John Reisman
speaker
51 appearances
1 recordings
1 series
first heard Nov 2024
last heard Nov 2024
John Reisman’s voice in public audio — every appearance, attributed to the second.
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3 Takeaways™ · I’m a Doctor. ChatGPT’s Bedside Manner Is Better Than Mine. (#223) · 12 Nov 2024
podcast
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.
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.
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.
Thank you for having me, Lynn.
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.
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.
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.
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.
Correct.
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.
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.
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
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.
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.
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.
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.
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.
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.
Another important do is to always have a tissue box nearby in case the patient starts crying, of course, which sometimes happens.
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.
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