As a competing anecdote, last summer my toddler woke up from a nap with bruises on his legs and swelling around his joints. We initially thought maybe he was tangled up in his crib, but later when changing his diaper found his testicles were swollen and rushed him to the emergency room. Over the next 6-7 days we saw no less that 5 doctors including his pediatrician, orthopedic specialists, and doctors at the ER and urgent care. None of whom were able to give us any answers about this weird bruising and swelling that randomly appeared on his legs. After all of this, during one of his flair ups, I took a picture of his legs and searched it with Google lens. The results set included pictures and symptoms of Henoch-Schonlein purpura [0], that were identical to what he was experiencing. We confirmed this with his pediatrician and decided on a treatment plan, but I was floored at how many doctors we had to see (and how much money we had to spend), only for me to diagnose this on my own with Google lens.

[0] https://www.mayoclinic.org/diseases-conditions/henoch-schonl...

I don't think this is the slam-dunk you think it is. You had to go to three doctors before someone recognized something was wrong. ChatGPT is the substitute for the first two doctors, not the third.

And even there, I bet ChatGPT would have told you to go see a doctor, since it can't feel your balls. And after your first appointment, if you had told it that you still thought something was wrong, it would probably have told you to go see a urologist.

I dislike that quote. It's not knowing where to make the mark. It's that there's no one else who knows where to make the mark charging less that $9,999. Knowing where to make the mark implies that payment is proportional to ability/productivity, but it is proportional chiefly to relative positions of power. Learning where to make the mark won't earn you $9,999, it will instead put you in competition with the other $9,999 markers in a downward race to the "true value" of those marks.

> Why you think an AI could do better than a human at that is beyond me.

You strike me as someone who thinks like me before I started using LLMs. Now when I read things like this rather than thinking in terms of black and white like I might have before, I instead think about percent likelihoods, and once you let in the grey it's no longer a matter of can/cannot but how many resources will be invested into making it so.

I think you hold doctors in pretty high esteem and I'm not sure how many other people hold doctors in as high esteem as you do. I've certainly ended up worse for having visited one. How seriously do you think most doctors take continuing education, particularly if they are overworked? An AI can consume the latest research/guidelines/text books immediately. Doctors can often act on 20 year old medical dogma. AI can get immediate social media feedback weighted in a way professionals deem appropriate.

I think diagnostic work is one of the things most likely to be taken over by AI. Even when asking specific technical questions in my own field, AI is capable of hitting some key points, and with extra prodding even getting to some very very specific niche points without too much coddling.

You answered why someone would want to pay $93, but not why they have to pay $93.

>Why you think an AI could do better than a human at that is beyond me.

AI can take your entire medical history and the entire history of physics, chemistry, biology, and medicine up to May 2025...

A human was sleep deprived in Med school 15 years ago.

An AI system with today's technology should be less trustworthy for medical diagnosis than a web search.

This is the problem with reasoning from first principles. This statement is easily proven false by giving it a try, whether it "should" be true or not.

I mean, it really depends on what you're trying to diagnose/do. Yeah, a math PhD might have spent a decade+ studying the subject. Doesn't mean I need to pay for their skills instead of using a calculator/program to solve my math problem.

> Why you think an AI could do better than a human at that is beyond me.

Why do you think an AI couldn't do better than a human, when we have ample evidence of computers/AI exceeding humans in many areas?

There's a limit though right? How about, if you can accurately predict the doctor's diagnosis it's free? If not you pay. This person needed a doctor's approval presumably for a prescription they couldn't get without authorization which leads to this gatekeeping. Not to mention also contributes to the insane medical costs in the US. $93 for 5 minutes is over 1k _an hour_ for what amounts to a rubber stamp (because how much can you really dig into a person's medical history and condition in 5 mins).

AI systems have been improving. O3 now has the capability to decide to search multiple times as part of its response.

Benzonatate is a commonly prescribed somewhat stronger cough medicine which requires a prescription. I've known a number of people who've had to take it for a persistent or stubborn cough.

Wikipedia says "Overdose of only a small number of capsules can be fatal" but the study they quote shows that you'd need to take 10x-20x the usual dose for the smallest amount that's been shown to kill anyone -- which is admittedly more narrow of a safety window than over-the-counter Tylenol/Acetaminophen/Paracetamol but still, few people take 10-20 pills in one day of something that says "take 1 per day".

