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I’m an ER doctor. Here’s how I’m already using ChatGPT to help treat patients

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Re: I’m an ER doctor. Here’s how I’m already using ChatGPT to help treat patients

#191

Post by bemusedthrow75 »

catchnear4321 wrote: post #187
bemusedthrow75 wrote: post #186

Two shocking things about this article: The first: with his doctor hat on, he should understand that the value is the piece of paper and reading from it consistently to relatives who may have mild cognitive impairment. ChatGPT wrote essentially identical content to the words he'd been delivering himself. The professionally responsible thing to do would have been to type up or get someone to type up his _actual words_…

the flip side of this is that the model acts as a universal translator. not just for language but also for emotional valence and context. are you a doctor? worked in an er? there are a lot of strong words about what doctors should and shouldn’t do, with regard to empathy and compassion. there is a shocking lack of compassion or empathy in the very words demanding them. (there is also a rather large assumption that th…

> are you a doctor? worked in an er?

No, I'm not. My dad -- who died with dementia -- was in medicine for his entire life. I am writing about what people with cognitive impairment tend to need from the perspective of reassuring, daily, a highly intelligent person who couldn't remember stuff.

> there are a lot of strong words about what doctors should and shouldn’t do, with regard to empathy and compassion. there is a shocking lack of compassion or empathy in the very words demanding them.

The bit about hiring someone with empathy was quite clearly in my second point, which was aimed at the HN audience, not at the doctor.

(Though the guy who wrote the article isn't writing as a doctor in some medical publication, he is writing an executive at VC firm that backs AI startups, as other commenters have observed.)

I have a lot of compassion for doctors. I don't have a lot of compassion or empathy for motivated reasoning in AI marketing bullshit written by well-remunerated people who are trying to force a technology into healthcare where it does not belong.

And yes, the value of the piece of paper is that it bridged the divide. That's exactly what I said. It does it through consistency and constancy. ChatGPT has _no_ magical impact on that.

Re: I’m an ER doctor. Here’s how I’m already using ChatGPT to help treat patients

#192

Post by Xen9 »

Applejinx wrote: post #189

I'd bet money that the Medium article has also been, in part, rewritten by ChatGPT. Here's why: the story being told is that of a doctor, needing to communicate, being able to get through to 'regular folks' through talking down to them using ChatGPT (which is actually well suited to that task, once you acknowledge that hallucination can also mean losing stuff in translation). Then, the article itself, including the d…

"...hallucinatory happytalk that paints with a very broad brush, and delivers not the tone you want, but an abstracted 'popularized' tone likely to convince large numbers of stupid and gullible people."

You capture essence beautifully.

Re: I’m an ER doctor. Here’s how I’m already using ChatGPT to help treat patients

#193

Post by vidarh »

williamcotton wrote: post #176
vidarh wrote: post #166

Earlier quoted context omitted.

We already do that during normal communication - people rarely say what they mean in the simplest way possible. We couch the message in all kinds of extraneous details. The tediousness of which is part of why some people want to use LLMs to generate messages for them in the first place. Stripping that out might ironically reduce the need: Of people come to expect their messages to be automatically stripped of fluff,…

It is possible to learn how to write concisely.

It's exactly because most of us can write concisely that there is a perceived benefit to use ChatGPT and similar to expand a concise instruction into a longer message that meets the social expectations. Those social expectations are what often prevents us from sending those concise messages to people today.

Re: I’m an ER doctor. Here’s how I’m already using ChatGPT to help treat patients

#194

Post by catchnear4321 »

bemusedthrow75 wrote: post #191
catchnear4321 wrote: post #187

Earlier quoted context omitted.

the flip side of this is that the model acts as a universal translator. not just for language but also for emotional valence and context. are you a doctor? worked in an er? there are a lot of strong words about what doctors should and shouldn’t do, with regard to empathy and compassion. there is a shocking lack of compassion or empathy in the very words demanding them. (there is also a rather large assumption that th…

> are you a doctor? worked in an er? No, I'm not. My dad -- who died with dementia -- was in medicine for his entire life. I am writing about what people with cognitive impairment tend to need from the perspective of reassuring, daily, a highly intelligent person who couldn't remember stuff. > there are a lot of strong words about what doctors should and shouldn’t do, with regard to empathy and compassion. there is a…

> The bit about hiring someone with empathy was quite clearly in my second point, which was aimed at the HN audience, not at the doctor.

then the assumption of ability to hire or impact hiring is broader.

the article author is quite biased, yes. part of the problem with current “ai” - bias from all sides.

chatgpt is not magical. it is a tool. a novel one. that many wish to sell. none of that lessens the possibilities it presents. nor the risks. but there are real, beneficial use cases. with a little time spent.

not everyone wishes to put greed ahead of linear algebra, or math before compassion.

