John Reisman
Appearances
3 Takeaways
I’m a Doctor. ChatGPT’s Bedside Manner Is Better Than Mine. (#223)
We probably have to ramp up even the more human sides of our lives as we interact more and more. with ais i don't see the interaction with doctors as hopefully a big part of people's social lives you know hopefully it's a small part of their lives i guess if you have complicated serious disease you see quite a number of doctors and perhaps many specialists
3 Takeaways
I’m a Doctor. ChatGPT’s Bedside Manner Is Better Than Mine. (#223)
And sadly, for some people, that might be the bulk of their social interactions in daily life. But hopefully humans can compensate for the kind of dehumanizing of more and more aspects of our lives by kind of ramping up the humanity of other parts. I guess we haven't done that super well lately, but hopefully we will.
3 Takeaways
I’m a Doctor. ChatGPT’s Bedside Manner Is Better Than Mine. (#223)
The first takeaway I'd say is that as much as medicine feels like a very human endeavor, much of it is really just technical and a matter of customer service. And I think AI is going to do splendidly at that side. The second takeaway I would say is that there's really no going back. There's only going through and going forward.
3 Takeaways
I’m a Doctor. ChatGPT’s Bedside Manner Is Better Than Mine. (#223)
And that applies to the way technology will affect healthcare and many other aspects of life. My third takeaway is that health care really needs to get into the 21st century in the way that it delivers care and interacts with patients. As many people have noticed, interacting with your doctor's office can be rather dreadful.
3 Takeaways
I’m a Doctor. ChatGPT’s Bedside Manner Is Better Than Mine. (#223)
You have to sit in traffic, wait in the waiting room, get herded through your visit like an animal. And the communication can be terrible. You can wait for a callback for days and weeks or the results from your exams. And this all seems kind of stuck in the 20th or even the 19th century in some ways.
3 Takeaways
I’m a Doctor. ChatGPT’s Bedside Manner Is Better Than Mine. (#223)
So while the technical side of medicine seems to be sprinting into the 21st century, the kind of customer service side of health care still seems rather dreadful and in need of updating quite dramatically.
3 Takeaways
I’m a Doctor. ChatGPT’s Bedside Manner Is Better Than Mine. (#223)
Thank you so much, Lynn. It's been a pleasure.
3 Takeaways
I’m a Doctor. ChatGPT’s Bedside Manner Is Better Than Mine. (#223)
As a young idealistic medical student in the 2000s, I thought my future job as a doctor would always be safe from artificial intelligence. At the time, it was already clear that machines would eventually outperform humans at the technical side of medicine.
3 Takeaways
I’m a Doctor. ChatGPT’s Bedside Manner Is Better Than Mine. (#223)
Thank you for having me, Lynn.
3 Takeaways
I’m a Doctor. ChatGPT’s Bedside Manner Is Better Than Mine. (#223)
Well, I have to say I was very surprised by ChatGPT's abilities, both on the technical side and just the verbal side of imitating human language to such an incredible degree, including very technical language that you expect sort of only from professionals who have studied some area for years and perhaps gotten several degrees.
3 Takeaways
I’m a Doctor. ChatGPT’s Bedside Manner Is Better Than Mine. (#223)
Computers seemed good at deciphering the technical side of medicine, so I was not surprised by its abilities there. When I was a medical student, we used to Google things like blood in the urine, blood in the sputum, and it would come up with the rare rheumatologic diseases that we were going after and things like that. And it always got it right. So that side I was not surprised at.
3 Takeaways
I’m a Doctor. ChatGPT’s Bedside Manner Is Better Than Mine. (#223)
But I think like many other people, I was very surprised by how good chat GPT was at mimicking humans, basically, and making you think that there was a human behind the words. And that goes for everything from technical explanations of medical concepts to even human conversation, which we often have in medicine.
3 Takeaways
I’m a Doctor. ChatGPT’s Bedside Manner Is Better Than Mine. (#223)
So, I would say it was that sort of mimicking of humanity side that really caught me off guard as it did many other people.