> Of course, some of the medications that include opioids will only be sold to me with the doctor's prescription

Ain't nothing wrong with a little Wockhardt to get you through the day

This is why most routine primary care can be delivered by Nurse Practitioners and Physician Assistants working under a doctor's supervision.

IMHO it is much easier to increase the supply of AI doctor hours than the supply of human doctor hours, and supply constraints are the main thing maintaining doctor hours at the high price it currently sells for.

My $700 laptop can run an 8B model in 2023.

It's also barely better, within the error bar on some metrics. So if this is the best they can do on their own benchmark that's pretty pathetic and shows they have no edge anymore.

> ... some synthesis of the two can't produce much better results than either on its own.

In theory, I agree with you. The world "some" is doing a lot of heavy lifting there though. I only hope that whatever definition of some emerges, it's not a horribly flawed one.

You would not hire or go to a a mentally unstable doctor. If a doc hallucinates or makes a mistake, it will be rare. They can self introspect and work on it if they realise there mistake even. AI is NOT same. It has no self reflection, hallucination isn't rare. AI is not mentally stable in any sense.

> What I care about is the results. If the "grade" is 10%, then I don't want to rely on it, whether it's a human or an AI.

So you judge mastery of a subject by some arbitrary grade? Produced, incidentally, by the same company that trained the model. But I'm sure they wouldn't cheat...

I also care about the results, but I judge it based on direct experience. IME the current SOTA models can't be relied on to accurately produce working code most of the time, yet I'm expected to trust they can produce accurate healthcare diagnosis and advice? Give me a break.

AI companies have sold us a fantasy that a neat computer trick, which can still be very useful for society, will somehow lead to AGI. Now that we're a decade into this hype cycle and investors are getting antsy, they're doubling down by anthropomorphizing the technology and selling us "chain of thought" and "reasoning", as if making everyone say these things will somehow magically produce intelligence.

What's really irresponsible is that the public and governments are buying into it, which is pushing the tech into industries that can actually harm people. Safety is not just about trusting some arbitrary grade.

This insanity needs to be regulated yesterday.

how is that relevant here?

I've never used LLMs for this, but as someone who's been through a lot of sports-related injuries, I find doctors more or less useless (except for prescribing painkillers and performing surgeries.)

No doctor or physio has ever been able to fix my chronic issues, and I've always had to figure them out myself through lots of self-study and experimentation.

I can't speak to the OP's condition, but having seen plenty of doctors and physical therapists in the US for over a decade:

Yes, they propose exercises.

No, they don't work.

For certain (common) conditions, PT seems to have it nailed - the exercises really help. For the others, it's just snake oil. Not backed by much research. The current state of the art is just not good when it comes to chronic pain.

So while I don't know if an LLM can be better than a battery of human experts, I do know that those human experts do not perform well. I'm guessing with the OP's case, that battery of human experts does not lead to a consensus - you just end up with 10 different treatments/diagnoses (and occasionally, one is a lot more common than the other, but it's still wrong).

Much of modern medicine's expertise is focused on areas that reimburse well (in some part because those industries subsidize the research).

I would not expect most physicians to have a deep fund of literature-backed knowledge to draw from regarding exercise. Telling someone to do an exercise probably doesn't compensate well.

That said, I'm also pretty negative about the availability of rigorous literature regarding much of nutrition, dentistry, podiatry, physical therapy, etc... you know, the things that affect the health of most human beings that have ever lived.

Good DPT with a team of PTs and PTAs, and possibly also see a DO who can do osteopathic manipulation therapy (OMT).

Start with a dedicated orthopaedic practice who will make referrals to the above and then order CATs/MRIs if the above isn’t helping and evaluate if surgery is necessary.

One challenge is that it is hard to even know how to navigate all this. LLMs could actually help with that.

From their story, it sounds like the one doctor had it right because the AI-empowered self diagnosis seems to agree. Or do I misunderstand?

They literally said they saw sport focused physicians.

Definitely - o3 proposed a few things initially: Costochondral separation, Intercostal strain, rib fracture, pericardial effusion and a few other things...

After answering questions about symptoms, it gave me a few movements/actions to do and to rate the pain of each. Based on that it diagnosed me and gave me a timeline of what to expect and things to watch out for.

Really it was as helpful as a doctor could have been in that scenario, IMO.

Whichever the default free model is right now- I stopped paying for it when Gemini 2.5 came out in Google's AI lab.

4o, o4? I'm certain it wasn't 3.5

Edit: while logged in

>I wonder if it was unable to read your report, and just answered as if role-playing?

