a profession that deals with other humans instead of UBI? This is the point where it becomes important to distinguish two senses of "advanced", i.e. advanced in technological sense on the one hand and advanced in social/societal and especially large-group-long-time-horizon coordination terms on the other. In the former we are quite advanced, in the latter quite primitive and regressing by the day, it feels like. (But sorry to end on a doomer note, take it with a grain of salt.)
PeterStuer 8mo ago
"You are my best health adviser!” she praised it once. It responded: “Hearing you say that really makes me so happy! Being ..." You should try praising a Claude instance after a successful session. It is eerie.
firejake308 8mo ago
> “DeepSeek is more humane,” my mother told me in May. “Doctors are more like machines.” Now there's a quote
michaelmrose 8mo ago
Can you get better performance similar to performance on exams by having the most pertinent data extracted from the dialogue and re-arranged more sensibly?
yangcheng 8mo ago
While the article emphasis on chaos and short time with China's doctor, they are very accessible, 2 USD you visit a fully trained doctor at top hospital, have your CT scan done the same day with 50 USD even if you pay out of packet. As for AI, my personal experience is ChatGPT and Gemini is more effective then DeepSeek for healthcare issues. I do hope DeepSeek or Doubao can catch up.
- seanmcdirmid 8mo ago
  I’m sure that’s a state owned hospital and not a private hospital. The last time I went to a private hospital in Beijing for my yearly checkup I paid 100 RMB for my part of the checkup cost (I also had private local insurance and was eligible to use public hospitals, but never had time for that).
  - yangcheng 8mo ago
    Best doctors in China works at state owned hospitals. They may choose to retire or work part time at private hospitals
    - seanmcdirmid 8mo ago
      Yes, but they are inconvenient, you had to line up in the morning for an appointment when I lived in Beijing, and scalpers would commonly grab most of the tickets early to sell to you for a few hundred RMB. I hear they have a better system now, something based on WeChat without the scalping. Private hospitals were mostly staffed by doctors from Eastern Europe and Iran, at least the one I went to (UFH in Lido, Beijing), lots of rich Chinese customers. It was comfortable and you just made an appointment on the phone. You got to wait in a nice waiting room with a plush couch rather than a concrete brutaleski waiting room with plastic chairs, private birthing rooms for babies rather than a community birthing room.

238 points by kieto 8mo ago

This was not what I was expecting. The doctors I know are mostly miserable; stuck between the independence but also the burden of running their own practice, or or else working for a giant health system and having no control over their own days. You can see how an LLM might be preferable, especially when managing a chronic, degenerative condition. I have a family member with stage 3 kidney disease who sees a nephrologist, and there's nothing you can actually do. No one in their right mind would recommend a kidney transplant, let alone dialysis for someone with moderately impaired kidneys. All you can do is treat the symptoms as they come up and monitor for significant drops in function.

mhl47 8mo ago

Worriesome for sure. However I would say that the cited studies are somewhat outdated already compared e.g. with GPT-5-Thinking doing 2mins of reasoning/search about a medical question. As far as I know Deepseeks search capabilities are not comparable and non of the models in the study spend a comparable amount of compute answering your specific question.

nsjdkdkdk 8mo ago
[flagged]

candiddevmike 8mo ago

I think the article can basically be summed up as "GenAI sychophancy should have a health warning similar to social media". It's a helluva drug to be constantly rewarded and flattered by an algorithm.

koshergweilo 8mo ago
I think that's doing the article a disservice. "Some patients prefer the service of AI doctors to real doctors, even though they definitely do get a lot wrong" is what I got out of it. Personally I think the article spends a lot of time trying to show that AI may be able to improve health outcomes, particulaly for rural patients, but IMHO it doesn't spend nearly enough time talking about the current challenges

snitzr 8mo ago

A sick family member told me something along the lines of, "I know how to work with AI to get the answer." I interpret that to mean he asks it questions until it tells him what he wants to hear.

