A.I. In Medicine
WORCESTER MEDICINE
Do Patients Want Artificial Intelligence or Human Intelligence? Continued This response can be edited and sent back to the patient. Early studies show that these responses are longer and felt to be more empathetic by patients compared to a prior baseline. This has led to physician concerns that when doing subsequent visits, the patients will expect the physician to speak longer and appear more empathetic! Patients are starting to benefit from AI in other ways as well. For instance, AI is making real-time ambient transcription and summarization of office visit dialogue a reality. A microphone recording the conversation in the exam room allows the physician to focus their attention on the patient and keep good eye contact without having to worry about writing their notes. AI is also performing translation of physician communications to patients, making them more understandable by lowering the reading grade level and translating into other languages. AI is similarly automatically creating timely after-visit summaries and discharge summaries that are more patient-friendly. And, of course, the use of AI in EHR clinical decision support is helping patients to receive higher-quality and safer care. So yes, patients do want artificial intelligence to assist in their care. Sometimes they even prefer it over human intelligence. But will AI replace physicians in caring for patients? That answer is “No”. However, as Dr. Karim Lakhani, a professor at Harvard Business School, pointed out, “AI is not going to replace humans, but humans with AI are going to replace humans without AI.” +
Can AI be a Good Doctor?: What measuring a computer’s medical ability teaches us about human doctors Andrew Beam, PhD
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s artificial intelligence (AI) advances, there is increasing interest in whether AI systems can take on roles traditionally filled by human experts, including doctors. AI systems are now being developed that can read medical images, analyze health records, diagnose diseases, and even communicate empathetically with patients. In some applications, these AI systems are reaching or even surpassing human-level performance. It is not an understatement to say the pace of progress on medical AI over the last decade has been staggering.
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What has become clear over the last five years is that AI has an impressively good grasp of medical knowledge.
Dr. Garber is an internist, the Medical Director for Informatics, and the Associate Medical Director of Research at Reliant Medical Group. References 1. Predmore ZS, Roth E, Breslau J, Fischer SH, Uscher-Pines L. Assessment of Patient Preferences for Telehealth in Post– COVID-19 Pandemic Health Care. JAMA Netw Open. 2021;4(12):e2136405. doi:10.1001/jamanetworkopen.2021.36405 2. https://openai.com/research/gpt-4 3. Nori, Harsha & King, Nicholas & McKinney, Scott & Carignan, Dean & Horvitz, Eric. (2023). Capabilities of GPT-4 on Medical Challenge Problems. https://browse.arxiv.org/pdf/2303.13375. pdf 4. Brin D, Sorin V, Vaid A, Soroush A, Glicksberg BS, Charney AW, Nadkarni G, Klang E. Comparing ChatGPT and GPT-4 performance in USMLE soft skill assessments. Sci Rep. 2023 Oct 1;13(1):16492. doi: 10.1038/s41598-023-43436-9. PMID: 37779171; PMCID: PMC10543445. 5. Ayers JW, Poliak A, Dredze M, et al. Comparing Physician and Artificial Intelligence Chatbot Responses to Patient Questions Posted to a Public Social Media Forum. JAMA Intern Med. 2023;183(6):589–596. doi:10.1001/jamainternmed.2023.1838
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This raises an inevitable question - can AI really ever be a good doctor? However, this question in turn raises another for human doctors that we rarely acknowledge outright: It is very challenging to reliably determine if any given person is a “good doctor”. Moreover, it is often still difficult to determine which doctors are good, even after decades of practice. Some doctors excel at diagnosis but have a problematic bedside manner. Some ace their boards but struggle to be a team player. Some are wonderful colleagues but may struggle with complex cases. Are any of these kinds of doctors better or worse when compared to each other? The answer from the field of health services research, is “It depends on what you’re measuring”. There is a long list of metrics that attempt to answer some form of this question, including aspects like test scores, RVUs, clinical
Winter 2023
