3 ms·

I don’t understand the negative reactions. Medical care as it exists requires the doctor and patient to have their brains switched on. I’ve almost never had a p

I don’t understand the negative reactions. Medical care as it exists requires the doctor and patient to have their brains switched on. I’ve almost never had a problem where a doctor provides me with a diagnosis and I go about my day. Most of the times that I have, I’ve been confident about the problem and known what I needed. The doctor was a barrier to accessing care. Dr. GPT is a good brainstorming tool. It helps synthesize information in a way that primary texts don’t. But it does force you to say “that doesn’t make sense”. I do think that people saying “doctors don’t know the state of the art” have a weaker case. If you think about it in terms of token density during pretraining and how post training datasets are constructed, I think it would take us a very long time to adapt to any fundamental shifts. If we have forgotten how to cure scurvy, how many journal articles would it take before we adapt to a discovery?

StefanBatory 4mo ago
> I do think that people saying “doctors don’t know the state of the art” have a weaker case. This is kinda the case though. In Poland I met only one psychiatrist that knew about DSM-5. In this year. DSM-5 was a thing from 2013. Doctors are people just as us, not every single of them is good.
- bonesss 4mo ago
  Many DSM-5 diagnosis come into effect with the ICD-11, ICD-10 doesn't have a good deal of them, and that rollout is still fresh & ongoing. It is kinda spooky, though, to have freshly minted doctors from a few years back whose school-knowledge will forever be "outdated and archaic" based on standards published before they were in school. Some good advice I got: treat this as a generation shift, find younger and newer doctors who are familiar with the "modern" standards.
  - junofan 4mo ago
    APA guidelines come with expiration dates [1]. 10 years is the maximum. Churn is built in to the specialty. Read into that what you will. [1]: https://www.apa.org/practice/guidelines/criteria?item=5 https://www.apa.org/practice/guidelines/criteria?item=5
- roryirvine 4mo ago
  Why would you expect a Polish psychiatrist to understand the differences between different versions of a diagnostic manual used only in the US?
  - StefanBatory 4mo ago
    Because when I got ADHD diagnosis in Poland, one of the criteria for diagnosis was according to DSM-V :P
- nostrebored 4mo ago
  Oh I agree with you, it's just that I don't think LLMs are either. If you think of LLM knowledge, especially in scientific/engineering fields, as a lossy representation of the density of ideas, then you'd expect to see some weird behavior. I'm sure there is some sort of a temporal discounting and people thinking about this, but a naive NLL or Reverse-KL on medical literature would engrain some weird, wrong ideas.
  - StefanBatory 4mo ago
    I brought down prod system because I was too stupid and relied down on LLM advice, even double checking it. I would not trust my health to LLMs, that is true.

StefanBatory 4mo ago

> I do think that people saying “doctors don’t know the state of the art” have a weaker case. This is kinda the case though. In Poland I met only one psychiatrist that knew about DSM-5. In this year. DSM-5 was a thing from 2013. Doctors are people just as us, not every single of them is good.

bonesss 4mo ago
Many DSM-5 diagnosis come into effect with the ICD-11, ICD-10 doesn't have a good deal of them, and that rollout is still fresh & ongoing. It is kinda spooky, though, to have freshly minted doctors from a few years back whose school-knowledge will forever be "outdated and archaic" based on standards published before they were in school. Some good advice I got: treat this as a generation shift, find younger and newer doctors who are familiar with the "modern" standards.
- junofan 4mo ago
  APA guidelines come with expiration dates [1]. 10 years is the maximum. Churn is built in to the specialty. Read into that what you will. [1]: https://www.apa.org/practice/guidelines/criteria?item=5 https://www.apa.org/practice/guidelines/criteria?item=5
roryirvine 4mo ago
Why would you expect a Polish psychiatrist to understand the differences between different versions of a diagnostic manual used only in the US?
- StefanBatory 4mo ago
  Because when I got ADHD diagnosis in Poland, one of the criteria for diagnosis was according to DSM-V :P
nostrebored 4mo ago
Oh I agree with you, it's just that I don't think LLMs are either. If you think of LLM knowledge, especially in scientific/engineering fields, as a lossy representation of the density of ideas, then you'd expect to see some weird behavior. I'm sure there is some sort of a temporal discounting and people thinking about this, but a naive NLL or Reverse-KL on medical literature would engrain some weird, wrong ideas.
- StefanBatory 4mo ago
  I brought down prod system because I was too stupid and relied down on LLM advice, even double checking it. I would not trust my health to LLMs, that is true.