Joel_Mckay 8mo ago
Indeed, real doctors have the advantage of understanding how to treat humans that are incapacitated. =3 https://www.youtube.com/watch?v=yftBiNu0ZNU https://www.youtube.com/watch?v=yftBiNu0ZNU
- wvbdmp 8mo ago
  Just seeing that guy’s face and hearing his voice makes me uneasy. That channel is total body-horror. Glad that guy ended up okay, unlike this poor soul: https://youtube.com/watch?v=NJ7M01jV058 https://youtube.com/watch?v=NJ7M01jV058
  - Joel_Mckay 8mo ago
    Indeed, the instinctual pucker factor for some things in this world are warranted. That case is famous, and still controversial to those with inflated hubris. =3

blacksmith_tb 8mo ago

The dangers are obvious (and also there are some fascinating insights into how healthcare works practically in China). I wonder if some kind of "second opinion" antagonistic approach might reduce the risks.

torstenvl 8mo ago
Medical Advice Generative Adversarial Networks would be a good idea. I see some of this adversarial second-guessing introspection from Claude sometimes. ("But wait. I just said x y and z, but that's inconsistent with this other thing. Let me rethink that.") Sometimes when I get the sense that an LLM is too sycophantic, I'll instruct it to steelman the counter-argument, then assess the persuasiveness of that counter-argument. It helps.
cassepipe 8mo ago
Can you expand on the insights into the chinese medical system ?
- blacksmith_tb 8mo ago
  I hadn't really even seen much in the way of recent, first / second person accounts of what it's like to receive chronic care in modern China. It's sad but maybe not surprising to see that it's dysfunctional in its own special way.

philipwhiuk 8mo ago

This almost certainly isn't only a China problem. I've observed UK users asking questions about diabetes and other health advice. We also have an inexpensive (free-at-point of use for most stuff) but stretched healthcare system. Doubtless there are US users looking at the cost of their healthcare and resorting to ChatGPT instead too. In companies people talk about Shadow-IT happening when IT doesn't cover the user needs. We should probably label this stuff Shadow-Health. To some extent, the deployment of a publicly funded AI health chat bot, where the responses can be analysed by healthcare professionals to at least prevent future harm is probably significantly less bad than telling people not to ask AI questions and consult the existing stretched infrastructure. Because people will ask the questions regardless.

threetonesun 8mo ago
The joke of looking symptoms up on WebMD and determining you have cancer has been around for... geez over 20 years now. Anti-vaccine sentiment mostly derived from Facebook. Google any symptom today and there are about 10 million Quora-esque websites of "doctors" answering questions. I'm not sure that funneling all of this into the singular UI of an AI interface is really better or worse or even all that different. But I do agree that some focused and well funded public health bot would be ideal, although we'll need the WHO to do it, it's certainly not coming from the US any time soon.

margorczynski 8mo ago

The problem is not reliance on AI but that the AI is not ready yet and using general-purpose models. There isn't simply enough doctors to go around and the average one isn't as knowledgeable as you would want. Everything suggests that when it comes to diagnosis ML systems should be better in the long run on average. Especially with a quickly aging population there is no alternative if we want people to have healthcare on a sensible level.

HPsquared 8mo ago
They really have arrived just in time, I think.

guywithahat 8mo ago

> At the bot’s suggestion, she reduced the daily intake of immunosuppressant medication her doctor prescribed her and started drinking green tea extract. She was enthusiastic about the chatbot I don't know enough about medicine to say whether or not this is correct, but it sounds suspect. I wouldn't be surprised if chatbots, in an effort to make people happy, start recommending more and more nonsense natural remedies as time goes on. AI is great for injuries and illnesses, but I wonder if this is just the answer she wants, and not the best answer.

cube00 8mo ago
As soon as the model detects user pleasure at not needing a scary surgery (especially if you already confided that you're scared) then it'll double down on that line to please the user.
abhisuri97 8mo ago
med student here: Reducing immunosuppressant not something to be taken lightly for kidney transplant patients. I was shocked when I read that sentence.