3 Takeaways
I’m a Doctor. ChatGPT’s Bedside Manner Is Better Than Mine. (#223)
Right, and I'm sorry to say perhaps many doctors are not either. I think a lot goes into what people perceive as an empathetic answer from a doctor. For instance, ChatGPT can generate language at a much quicker rate than a human.
3 Takeaways
I’m a Doctor. ChatGPT’s Bedside Manner Is Better Than Mine. (#223)
Whenever I searched Google with a list of symptoms from a rare disease, for example, the same abstruse answers that I was struggling to memorize for exams reliably appeared within the first few results. But I was certain that the other side of practicing medicine, the human side, would keep my job safe. This side requires compassion, empathy, and clear communication between doctor and patient.
3 Takeaways
I’m a Doctor. ChatGPT’s Bedside Manner Is Better Than Mine. (#223)
If a human doctor is slowly typing into their computer an answer or just speaking the answer, it takes some time to come up with that answer, as where ChatGPT can kind of generate a large chunk of text in an instant, seemingly. I thought about this a lot. And I think what goes into feeling that a doctor's answer is empathetic, part of it might just be the length of the answer alone.
3 Takeaways
I’m a Doctor. ChatGPT’s Bedside Manner Is Better Than Mine. (#223)
Obviously, that's not the only thing. But if a doctor says something short and blunt, like, oh, you're fine, don't worry about it. Maybe from a doctor's perspective, we think that sounds authoritative, and it sounds reassuring to a patient. But in reality, it sounds like
3 Takeaways
I’m a Doctor. ChatGPT’s Bedside Manner Is Better Than Mine. (#223)
You're treating the patient like they can't handle the more details, they can't handle a more in-depth dive into what the technicalities of your decision are. And so perhaps we think that's reassuring, but I think a patient wants more information and wants to be a part of the decision, too, and not just take our word for it, as they might have in decades past when medicine was more paternalistic.
3 Takeaways
I’m a Doctor. ChatGPT’s Bedside Manner Is Better Than Mine. (#223)
So I think just the length alone and the instant it takes for ChatGPT to generate a more in-depth, more explanatory explanation of what we think is going on and how the advice we're giving stems from that. I think that's a big part of it too. So I don't think that's the whole story, but perhaps that's a big part of it.
3 Takeaways
I’m a Doctor. ChatGPT’s Bedside Manner Is Better Than Mine. (#223)
And doctors being very busy and rushed all the time, perhaps don't have the time to give those more in-depth answers that patients want and deserve.
3 Takeaways
I’m a Doctor. ChatGPT’s Bedside Manner Is Better Than Mine. (#223)
As a medical student, I learned that too. It was actually the only training I really got in bedside manner, besides watching more senior doctors and more senior residents enact the do's and the don'ts, learning from their positive examples and negative examples. For instance, when you come into the room, you don't want to clobber the patient over the head with the news that they have cancer.
3 Takeaways
I’m a Doctor. ChatGPT’s Bedside Manner Is Better Than Mine. (#223)
But at the same time, you don't want to beat around the bush. They're there to get the results of their biopsy, let's say. So don't talk about the weather, get to the point. There's this tendency to soften the blow of the news by using overly technical language, words like adenocarcinoma, which is a technical description of some kinds of cancer.
3 Takeaways
I’m a Doctor. ChatGPT’s Bedside Manner Is Better Than Mine. (#223)
You sort of can hide behind those technical words that the patient may not understand. And instead of coming out and saying words like cancer that feel hard to say when you're faced with that patient, it is actually difficult to come out with those words. So we tend to hide behind technical words. That's obviously a don't.
3 Takeaways
I’m a Doctor. ChatGPT’s Bedside Manner Is Better Than Mine. (#223)
Another important do is to always have a tissue box nearby in case the patient starts crying, of course, which sometimes happens.
3 Takeaways
I’m a Doctor. ChatGPT’s Bedside Manner Is Better Than Mine. (#223)
And then, of course, a big do is to ask the patient what they know about cancer, what they know about perhaps a specific kind of cancer that you're diagnosing them with to educate them because many people know the word cancer is bad, but really don't know much more than that or what to expect in the coming months and years. So explaining all that is very important.