Re: I’m an ER doctor. Here’s how I’m already using ChatGPT to help treat patients

#195

Post by fifteenforty »

seabombs wrote: post #52
firebirdn99 wrote: post #44

This really feels farcical, and kind of like vc bros hyping up a product. Considering this was a serious issue of life and death of a patient, it was surprising how it read like a prank or like the scene from Harold and Kumar, where Kumar plays a fake doctor and saves an ER patient through sheer luck. I know some doctors are full of baloney but c'mon. I really hope maybe that we create better doctors that have a lot…

The author is a doctor, but also an executive at a health-focused VC fund, with several AI companies in it's portfolio. Helpful context to have before reading his article I think.

The most unbelievable part of this story is that he claims to have read it out to the family.

Re: I’m an ER doctor. Here’s how I’m already using ChatGPT to help treat patients

#196

Post by bemusedthrow75 »

catchnear4321 wrote: post #194
bemusedthrow75 wrote: post #191

Earlier quoted context omitted.

> are you a doctor? worked in an er? No, I'm not. My dad -- who died with dementia -- was in medicine for his entire life. I am writing about what people with cognitive impairment tend to need from the perspective of reassuring, daily, a highly intelligent person who couldn't remember stuff. > there are a lot of strong words about what doctors should and shouldn’t do, with regard to empathy and compassion. there is a…

> The bit about hiring someone with empathy was quite clearly in my second point, which was aimed at the HN audience, not at the doctor. then the assumption of ability to hire or impact hiring is broader. the article author is quite biased, yes. part of the problem with current “ai” - bias from all sides. chatgpt is not magical. it is a tool. a novel one. that many wish to sell. none of that lessens the possibilities…

> then the assumption of ability to hire or impact hiring is broader.

It is, but so what?

What I am suggesting is that using AI tools to fake empathy is worse than not being able to do empathy yourself. This should be evident.

If you have a task that requires significant empathy (a patient advocate, a customer advocate, a serious complaints line, anything with extensive exposure to the emotions of your customer) and you feel unable to do that (not everyone can), the ethical, responsible thing to do is to hire someone who does that job properly.

Professionalise caring. Don't just give the role to an AI that can fake it with a simulacrum of past human caring that it read on the (largely corporate) internet.

We are heading down a dark path if we pretend that automated fake empathy is acceptable.

Edit: and yes, people fake empathy all the time, they copy and paste it. Of course they do. But each time someone fakes empathy there is a glimmer of a chance that they will realise that it's a bad, inappropriate thing to do. There's a glimmer of a chance that they go back to their boss and say "you know, I feel bad brushing them off; what they are going through is real and awful and we should address this more personally".

AI empathy will never do that. And we should feel very, very nervous about using AI to deliver highly bespoke fake empathy to eliminate any guilt from that.

Re: I’m an ER doctor. Here’s how I’m already using ChatGPT to help treat patients

#197

Post by notahacker »

Kiro wrote: post #150
firebirdn99 wrote: post #44

This really feels farcical, and kind of like vc bros hyping up a product. Considering this was a serious issue of life and death of a patient, it was surprising how it read like a prank or like the scene from Harold and Kumar, where Kumar plays a fake doctor and saves an ER patient through sheer luck. I know some doctors are full of baloney but c'mon. I really hope maybe that we create better doctors that have a lot…

Actual ER doctors disagree with you: https://news.ycombinator.com/item?id=36336615 https://news.ycombinator.com/item?id=36337227 Classic HN to confidently dismiss something in areas we're actually clueless about.

I'm going to go out on a limb and suggest that most people on HN have some experience of the patient family side of medical problems, some of them no doubt significant and regular.

We're not doubting the medical situation the ER doctor agrees sounds plausible, that GPT could have produced that response or that doctors finding it difficult to communicate with family members in intelligible and empathetic terms is a real problem.

But if you're the sort of person that would "melt into calm agreeability" when basically the same explanation was offered with generic corpspeak appended (i.e. they'd trust the doctor more if he was answering your question by reading from a script so non-specific and non-empathetic it finished up with "if you have any questions or concerns please contact the medical team"!), and would also be delighted to get the same script read out to you each time you asked a different staff member the same question, I think you're very much in the minority. Certainly in my limited experience, I can assure you that I was more reassured by the empathy levels of professionals completely misunderstanding my question and thinking I was threatening to make a complaint about their standard of care than I would have been if they pulled out an index card and read that they were all doing their best, the treatment is [boilerplate], please do not hesitate to contact medical team in case of any questions and we will reread index card to you.

At best, I suppose, my reaction might be to interpret the index card boilerplate repetition as a polite way of telling me to fuck off and not offer any followup questions. You could even make an argument that this is medically useful; a more specific version of "here's a leaflet" so they can get on with doing their job.