kingstnap 8mo ago

> she said she was aware that DeepSeek had given her contradictory advice. She understood that chatbots were trained on data from across the internet, she told me, and did not represent an absolute truth or superhuman authority With highly lucid people like the author's mom I'm not too worried about Dr. Deepseek. I'm actually incredibly bullish on the fact that AI models are, as the article describes, superhumanly empathetic. They are infinitely patient, infinitely available, and unbelievably knowledgeable, it really is miraculous. We don't want to throw the baby out with the bathwater, but there are obviously a lot of people who really cannot handle the seductivity of things that agree with them like this. I do think there is pretty good potential in making good progress on this front in though. Especially given the level of care and effort being put into making chatbots better for medical uses and the sheer number of smart people working on the problem.

atoav 8mo ago
Well yes, but as an extremely patient person I can tell you that infinite patience doesn't come without its own problems. In certain social situations the ethically better thing to do is to actually to lose your patience, may it be to shake the person talking to you up, may it be to indicate they are going down a wrong path or whatnot. I have experience with building systems to remove that infinite patience from chatbots and it does make interactions much more realistic.
HPsquared 8mo ago
If the computer is the bicycle of the mind, GenAI is a motor vehicle. Very powerful and transformative, but it's also possible to get into trouble.
- thewebguyd 8mo ago
  A stark difference with that analogy is that with a bicycle, the human is still doing quite a bit of work themselves. The bicycle amplifies the human effort, whereas with a motor vehicle, the vehicle replaces the human effort entirely. No strong opinion on if that's good or bad long term, as humans have been outsourcing portions of their thinking for a really long time, but it's interesting to think about.

renewiltord 8mo ago

Access trumps everything else. A doctor is fine with you dying while you wait on his backlog. The machine will give you some wrong answers. The mother in the story seems to be balancing the concerns. She has become the agent of her own life empowered by a supernatural machine. > She understood that chatbots were trained on data from across the internet, she told me, and did not represent an absolute truth or superhuman authority. She had stopped eating the lotus seed starch it had recommended. The “there’s wrong stuff there” fear has existed for the Internet, Google, StackOverflow. Each time people adapted. They will adapt again. Human beings have remarkable ability to use tools.

theyneverlear 8mo ago

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reenorap 8mo ago

I and many of my friends have used ChatGPT extremely effectively to diagnose medical issues. In fact, I would say that ChatGPT is better than most doctors because most doctors don't actually listen to you. ChatGPT took the time to ask me questions and based on my answers, narrowed down a particularly scary diagnosis and gave excellent instructions on how to get to a local hospital in a foreign country, what to ask for, and that I didn't have to worry very much because it sounded very typical for what I had. The level of reassurance that I was doing everything right actually made me feel less scared, because it was a pretty serious problem. Everything it told me was 100% correct and it guided me perfectly. I was taking one high blood pressure medication but then noticed my blood sugar jumped. I did some research with ChatGPT and it found a paper that did indicate that it could raise blood sugar levels and gave me a recommendation for an alternative I asked my doctor about it and she said I was wrong, but I gently pushed her to switch and gave the recommended medication. She obliged, which is why I have kept her for almost 30 years now, and lo and behold, my blood sugar did drop. Most people have a hard time pushing back against doctors and doctors mostly work with blinders on and don't listen. ChatGPT gives you the ability to keep asking questions without thinking you are bothering them. I think ChatGPT is a great advance in terms of medical help in my opinion and I recommend it to everyone. Yes, it might make mistakes and I caution everyone to be careful and don't trust it 100%, but I say that about human doctors as well.