3 Takeaways
I’m a Doctor. ChatGPT’s Bedside Manner Is Better Than Mine. (#223)
One of the lines that I learned, one of the scripts was the I wish line. I wish I had better news. That kind of does make it more personal. And having those lines, I almost think about it like you have a tool belt with different tools you can pull out, different lines you can pull out in different instances. And, you know, it sounds robotic.
3 Takeaways
I’m a Doctor. ChatGPT’s Bedside Manner Is Better Than Mine. (#223)
It sounds technical when you should be utterly human in that situation, yet you're pulling out these prescripted lines, but they really do help in those situations.
3 Takeaways
I’m a Doctor. ChatGPT’s Bedside Manner Is Better Than Mine. (#223)
As long as patients were still composed of flesh and blood, I figured, their doctors would need to be too. The one thing I would always have over AI was my bedside manner.
3 Takeaways
I’m a Doctor. ChatGPT’s Bedside Manner Is Better Than Mine. (#223)
I did find that having that script, having those tools, those lines really, really helps. It's such a surreal situation. You know, I would have thought I did think as a medical student, these situations are you just one human to another. You're just having a heart to heart conversation and while at the same time conveying some technical information about the diagnosis and prognosis.
3 Takeaways
I’m a Doctor. ChatGPT’s Bedside Manner Is Better Than Mine. (#223)
But it is a very unnatural setting. So as an ER doctor, I often find cancer, let's say, on a CAT scan when I'm working up a patient's symptoms. This is a person I've never met before. They've never met me. I'm playing a role that I play every day to make a living. For me, this happens semi-often. And for them, it could be the worst day of their life.
3 Takeaways
I’m a Doctor. ChatGPT’s Bedside Manner Is Better Than Mine. (#223)
So there's this huge chasm between us, this stranger I've never met before and likely will never meet again. It's not surprising that a human... might act unnaturally in such a situation.
3 Takeaways
I’m a Doctor. ChatGPT’s Bedside Manner Is Better Than Mine. (#223)
You know, we're all in our jobs acting out this unnatural role, playing a role, really, no matter what our job is, and that the same goes for doctors and even in those most human moments when you are telling a patient some life-changing information.
3 Takeaways
I’m a Doctor. ChatGPT’s Bedside Manner Is Better Than Mine. (#223)
So in retrospect, it's not surprising that these sort of lines, these pre-written scripts help in that situation to sort of bridge that emotional, professional chasm from which both of me and the patient are coming at this very difficult conversation.
3 Takeaways
I’m a Doctor. ChatGPT’s Bedside Manner Is Better Than Mine. (#223)
Scripts are everywhere. When you think about it for a second, you think, oh, we're just humans. And when we talk, it's human to human interactions. But our society and our lives are pervaded with scripts. When we greet people, we're following a script. And when we say goodbye, there's scripts between husbands and wives. There's scripts between friends.
3 Takeaways
I’m a Doctor. ChatGPT’s Bedside Manner Is Better Than Mine. (#223)
There's scripts between professional colleagues. There's things you don't say in certain contexts and that you do say in others contexts. whatever your job is, if you're in politics, if you're in the medical setting, you know, there's things you say and there's things you don't say in those contexts. So we're kind of all following all these scripts.
3 Takeaways
I’m a Doctor. ChatGPT’s Bedside Manner Is Better Than Mine. (#223)
And, you know, it seemed repulsive to me at first to think, oh, there's this pre-written script and I'm just an actor on a stage following stage directions when I should be a human in the moment connecting with this other human. But pre-written scripts, pre-written actions and choreographed motions and gestures pervades every aspect of society.
3 Takeaways
I’m a Doctor. ChatGPT’s Bedside Manner Is Better Than Mine. (#223)
And I think when I thought about it, I realized it's actually a big part of being a human is a script. And you're not just improvising and freewheeling it all day long every day. We're all kind of following roles to some extent, though we may improvise on the script. Obviously, I'm not reciting the same words. exact words to every patient. It is a conversation. There is a back and forth.
3 Takeaways
I’m a Doctor. ChatGPT’s Bedside Manner Is Better Than Mine. (#223)
So it's sort of like you have the script, but then you sort of improvise on it to fit it to the specific context or the specific conversation that you're having. And that's kind of like how human life works in society, I think.
