Totally wrong. How do you account for the burgeoning popularity of AI girl/boyfriends - 1/3 of US adults and growing? Or the 30-50% using AI for counseling or psych therapy? With each iteration these percents will increase. People bond just fine with LLMs, and have transparent, constructive conversations with them. I am not a primary care doc (I'm a periodontist) so count me as somewhat clueless. But my interactions with Claude, Chat, Gemini, etc. have been overwhelmingly constructive wrt medical, diagnostic, surgical, and relational advice. I filter its output through my PCP and specialists, but I usually benefit more from AI than my "real" docs. Given the ridiculous time pressure on most primary docs these days, that is no surprise. And as Dr. Cifu and his colleagues on Sensible Medicine, etc., acknowledge, the average MD bases little of his/her practice on rigorous understanding and application of clinical research - a foible not shared by AI (although it is not flawless in its understanding of the science). I routinely recommend that my patients check whatever I tell them using AI when I hit a diagnostic challenge. (Still not on the BFF or shrink page though ;)
IMO AI is an existential threat to primary care medicine, sadly for the profession. Whether that will be a good thing for humanity remains to be seen. I'm betting yes.
Sensible Medicine has been great at educating readers on critical appraisal concepts lacking in most physicians and “providers”. So, consider the way-to-common 80 y/o patient complaining about the $500/month prescription she received (and can’t afford) from the …ologist who e-scribed the drug while proudly documenting compliance with “GDMT” (guideline directed medical therapy). Of course, the drug only offers a 1.5% absolute risk reduction instead of the 82% relative risk reduction touted by the drug company and neither the patient or the “provider” are aware of, or understand, the difference. Furthermore, there were no multiple co-morbidity patients over age 60 in the research trial that was used to develop the “evidence” that became the “guideline” being followed by the “provider”. But, why couldn’t AI be embedded in the EMR to offer up a brief and honest critical appraisal of the “evidence” cited in support of the treatment being prescribed to the specific patient? Unfortunately, the challenge would be to prevent big pharma and others from corrupting the AI.
"I cannot imagine a time when a person, a patient, will be satisfied making a complicated decision about their health with only a computer consultant."
I already made decisions like that regarding prostate cancer and atrial fibrillation treatment using ChatGPT. It could read my entire medical history and a huge number of trials quicker than my regular doctor could log into Epic.
What do I make of the Pangram opinion that 8% of the text of the article was AI generated? Perhaps simply that editing is one of the tasks that can be off-loaded to AI.
How to tell if a current EHR using doc is still alive….. is his index finger still tapping as if clicking on the mouse … We are advancing at warp speed on fancy stuff but still don’t have common stops for more common situations like having to enter every first visit of the year that the amputated leg remains, absent. That the pt had bilateral mastectomies so mammogram not indicated. That the pt in a coma is not well developed, well nourished , in no acute distress and alert and oriented x 3. Or asking a Caucasian pt on preop anesthesia screen , whether they have sickle cell. Need to CTL-ALT-DEL and focus on some basic issues that we encounter daily. We are becoming templaters and box checkers.
AI isn’t making anyone smarter. It brings laziness, loss of critical or imaginative thinking, and is bringing on a new generation of people watching a screen or phone. I loved the article and it’s 100% true. Great job.
I sure appreciate this article. I am doing my best not to become that crotchety jaded old man with AI’s miraculous help for humans - although I AM jaded by the propaga-I mean media-that says AI will kill us all by next week. Besides, humans have been using AI to kill humans for awhile now. I digress, er, sorry. I have watched what I call clicker medicine replace critical thinking, a very real politicization of medical care, and wonder why anyone would even WANT to be in primary care. We need as many Dr. McBrides as possible, and if my own senses notice anything other than human in my care, I’ll find another PCP while I still have an option.
Huzzah!!!
Totally wrong. How do you account for the burgeoning popularity of AI girl/boyfriends - 1/3 of US adults and growing? Or the 30-50% using AI for counseling or psych therapy? With each iteration these percents will increase. People bond just fine with LLMs, and have transparent, constructive conversations with them. I am not a primary care doc (I'm a periodontist) so count me as somewhat clueless. But my interactions with Claude, Chat, Gemini, etc. have been overwhelmingly constructive wrt medical, diagnostic, surgical, and relational advice. I filter its output through my PCP and specialists, but I usually benefit more from AI than my "real" docs. Given the ridiculous time pressure on most primary docs these days, that is no surprise. And as Dr. Cifu and his colleagues on Sensible Medicine, etc., acknowledge, the average MD bases little of his/her practice on rigorous understanding and application of clinical research - a foible not shared by AI (although it is not flawless in its understanding of the science). I routinely recommend that my patients check whatever I tell them using AI when I hit a diagnostic challenge. (Still not on the BFF or shrink page though ;)
IMO AI is an existential threat to primary care medicine, sadly for the profession. Whether that will be a good thing for humanity remains to be seen. I'm betting yes.
Sensible Medicine has been great at educating readers on critical appraisal concepts lacking in most physicians and “providers”. So, consider the way-to-common 80 y/o patient complaining about the $500/month prescription she received (and can’t afford) from the …ologist who e-scribed the drug while proudly documenting compliance with “GDMT” (guideline directed medical therapy). Of course, the drug only offers a 1.5% absolute risk reduction instead of the 82% relative risk reduction touted by the drug company and neither the patient or the “provider” are aware of, or understand, the difference. Furthermore, there were no multiple co-morbidity patients over age 60 in the research trial that was used to develop the “evidence” that became the “guideline” being followed by the “provider”. But, why couldn’t AI be embedded in the EMR to offer up a brief and honest critical appraisal of the “evidence” cited in support of the treatment being prescribed to the specific patient? Unfortunately, the challenge would be to prevent big pharma and others from corrupting the AI.
"I cannot imagine a time when a person, a patient, will be satisfied making a complicated decision about their health with only a computer consultant."
I already made decisions like that regarding prostate cancer and atrial fibrillation treatment using ChatGPT. It could read my entire medical history and a huge number of trials quicker than my regular doctor could log into Epic.
What do I make of the Pangram opinion that 8% of the text of the article was AI generated? Perhaps simply that editing is one of the tasks that can be off-loaded to AI.
I did appreciate the article.
How to tell if a current EHR using doc is still alive….. is his index finger still tapping as if clicking on the mouse … We are advancing at warp speed on fancy stuff but still don’t have common stops for more common situations like having to enter every first visit of the year that the amputated leg remains, absent. That the pt had bilateral mastectomies so mammogram not indicated. That the pt in a coma is not well developed, well nourished , in no acute distress and alert and oriented x 3. Or asking a Caucasian pt on preop anesthesia screen , whether they have sickle cell. Need to CTL-ALT-DEL and focus on some basic issues that we encounter daily. We are becoming templaters and box checkers.
AI isn’t making anyone smarter. It brings laziness, loss of critical or imaginative thinking, and is bringing on a new generation of people watching a screen or phone. I loved the article and it’s 100% true. Great job.
I sure appreciate this article. I am doing my best not to become that crotchety jaded old man with AI’s miraculous help for humans - although I AM jaded by the propaga-I mean media-that says AI will kill us all by next week. Besides, humans have been using AI to kill humans for awhile now. I digress, er, sorry. I have watched what I call clicker medicine replace critical thinking, a very real politicization of medical care, and wonder why anyone would even WANT to be in primary care. We need as many Dr. McBrides as possible, and if my own senses notice anything other than human in my care, I’ll find another PCP while I still have an option.