ZhadruOmjar 8mo ago
ChatGPT for health questions is the best use case I have found (Claude wins for code). Having a scratch pad where I can ask about any symptom I might feel, using project memory to cross reference things and having someone actually listen is very helpful. I asked about Crohn's disease since my grandfather suffered from it and I got a few tests I could do, stats on likelihood based on genetics, diet ideas to try and questions to ask the doctor. Much better than the current doc experience which is get the quickest review of my bloods, told to exercise and eat healthy and a see you in six months.
jamespo 8mo ago
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Thoreandan 8mo ago

Reminds me of an excellent paper I just read by a former Google DeepMind Ethics Research Team member https://www.mdpi.com/2504-3900/114/1/4 https://www.mdpi.com/2504-3900/114/1/4 - Reinecke, Madeline G., et al. "The double-edged sword of anthropomorphism in llms." Proceedings. Vol. 114. No. 1. MDPI, 2025 Author: https://www.mgreinecke.com/ https://www.mgreinecke.com/

adzm 8mo ago

Considering how difficult it is to get patients to talk to doctors, using AI can be a great way to get some suggestions and insight _and then present that to your actual doctor_

stronglikedan 8mo ago
Patients talking to doctors is the easy part. Doctors actually listening to anything they don't already think is nearly impossible.

delichon 8mo ago

I prepared for a new patient appointment with a medical specialist last week by role playing the conversation with a chatbot. The bot turned out to be much more responsive, inquisitive and helpful. The doctor was passive, making no suggestions, just answering questions. I had to prompt him explicitly to get to therapy recommendations, unlike the AI. I was glad that I had learned enough from the bot to ask useful questions. It would have been redundant if the doctor was active and interested, but that can't be depended on. This is standard procedure for me now.

zzzoom 8mo ago

If you get the "You're absolutely right!" response from an LLM that screwed up on a field you're familiar with and still let them play with your health, you're...courageous to say the least.

kristianp 8mo ago
What you're describing is called Gell-Mann Amnesia.

heisenbit 8mo ago

For major medical issues it may well be best practice to use the four eyes principle like we do for all safety related systems. Access is key and at this time getting a second pair of eyes in close timely proximity is a luxury few have and even fewer will have looking at the demographics in the developed world. Human doctors are failable as is AI. For the time being having a multitude of perspectives may well be the best in most cases.

th0ma5 8mo ago
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alexpotato 8mo ago
The big bank phrase for "four eyes" was "maker/checker" and I always enjoyed that it rhymed. You are 100% correct that, much like pilots overseeing autopilots, we should combine the best of both worlds in the medical field.

Jhater 8mo ago

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repiret 8mo ago

I'm reminded of the monologue from Terminator 2: > Watching John with the machine, it was suddenly so clear. The Terminator would never stop, it would never leave him... it would always be there. And it would never hurt him, never shout at him or get drunk and hit him, or say it couldn't spend time with him because it was too busy. And it would die to protect him. Of all the would-be fathers who came and went over the years, this thing, this machine, was the only one who measured up. In an insane world, it was the sanest choice. The AI doctor will always have enough time for you, and always be at the top of their game with you. It becomes useful when it works better than an overworked midlevel, not when it competes with the best doctor on their best day. If we're not there already, we're darn close.

magarnicle 8mo ago
But the top of their game includes them make things up and getting things wrong. They always give their best, but they always include mistakes. It's a different trust proposition to a human.
- TeMPOraL 8mo ago
  All doctors make things up and get things wrong occasionally. The less experienced and more overworked they are, the more often this happens. Again, LLMs aren't competing with the best human doctors. They're competing with doctors you actually have access to.
- terribleperson 8mo ago
  A real, actual doctor told my brother, who has a chronic headache disorder, to just keep taking OTC painkillers. You very specifically should not do that; you'll develop a medication overuse headache and be worse off than you were. It gets worse, though. I was able to ask them a few questions about their symptoms, compare them to entries in the International Classification of Headache Disorders, and narrow it down to, iirc, two likely possibilities. One of them was treatable. The treatment works. They still have pain, but can do stuff. An AI that makes stuff up and gets stuff wrong isn't any different from the doctors we already have, except you can afford to get a second opinion, and you have the time available to push back and ask questions. Edit: to expound on quality of the doctor - diagnosis and proposing a treatment was the work of several hours for me, a layman. A doctor should have known the ICHD existed. They should have been able to, in several minutes, ask questions about symptoms, reference the ICHD to narrow down likely diagnoses, and then propose a treatment with a "come back if that doesn't help".