3 Takeaways
I’m a Doctor. ChatGPT’s Bedside Manner Is Better Than Mine. (#223)
I think we will. I think there's no other way. I think so many areas of life have reduced human to human interaction. You know, I sometimes use chat bots online to get certain banking tasks accomplished. And I think most of health care can go that same way. You know, doctors are expensive. Maintaining facilities are very expensive.
3 Takeaways
I’m a Doctor. ChatGPT’s Bedside Manner Is Better Than Mine. (#223)
Health care is a huge proportion of our national costs for the country. And so reducing those costs will be great. Hopefully, in some ways, we'll increase access, decrease the cost. But as a side effect, there'll be less human interaction. There'll be more interaction with machines, with AIs. So it's kind of a brave new world we're entering.
3 Takeaways
I’m a Doctor. ChatGPT’s Bedside Manner Is Better Than Mine. (#223)
And hopefully, we can find the right balance without losing our humanity, even though we're interacting less and less with other humans.
3 Takeaways
I’m a Doctor. ChatGPT’s Bedside Manner Is Better Than Mine. (#223)
Certainly AI can be very helpful even without feeling any compassion itself. I don't think any of us strive for a world where all human compassion and emotion is driven out and only technical verbal scripts of compassion remain.
3 Takeaways
I’m a Doctor. ChatGPT’s Bedside Manner Is Better Than Mine. (#223)
Surely humans caring for each other, a doctor caring for their patient, a doctor feeling terrible about what they've just discovered on a CAT scan inside a patient's abdomen or skull. Surely that compassion must stay in the world and we must maintain it. And AI, you know, if you're just writing a form letter to a patient about some ho-hum test result, that's not that serious.
3 Takeaways
I’m a Doctor. ChatGPT’s Bedside Manner Is Better Than Mine. (#223)
I don't think tremendous compassion is needed. But certainly some is needed in these more human moments. And I think it will take some adaptation. And I wonder how far... Humans can take it. You know, traditionally, we talk to each other face to face.
3 Takeaways
I’m a Doctor. ChatGPT’s Bedside Manner Is Better Than Mine. (#223)
We hear each other's voice, which turned into the written word where you can send a letter across the country and you're not looking at the patient, which turned into sort of like a telecommunications where we see each other, but we're across some distant geographic chasm. So the way we communicate with each other has changed so much. So I wonder how much AI communication we can tolerate.
3 Takeaways
I’m a Doctor. ChatGPT’s Bedside Manner Is Better Than Mine. (#223)
Maybe patients won't actually miss their human doctors all that much. Most diagnoses I deliver are not life changing. they're pretty ho-hum. They are, oh, you sprained your ankle, you didn't break it, or you broke it and didn't sprain and you're going to follow up with an orthopedist, or you have strep throat, or you don't have strep throat, you have a viral cause of your sore throat.
3 Takeaways
I’m a Doctor. ChatGPT’s Bedside Manner Is Better Than Mine. (#223)
You know, these are not life-changing conversations. They don't require tremendous compassion or brilliance in bedside manner at all. It's actually rare that I have to, relative to other diagnoses, that I have to deliver these life-changing ones. So, I think a lot of medicine can change and people are not going to
3 Takeaways
I’m a Doctor. ChatGPT’s Bedside Manner Is Better Than Mine. (#223)
miss the more awkward conversations with their doctor about these sort of everyday, not so dangerous diagnoses. So I think medicine's in for a lot of change.
3 Takeaways
I’m a Doctor. ChatGPT’s Bedside Manner Is Better Than Mine. (#223)
I do think it will probably get harder to maintain human relationship, though I do think that is very important. I think already with the technology we have, even without AIs that imitate humans nearly perfectly, we're more isolated as time goes on since we can kind of do almost everything in our daily lives without ever leaving the house. or often without even speaking to a human.
3 Takeaways
I’m a Doctor. ChatGPT’s Bedside Manner Is Better Than Mine. (#223)
We accomplish so many things through websites, let's say personal finances and banking and all these other things. We don't interact with humans as much as we used to. Is it making us more lonely? Probably. As we interact less and less with humans, will we get lonelier? Probably. Hopefully we'll find ways to compensate.