FWIW,

This is what chatgpt gave me when I uploaded a lab report, it read the results back to me:

Here’s an interpretation of the blood test results you provided:

White Blood Cell Count (WBC) Value: 9.2 (Normal: 3.8 - 10.8 Thousand/uL)

Within the normal range, indicating no immediate signs of infection or inflammation.

Red Blood Cell Count (RBC) Value: 5.29 (Normal: 3.8 - 5.1 Million/uL)

Elevated (High). This could indicate dehydration, stress, or other conditions like polycythemia.

Hemoglobin Value: 10.9 (Normal: 11.7 - 15.5 g/dL)

Low. Suggests anemia, possibly due to iron deficiency or chronic disease.

Hematocrit Value: 36.0% (Normal: 35.0 - 45.0%)

Within the normal range, but on the lower side, supporting the presence of mild anemia.

Mean Corpuscular Volume (MCV) Value: 68.1 (Normal: 80.0 - 100.0 fL)

Low. Indicates microcytic anemia, often due to iron deficiency.

Mean Corpuscular Hemoglobin (MCH) Value: 20.6 (Normal: 27.0 - 33.0 pg)

Low. Suggests hypochromia (paler red blood cells), often associated with iron-deficiency anemia.

Mean Corpuscular Hemoglobin Concentration (MCHC) Value: 30.3 (Normal: 32.0 - 36.0 g/dL)

Slightly low. May reflect reduced hemoglobin in red blood cells, consistent with iron-deficiency anemia.

Red Cell Distribution Width (RDW) Value: 15.8% (Normal: 11.0 - 15.0%)

Elevated. Indicates variability in red blood cell size, common in iron-deficiency anemia.

Platelet Count Value: 397 (Normal: 140 - 400 Thousand/uL)

Normal, but on the higher side of the range.

Other Key Metrics Absolute Neutrophils, Lymphocytes, Monocytes, Eosinophils, Basophils: All within normal ranges, suggesting no significant abnormalities in immune cell populations.

Anisocytosis (1+): Indicates variation in red blood cell size.

Hypochromasia (1+): Suggests pale red blood cells, supporting iron-deficiency anemia.

Summary These results suggest iron-deficiency anemia, characterized by low hemoglobin, low MCV, low MCH, and high RDW. The elevated red blood cell count may reflect compensatory mechanisms or mild dehydration.

Your provider recommends a heart-healthy, low-fat diet, which is great for overall health. However, addressing the anemia might also involve increasing dietary iron or taking iron supplements.

The diagnosis is wrong, btw, I don't have iron deficiency. The anemia is caused by a genetic condition called thalassemia, which has been verified by genetic tests. You can use the Mentzer Index to differentiate the two on a simple CBC - https://www.mdcalc.com/calc/10534/mentzer-index

Mine numbers return a "probable diagnosis."

I was wondering if chatgpt would catch it, nope, it didn't. It did say that it was a possibility once I suggested it though.

You're not on Reddit.

The lab report clearly described in medical jargon what the sample was, and that the sample was not cancer.

There was no reference in the report that the LLM might have pulled out to think otherwise.

That’s a valid concern, especially in a system so focused on cutting costs. What felt a bit different here is that the doctors helped define the evaluation standards. If AI gets built with them instead of for them, maybe there’s still some hope it won’t just be about saving money.

Exactly correct. So eventually we’ll pay a nurse’s aide to type prompts into GPT the same price for a visit where we used to see an MD (and then an NP, and then a PA, and then a BSN, and then an RN…), and get charged the same.

the amount of obvious astroturfing by people with investments in LLMs on this website is insane.

you only need to look at this thread alone to prove your point. this is a race to the bottom that we're being accelerated towards by some of the worst people on earth.

I use Medicaid and have never found that to be the case.

In fact, I’d prefer to be back on full work duties, but I’m still on light duty until my next appointment, assuming he restores me to full duty.

Providers who are reimbursed via Medicaid have zero incentive specific to Medicaid to not give out work “excuses”, document disabilities and so on. Generally speaking the same providers serve both Medicaid and non-Medicaid patients.

Perhaps there are some states where the Medicaid providers are really awful (California?).

And OpenAI is definitely thinking about this on their end:

https://www.axios.com/2024/12/03/openai-ads-chatgpt

> OpenAI CFO Sarah Friar told the Financial Times that OpenAI is weighing the inclusion of ads in its products but wants to be "thoughtful about when and where we implement them."