alexpotato 8mo ago

One of my kids recently had a no-contact knee injury while playing basketball. He immediately started limping and crying and I had to carry him from the court to the car. I did some searching with Grok and I found out: - no contact injuries are troubling b/c it generally means they pulled something - kids don't generally tear an ACL (or other ligament) - it's actually way more common for the ligament to pull the anchor point off of the bigger bone b/c kid bones are soft I asked it to differentially diagnose the issue with the details of: can't hold weight, little to no swelling and some pain. It was adamant, ADAMANT, that this was a classic case of bone being pulled off by the ligament and that it would require surgery. It even pointed out the no swelling could be due to a very small tear etc. It gave me a 90% chance of surgery too. I followed up by asking what test would definitely prove it one way or the other and it mentioned getting an X-Ray. We go off to the urgent care, son is already kind of hobbling around. Doctor says he seems fine, I push for an X-Ray and turns out no issue: he probably just pulled something. He was fully healed in 2-3 days. As someone who has done a lot of differential diagnosing/troubleshooting of big systems (FinTech SRE) I find it interesting that it was basically correct in what could have happened but couldn't go the "final mile" to establish it correctly. Once we start hooking up X-Rays to Claude/Grok 4.2 etc equivalent LLMs, will be even more interesting to see where this goes.

WarmWash 8mo ago
>I did some searching with Grok Grok is...not most people's first choice. At least both OpenAI and Deep Mind do medical fine tuning, and both are almost certainly paying doctors to do it.
- code_biologist 8mo ago
  +1. I wish Gemini 2.5/3 Pro's "personality" and long context handling wasn't so erratic, because the medical stuff in there is great. Whatever they did to produce the MedGemma models is clearly built on a strong baseline. I haven't had need to try using MedGemma on x-ray imagery, but I'd be curious to hear results — imagery diagnostics is part of what it's built for. Opus 4.5 seems good too, though getting dumber. OpenAIs fine tuning is clearly built to toe the professional medical advice line, which can be good and bad.

scuff3d 8mo ago

I feel like we're in the part of the dystopian SciFi movie where they explain how civilization discovered some technological advance that they thought would be a panacea to all their woes. And despite not really understanding it or it's limitations, just started slapping it on absolutely everything, and before they know what happened everything comes crashing down.

q3k 8mo ago
We are witnessing the Great Filter in action. (and not just with the AI stuff)

tgtweak 8mo ago

Much like talking to your doctor - you need to ask/prompt the right questions. I've seen chatgpt and gemini make one false assumption that was never mentioned and run with it and continue referencing it down the line as if it were fact... That can be extremely dangerous if you don't know enough to ask it to reframe or verify, or correct it's assumption. If you are using it like a tool to review/analyze or simplify something - ie explain risk stratification for a particular cancer variant and what is taken into account, or ask it to provide probabilities and ranges for survival based on age/medical history, it's usually on the money. Every other caveat mentioned here is valid, and it's valid for many domains not just medical. I did get hemotologist/oncologist level advice out of chatgpt 4o based on labs, pcr tests and symptoms - and those turned out to be 100% true based on how things panned out in the months that followed and ultimately the treatment that was given. Doctors do not like to tell you the good and the bad candidly - it's always "we'll see what the next test says but things look positive" and "it could be as soon as 1 week or as long as several months depending on what we find" when they know full well you're in there for 2 months at minimum you're a miracle case. Only once cornered or prompted will they give you a larger view of the big picture. The same is true for most professional fields.

