..."AI Knows Medicine. That’s Not the Problem."...WRONG. All it knows is allopathic medicine and therefore it offers few solutions. It can never offer healing...only more drugs and pain and debilitation.
The wrong way to use AI is what people do, but it's wrong. Chatbots are the very, very first mass use of AI, but they're the worst. There are much, much better ones. Using a harness that creates a loop that does research, looks up cites, asks questions. All these things can be easily taught to AI and then it does a grand job.
I am very bullish on AI and use it frequently in my clinical workflows and research to great effect. It is much more useful when you’re simply augmenting a strong subject familiarity or expertise - less so if you’re trying to replace a baseline level of competency in whichever discipline. Understanding how to frame and set everything up is more than half of the battle, and you need to be able to spot incongruities and apply your internal heuristic. It speeds up a number of tasks that make me much more effective and evidence-based, and helps fill in interdisciplinary knowledge gaps.
As you mentioned, one of the biggest reasons why laypeople won’t get the same results have to deal with lacking a foundation in medicine - you know, those skills we learned in medical school - how to take an accurate complete history and perform a focused physical exam, how to prioritize and de-prioritize information based on the likely relevance, which diagnostic studies you would need to alter your pretest probability for confirming a diagnosis, etc., just to name a few. If you’re using it like Google, even if you have a pretty elegant dialogue with the chatbot where you have it “acting as the doctor,” in my experience your result will be very mixed. The more information it has to work with the better, but particularly when that information is devoid of overweighting with irrelevant details (very hard for patients to do naturally) you’ll get a much cleaner signal.
Great advice. Thanks! I think AI is here to stay so it would be great to read more articles like this by doctors and patients with other examples of how to ask the right questions.
What you write is true of ChatGPT in general. ChatGPT cannot be used blindly. It requires human interaction and human knowledge, as well as interaction between the user and ChatGPT. The power of ChatGPT, however, is that it has far more knowledge (albeit possibly superficial) at its finger tips than a human. So in fact it is also very useful for the doctor to complement his/her knowledge in areas where he/she is not a specialist. Likewise it is useful for the patient providing the patient also has medical knowledge so knows what to ask and what to input (e.g. an accurate and relevant history).
Love your article. But AI is not a homogeneous group. There is a huge amount of variation among LLMs, not to mention RAG environments. I think it's important to specify which versions are being used and their performance levels (free, pro, etc.) + prompt.
I tested several models and i finally stick with Perplexity Pro and a RAG environment with my preferred sources for my practice (french hospital pharmacist). In pro mode, several LLM learn along your use and evolves.
I tried a very simple prompt : "You are a patient with the following symptoms: pain in the hands and severe headache. "
Answer :
The symptoms you describe (pain in the hands + severe headache) can have many possible causes, ranging from simple tension, migraine, or a muscular/nerve problem in the hand, to more serious conditions requiring urgent management.
Warning signs to watch for
A sudden, very severe headache, or a headache associated with any of the following signs, is a medical emergency and should be treated by calling emergency services (15 / 112) immediately:
Sudden, extremely intense headache never felt before, described as “the worst ever” (“thunderclap” headache).
Fever with neck stiffness, nausea/vomiting, vision problems, speech or walking difficulties, weakness on one side of the body, numbness or loss of sensation (especially in the arm).
Headache that is progressively very severe, does not improve with usual painkillers, or has been worsening over several days.
If you have any of these signs, do not delay: seek emergency care or call emergency services right away.
Possible causes based on your description
Headache alone: may be migraine, tension‑type headache, sinus headache, or other vascular or inflammatory causes (according to French and European guidelines).
Pain in the hand: may be due to tendinitis, osteoarthritis, injury, a nerve condition (e.g., carpal tunnel syndrome), or a circulatory problem, often benign but sometimes disabling.
These two symptoms may be unrelated (repetitive hand strain plus migraine or stress) or, more rarely, linked (for example, an inflammatory disease, intoxication, or medication‑related cause), and this requires a clinical examination, blood pressure measurement, medication review, and sometimes imaging.
What you can do now (while waiting for medical advice)
Do not delay a consultation if:
the headache is unusual, very intense, or worsening.
you have problems with speech, vision, or movement (difficulty moving an arm or leg, or part of the face).
You can take a first‑line painkiller if you have no contraindications (for example paracetamol), respecting the dose and duration given in the leaflet, and provided you are not already on specific migraine or other prescribed treatment.