But as written where everybody loves the GPT boilerplate, the story reads like a classic of the LinkedIn/politician people miraculously came round to supporting me and everybody cheered genre.

Re: I’m an ER doctor. Here’s how I’m already using ChatGPT to help treat patients

#198

Post by williamcotton »

bohner wrote: post #85
Spooky23 wrote: post #77

Earlier quoted context omitted.

Some specialties attract different personalities. If you’ve ever been in a hospital setting around a lot of neuro residents, many of them will present… oddly. It’s a feature. Likewise, a lot of ER docs are kinda adrenaline people who are great at triage and quickly stabilizing you, but maybe not so much good at relating with people. That’s a feature — you don’t need a soft touch dealing with trauma. If ChatGPT can he…

Have worked with many poor communicators and outright idiots but there is virtually no one graduating a decent medical school with native speaker skills that cant explain in simple terms why giving more fluids to someone that is overloaded with fluid is a bad idea (oh and without using any jargon like edema or diuresis, another thing missing in this whole farce, any 1st year let alone decent attending will explain cl…

It only sounds idiotic with sufficient levels of cynicism coupled with a lack of empathy.

Two years ago I rushed to the ER suffering from pulmonary edema caused by misdiagnosed endocarditis which required emergency open-heart surgery. The most qualified of the surgeons were very terse and very busy with, you know, prying people’s rib cages open and such. Do the math and think about what else the ER could have been dealing with at that time…

Re: I’m an ER doctor. Here’s how I’m already using ChatGPT to help treat patients

#199

Post by Applejinx »

Xen9 wrote: post #192
Applejinx wrote: post #189

I'd bet money that the Medium article has also been, in part, rewritten by ChatGPT. Here's why: the story being told is that of a doctor, needing to communicate, being able to get through to 'regular folks' through talking down to them using ChatGPT (which is actually well suited to that task, once you acknowledge that hallucination can also mean losing stuff in translation). Then, the article itself, including the d…

"...hallucinatory happytalk that paints with a very broad brush, and delivers not the tone you want, but an abstracted 'popularized' tone likely to convince large numbers of stupid and gullible people." You capture essence beautifully.

Only because I've written many words and had very specific concepts, 'essence', to represent with words. What I'm saying is not 'popularized', it's a set of very specific points.

You could GPT-ize what I said into 'feel-good talk' or 'hallmark cards' but you would lose the concept of 'the very broad brush does not deliver the tone you want, but a generalized one that will reach more people through being already based in how they see things'.

If you need to get a mass audience to see a new thing, ChatGPT is NOT your friend… it will tell them what they already know… the wild thing is how the original claim is just this, 'ChatGPT got an audience to see a new thing', but the ChatGPT-style payoff of 'they smiled bovinely and accepted the new information' is clearly what the ARTICLE AUTHOR wanted to hear, and thus it's a really suspicious take.

Re: I’m an ER doctor. Here’s how I’m already using ChatGPT to help treat patients

#200

Post by Calavar »

Kiro wrote: post #150
firebirdn99 wrote: post #44

This really feels farcical, and kind of like vc bros hyping up a product. Considering this was a serious issue of life and death of a patient, it was surprising how it read like a prank or like the scene from Harold and Kumar, where Kumar plays a fake doctor and saves an ER patient through sheer luck. I know some doctors are full of baloney but c'mon. I really hope maybe that we create better doctors that have a lot…

Actual ER doctors disagree with you: https://news.ycombinator.com/item?id=36336615 https://news.ycombinator.com/item?id=36337227 Classic HN to confidently dismiss something in areas we're actually clueless about.

For what it's worth, I'm a doctor and I find this story hard to believe. It does sound to me like wishful thinking by an AI hype guy.

In my experience, these sorts of situations happen when two things come together:

1. The patient's family has just enough medical knowledge to fall onto the wrong part of a Dunning-Kruger curve.

2. The family has certain beliefs about the medical establishment. Namely, that medical staff (especially doctors) are trained in medical school to have an inflexible way of thinking and that the doctors are dismissive of the family's proposed treatment because they are married to textbook thinking and rigidly following hospital protocols.

#1 happens all the time - maybe even the majority of the time - but it isn't enough to cause conflict on its own. #2 is the special sauce that makes the situation boil over.

What is the absolute last thing you want to do given #2? Probably something along the lines of handing every member of the staff a pre-written script to recite every time a family member asks questions. This will make them feel like they are being stonewalled, not like they are being listened to. This will confirm their fears about point #2, not ameliorate them.

I can't say I've ever seen someone print off a script quite like this before, but I have seen some doctors piss off patients/families by relying too much on pat phrases or repeatedly pointing to a particular clinical guideline or hospital policy as the rationale for their decision.

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