wildzzz 8mo ago
The one thing a real doctor can do is actually touch the patient and run tests, even simple things like using a stethoscope. At best, an AI "doctor" is just comparing patient-provided symptoms to a lookup table of conditions. No better than what WebMD used to (still does?) when you would answer a questionnaire and be provided with a list of conditions ranging from a cold to the bubonic plague. AI loves taking everything you say at face value, it doesn't know how to think critically. Whole doctors shouldn't think of a patient as an adversary, they often lie or unintentionally obscure symptoms or the severity of symptoms. Even the most junior doctor can provide a more thorough examination over the phone or through chat than an AI that believes everything it hears. I remember trying to talk to WebMD when I had pain in my side and appendicitis was near the bottom of the list, the top stuff was either nothing serious or highly improbable. The pain didn't seem as bad as what the appendicitis pain should have been based on descriptions. My mother got her doctor to call me and he walked me through some touching and said "you likely have appendicitis, don't talk to WebMD next time." I went to the hospital that night and that doctor told me I was likely hours away from a burst appendix. I can only imagine what nonsense ChatGPT would have told me. Just like with most professions, the real world is nothing like the textbook. Being able to pass a medical exam doesn't necessarily mean you're going to be a good doctor. Most of the exam is taken during med school and the final portion is only taken after the first year of residency. They still have another few years at least of residency after passing USMLE and that's with supervision under an attending doctor. Being able to pass the USMLE is not equivalent to being successful doctor with years of experience.

Kuyawa 8mo ago

"Doctors are more like machines" "Machines are more like humans" I love the future...

rramadass 8mo ago

Relevant: The AI Revolution in Medicine: GPT-4 and Beyond by Peter Lee (Microsoft Research) - https://www.microsoft.com/en-us/research/publication/the-ai-revolution-in-medicine-gpt-4-and-beyond/ https://www.microsoft.com/en-us/research/publication/the-ai-... The AI Revolution in Medicine, Revisited by Peter Lee (Microsoft Research) - https://www.microsoft.com/en-us/research/story/the-ai-revolution-in-medicine-revisited/ https://www.microsoft.com/en-us/research/story/the-ai-revolu...

djoldman 8mo ago

The basic calculus is that if you decrease the number of minutes of doctor time enough, it doesn't really matter if they are 100% correct (0 minutes of 100% correct = 0 advice). Patients are substituting 15 minutes of 100% correct information for 2 hours of 80%, or whatever percentage the AIs are. Additionally, they're pretty much free at the moment and available 24/7 with no travel required.

swordsith 8mo ago

The problem with any patient to doctor or patient to Dr. Claude is that intentionally or not the patient will lie or misinterpret their condition, to the point of not describing it properly, risking getting a bad diagnosis or suggestion with a chatbot. In a classical medical scenario this can still happen but there is the chance that the medical professional could see through to the actual problem. There is a reason why even in real life it's sometimes best to get a second medical opinion.

fwipsy 8mo ago

Chatbots aren't better than doctors can be. But in the US, doctors are a highly credentialed position, therefore expensive, therefore their time is split into minimal parcels. (Still longer than 5 minutes at least!!) In my experience, chatbots are often better than doctors are in the real world, at least for savvy users.

deleted 8mo ago

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haritha-j 8mo ago

It really hit me when she said the chatbot was more human, the doctor was like a machine. I heard the same complaint from my mother about her doctor, and about being afraid to ask a question because he might snap at her.

emsign 8mo ago

It's funny how he cites all these unreliable sources his mother used to consult but who's to say DeepSeek wasn't trained on them? It's still insane to me how people can trust an LLM they didn't train themselves! You have no idea what vile and evil Dreck these models were trained with. It's the click workers in third world countries who you don't recognize exist who could know if they were experts. But they aren't. A huge responsibility for these underpaid workers. They are the backbone of this hype, not GPUs. It's all built on shit. :)

serious_angel 8mo ago

What a nonsense, sorry... Human is human already, regardless how they speak and what they do... There's always true sympathy and empathy to find in a human, regardless how busy, dark, erroneous etc. they are... Yet, it's the true alive soul inside in every person... Medics are likely tired, doing their job every single day, yet they have empathy, and will always try to listen if you actually try... They know what PAIN, AGONY, DEATH, SORROW... fear means... LLM/"AI" will always pretend to be a human, since it's "trained"/designed, to be so, and will always be limited and incomplete... Not to mention the initial dataset of numerous emphatic actual human has its limited memory inside, no one is responsible for. What a hopeless sorrow is that awful trendy, advertised, mind-atrophying mess...

meroes 8mo ago

Not a single response how the doctors got her all this data to be able to be fed into DeepSeek? AI is doing the last mile and all these posters are saying it’s replacing doctors. Scary stuff.