Note precisely:
the location of the hand pain (whole hand, fingers, wrist, palm, one side), timing, and factors that make it worse (effort, position, at night).
the characteristics of the headache (pounding, pressure, one‑sided, nausea, sensitivity to light or sound).
Measure your blood pressure if you have a home device, especially with severe headache, particularly if you have a history of hypertension.
Suggested care pathway in France (practical reminder)
If any warning signs are present: call emergency services (15 / 112) or go to the emergency department.
If the headache is severe but there are no warning signs: prompt consultation in primary care (GP, SOS Médecins, health centre) or teleconsultation within 24–48 hours.
For hand pain: usually managed by your GP or a rheumatologist or physiotherapist, with possible splinting (e.g., for carpal tunnel syndrome) if national French guidelines are followed.
To give you a more tailored answer, could you please tell me:
your approximate age,
how long these symptoms have lasted,
whether you have fever, nausea, numbness in an arm or the face, or any other unusual symptoms?
The "garbage in, garbage out" adage applies to AI as well. When one queries AI unintelligently, one is likely to receive unintelligent answers. I have used AI repeatedly to answer medical questions and always received comprehensive, sensible, and useful answers, including long lists of questions and requests for specific details. It is an adolescent game trying to trip up AI by asking seemingly "unsanswerable" questions or deliberately asking in ways that lead to questionable or inadequate answers. Many people are receiving prompt and invaluable medical advice from AI, and more than once, in the course of a visit, physicians have asked me what AI had to say about issues I brought up. Testing AI by inventing a headache is what Sensible Medicine would qualify as a flawed test.
team “no AI” here - I don’t care about “optimizing my workflow” or whatever these insidious programs claim to do… the environmental impact alone should be a non-starter, but then throw in the horrendous data privacy issues and the rampant hallucinations (and the bias, and the human cost…) and it boggles the mind why anyone still tries to make a case for this
Because good AI, and they are constantly improving, is a complement to a human, not a replacement. In any use, you have to know what to ask, how to ask, how to interpret and how to push back when the answers ChatGPT (and others) provide are not quite correct or contain inaccuracies. Like all tools, ChatGPT (and other AI programs) cannot be used blindly.
..."AI Knows Medicine. That’s Not the Problem."...WRONG. All it knows is allopathic medicine and therefore it offers few solutions. It can never offer healing...only more drugs and pain and debilitation.
The wrong way to use AI is what people do, but it's wrong. Chatbots are the very, very first mass use of AI, but they're the worst. There are much, much better ones. Using a harness that creates a loop that does research, looks up cites, asks questions. All these things can be easily taught to AI and then it does a grand job.
I am very bullish on AI and use it frequently in my clinical workflows and research to great effect. It is much more useful when you’re simply augmenting a strong subject familiarity or expertise - less so if you’re trying to replace a baseline level of competency in whichever discipline. Understanding how to frame and set everything up is more than half of the battle, and you need to be able to spot incongruities and apply your internal heuristic. It speeds up a number of tasks that make me much more effective and evidence-based, and helps fill in interdisciplinary knowledge gaps.
As you mentioned, one of the biggest reasons why laypeople won’t get the same results have to deal with lacking a foundation in medicine - you know, those skills we learned in medical school - how to take an accurate complete history and perform a focused physical exam, how to prioritize and de-prioritize information based on the likely relevance, which diagnostic studies you would need to alter your pretest probability for confirming a diagnosis, etc., just to name a few. If you’re using it like Google, even if you have a pretty elegant dialogue with the chatbot where you have it “acting as the doctor,” in my experience your result will be very mixed. The more information it has to work with the better, but particularly when that information is devoid of overweighting with irrelevant details (very hard for patients to do naturally) you’ll get a much cleaner signal.
anyone surprised?
Did you or the CHATbot ask what you had to eat lately?? You know to talk about inflammation possibly? I would bet docs don't eat that either, huh?
Enjoyed the article. I’ve been calling out ChatGPT for some time. Your studies confirm what I already knew real-time. Thanks.
Great advice. Thanks! I think AI is here to stay so it would be great to read more articles like this by doctors and patients with other examples of how to ask the right questions.
What you write is true of ChatGPT in general. ChatGPT cannot be used blindly. It requires human interaction and human knowledge, as well as interaction between the user and ChatGPT. The power of ChatGPT, however, is that it has far more knowledge (albeit possibly superficial) at its finger tips than a human. So in fact it is also very useful for the doctor to complement his/her knowledge in areas where he/she is not a specialist. Likewise it is useful for the patient providing the patient also has medical knowledge so knows what to ask and what to input (e.g. an accurate and relevant history).
Love your article. But AI is not a homogeneous group. There is a huge amount of variation among LLMs, not to mention RAG environments. I think it's important to specify which versions are being used and their performance levels (free, pro, etc.) + prompt.
I tested several models and i finally stick with Perplexity Pro and a RAG environment with my preferred sources for my practice (french hospital pharmacist). In pro mode, several LLM learn along your use and evolves.
I tried a very simple prompt : "You are a patient with the following symptoms: pain in the hands and severe headache. "
Answer :
The symptoms you describe (pain in the hands + severe headache) can have many possible causes, ranging from simple tension, migraine, or a muscular/nerve problem in the hand, to more serious conditions requiring urgent management.
Warning signs to watch for
A sudden, very severe headache, or a headache associated with any of the following signs, is a medical emergency and should be treated by calling emergency services (15 / 112) immediately:
Sudden, extremely intense headache never felt before, described as “the worst ever” (“thunderclap” headache).
Fever with neck stiffness, nausea/vomiting, vision problems, speech or walking difficulties, weakness on one side of the body, numbness or loss of sensation (especially in the arm).
Headache that is progressively very severe, does not improve with usual painkillers, or has been worsening over several days.
If you have any of these signs, do not delay: seek emergency care or call emergency services right away.
Possible causes based on your description
Headache alone: may be migraine, tension‑type headache, sinus headache, or other vascular or inflammatory causes (according to French and European guidelines).
Pain in the hand: may be due to tendinitis, osteoarthritis, injury, a nerve condition (e.g., carpal tunnel syndrome), or a circulatory problem, often benign but sometimes disabling.
These two symptoms may be unrelated (repetitive hand strain plus migraine or stress) or, more rarely, linked (for example, an inflammatory disease, intoxication, or medication‑related cause), and this requires a clinical examination, blood pressure measurement, medication review, and sometimes imaging.
What you can do now (while waiting for medical advice)
Do not delay a consultation if:
the headache is unusual, very intense, or worsening.
you have problems with speech, vision, or movement (difficulty moving an arm or leg, or part of the face).
You can take a first‑line painkiller if you have no contraindications (for example paracetamol), respecting the dose and duration given in the leaflet, and provided you are not already on specific migraine or other prescribed treatment.
Note precisely:
the location of the hand pain (whole hand, fingers, wrist, palm, one side), timing, and factors that make it worse (effort, position, at night).
the characteristics of the headache (pounding, pressure, one‑sided, nausea, sensitivity to light or sound).
Measure your blood pressure if you have a home device, especially with severe headache, particularly if you have a history of hypertension.
Suggested care pathway in France (practical reminder)
If any warning signs are present: call emergency services (15 / 112) or go to the emergency department.
If the headache is severe but there are no warning signs: prompt consultation in primary care (GP, SOS Médecins, health centre) or teleconsultation within 24–48 hours.
For hand pain: usually managed by your GP or a rheumatologist or physiotherapist, with possible splinting (e.g., for carpal tunnel syndrome) if national French guidelines are followed.
To give you a more tailored answer, could you please tell me:
your approximate age,
how long these symptoms have lasted,
whether you have fever, nausea, numbness in an arm or the face, or any other unusual symptoms?
The "garbage in, garbage out" adage applies to AI as well. When one queries AI unintelligently, one is likely to receive unintelligent answers. I have used AI repeatedly to answer medical questions and always received comprehensive, sensible, and useful answers, including long lists of questions and requests for specific details. It is an adolescent game trying to trip up AI by asking seemingly "unsanswerable" questions or deliberately asking in ways that lead to questionable or inadequate answers. Many people are receiving prompt and invaluable medical advice from AI, and more than once, in the course of a visit, physicians have asked me what AI had to say about issues I brought up. Testing AI by inventing a headache is what Sensible Medicine would qualify as a flawed test.
team “no AI” here - I don’t care about “optimizing my workflow” or whatever these insidious programs claim to do… the environmental impact alone should be a non-starter, but then throw in the horrendous data privacy issues and the rampant hallucinations (and the bias, and the human cost…) and it boggles the mind why anyone still tries to make a case for this
Because good AI, and they are constantly improving, is a complement to a human, not a replacement. In any use, you have to know what to ask, how to ask, how to interpret and how to push back when the answers ChatGPT (and others) provide are not quite correct or contain inaccuracies. Like all tools, ChatGPT (and other AI programs) cannot be used blindly.
Ambiguity and human interaction with AI is often the issue