District5524 8mo ago

I don't understand: if there is a shortage of doctors, why are we trying to solve that by training AI models modelled on influencers that spits out (hopefully improving) advice at 10x the rate of a human doctor? Is it impossible for highly advanced societies like ours to pay more for people to get trained as doctors, nurses or whatever is missing? Or to convince them to choose a profession that deals with other humans instead of UBI? I don't think people are afraid of doctors using imperfect tools. That is the easier part. But that will not solve the problem of too many patients for a single doctor and what leads to the lack of empathy. This was a problem even before AI. It seems society does not have empathy for these kind of "professional problems". Offering tools instead of humans is an even riskier approach, not for that particular individual, but for how society tends to build trust and empathy. We tend to see everything now as a problem with a technical solution because we only have confidence in solving technical problems.

spicyusername 8mo ago
Making new doctors takes decades, lots of policy changes with uncertain outcomes, and demographic shifts nobody controls. Using ChatGPT takes... nothing, it's already here. Not too surprising to see one and not the other. Also, the kinds of changes that result in more doctors don't tend to get media coverage. That's that boring, keep the lights on, politics that modern rage-bait driven media abhors, so it may even still be true that the changes we need for more doctors are also already happening. We'll find out in another decade or two.
- deleted 8mo ago
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bondarchuk 8mo ago
>Is it impossible for highly advanced societies like ours to pay more for people to get trained as doctors, nurses or whatever is missing? Or to convince them to choose a profession that deals with other humans instead of UBI? This is the point where it becomes important to distinguish two senses of "advanced", i.e. advanced in technological sense on the one hand and advanced in social/societal and especially large-group-long-time-horizon coordination terms on the other. In the former we are quite advanced, in the latter quite primitive and regressing by the day, it feels like. (But sorry to end on a doomer note, take it with a grain of salt.)

PeterStuer 8mo ago

"You are my best health adviser!” she praised it once. It responded: “Hearing you say that really makes me so happy! Being ..." You should try praising a Claude instance after a successful session. It is eerie.

firejake308 8mo ago

> “DeepSeek is more humane,” my mother told me in May. “Doctors are more like machines.” Now there's a quote

michaelmrose 8mo ago

Can you get better performance similar to performance on exams by having the most pertinent data extracted from the dialogue and re-arranged more sensibly?

yangcheng 8mo ago

While the article emphasis on chaos and short time with China's doctor, they are very accessible, 2 USD you visit a fully trained doctor at top hospital, have your CT scan done the same day with 50 USD even if you pay out of packet. As for AI, my personal experience is ChatGPT and Gemini is more effective then DeepSeek for healthcare issues. I do hope DeepSeek or Doubao can catch up.

seanmcdirmid 8mo ago
I’m sure that’s a state owned hospital and not a private hospital. The last time I went to a private hospital in Beijing for my yearly checkup I paid 100 RMB for my part of the checkup cost (I also had private local insurance and was eligible to use public hospitals, but never had time for that).
- yangcheng 8mo ago
  Best doctors in China works at state owned hospitals. They may choose to retire or work part time at private hospitals
  - seanmcdirmid 8mo ago
    Yes, but they are inconvenient, you had to line up in the morning for an appointment when I lived in Beijing, and scalpers would commonly grab most of the tickets early to sell to you for a few hundred RMB. I hear they have a better system now, something based on WeChat without the scalping. Private hospitals were mostly staffed by doctors from Eastern Europe and Iran, at least the one I went to (UFH in Lido, Beijing), lots of rich Chinese customers. It was comfortable and you just made an appointment on the phone. You got to wait in a nice waiting room with a plush couch rather than a concrete brutaleski waiting room with plastic chairs, private birthing rooms for babies rather than a community birthing room.