by ricardobayes 10 hours ago
That might be doctors new nightmare: people who second guess everything with AI. Previously it was "google your symptoms".
Well I live in the nightmare that is the Dutch healthcare system [1]. There are many things that they will fix but they didn’t fix my sleep. A friend fixed my sleep. He is a doctor and prescribed me the right thing. The thing is, he shouldn’t have had to intervene. Without him I could have ended up poor and destitute as my sleep was wrecking me.
And yea, I already did all the standard things. CBT for insomnia helped somewhat. My insurance didn’t fully cover it either, unless I was willing to wait for 8 to 12 months.
And I recently met someone with slow moving metastatic cancer. Thanks to LLMs they will most likely live another 3 to 5 years extra since the Dutch conventional mainline treatment hasn’t been taken yet. But it is German doctors that helped them and Belgian doctors that pointed out in a second opinion that a lot more can be done.
LLMs have a part to play. The false positives are awful, but I have seen an average of 5 out of 10 care when things become too complicated.
Except for trauma treatment. The Dutch healthcare system is amazing once they diagnose classic PTSD.
So it’s definitely not all bad but the trust I had when I was younger has been eroded quite a bit and LLMs can meaningfully step in, in my case at least.
[1] I know there are worse systems. But from what I have heard there are clearly better systems nowadays. It has slipped a lot
Hey what did you do to fix your sleep? Help us all and maybe an llm will index your diagnosis (hi ChatGPT)
For me what helped is taking 7.5 mg of mirtazapine. At higher levels it's an anti-depressant but at lower levels it's an anti-histamine. It gets me drowsy. Together with 0.3 mg melatonin it knocks me out. I only take it 3 times per week max to not have habituation kick in.
So 3 days out of 7 days I have guaranteed good sleep. The other 4 days are a toss up. But an average of 5 days of good sleep is much better than 3.5 days out of 7 days.
Interesting. There recently was an article about how premenopausal and menopausal women are taking antihistamines with pepcid to help them sleep due to it going viral on tiktok.
https://www.thecut.com/article/antihistamines-pepcid-ac-peri...
> Then, a few months ago, Angela saw a social-media post from a woman who took daily anti-histamines (like Allegra, Claritin, or Zyrtec) plus Pepcid AC (a common antacid) for her perimenopause symptoms. Her results, as reported, sounded miraculous: no more brain fog, no more tossing and turning all night. Even her mood vastly improved.
AFAIK mirtazapine shouldn't cause habituation the way actual "sleeping pills" or benzodiazepines do. That's one of the reasons it may be preferable as a sleeping aid, especially in the longer term.
Anecdotally, when I took mirtazapine for sleeping problems, it did sometimes seem to have a stronger effect the first time I took it after not using it for a while. After that the effect stayed stable. Overall it shouldn't cause habituation, and my doctor said as much.
Of course trust your doctor and not strangers on the internet, though.
Is the dutch healthcare system broadly against hypnotics? Culture (of the country or its medical system) can massively influence prescriptions or their lack thereof e.g. france is pretty famous for prescribing hypnotics very easily (and having a broad range of them), while the UK is generally a lot more reluctant.
yeah, I’m surprised Trazodone didn’t get mentioned as a very low dose
The NYT did this profile a while back: "Ben Riley was already writing about the risks of chatbots when his dad started trusting A.I. over his doctor."
The dad was a retired neuroscientist who delayed cancer treatment against medical advice because he was certain he had been misdiagnosed based on his own research that he did with the help of A.I.
https://www.nytimes.com/2026/04/13/well/ai-chatbots-cancer.h...
There's a comment on the article from Ben Riley:
> I am very grateful to Teddy Rosenbluth for sharing my father's story with the world, her kindness and curiousity proved to be restorative in ways I didn't anticipate.
> The two words that everyone used to describe my dad: "intelligent" and "kind," and he was indeed both of those things. The sad irony here is that it was his human intelligence, combined with these strange new tools that purport to be a form of 'artificial' intelligence, that led to his ill-advised decision to forego the treatment he needed for his CLL. A doctor has already commented on this story with the observation that AI "confidently asserts erroneous conclusions," and we simply have no idea how often this is happening or the magnitude of the harm that results.
> Not a day goes by that I don't feel the pang of my father's absence. He might still be here if not for AI. I try not to think about that, but sometimes I can't help myself.
The context is very important: decades of a poorly-diagnosed chronic illness had left him deeply distrustful of the medical system.
This is the real root issue.
At 75 years old, he was stubborn. Is that reasonable ? Yes, perfectly. Could he have been right since the beginning ? Certainly. Did he deny evidence ? Yes.
Zero doubt that he was intelligent, everything points toward that direction, but that doesn't make a person less stubborn, because accepting the evidence, is also accepting that you were wrong if you initially postured yourself as adversarial instead of cooperative.
He would have read Wikipedia, scientific papers, etc, even without AI.
He did not want to be convinced. It works both ways:
https://www.foxnews.com/health/woman-says-chatgpt-saved-her-...
or
https://www.today.com/health/mom-chatgpt-diagnosis-pain-rcna...
Nonetheless, someone very smart, just didn't want to move from his position.
i mean, other smart people have famously delayed cancer treatment without needing poor guidance from LLMs! that's not at all new or unique to LLM chatbots
GPT-4o, which is what that article is most likely about, was an older low param count slop model which was known for abusing emojis and sycophancy. It does not really have any relevance to latest claude frontier models.
Your comment is akin to saying "Karen from facebook who is a human pushed essential oils and ivermectin as a cure to cancer. Now doctor Y is suggesting chemo. Both are humans, humans cannot be trusted!"
It's not just the second-guessing. It's the getting in the ballpark but striking out: explaining in detail why they are not correct. A little bit of patient knowledge requires a tremendous amount of doctor time to explain away the ignorance.
It's a 180 for me: While I believe doctors should explain diagnosis or treatment decisions when asked, I don't believe they should be taxed with explaining away alternatives. In my anecdotal 2nd- and 3rd-hand experience, doing that is taking at least a third of their time (on roughly 5% of the patients who think demanding answers will make things better) -- with zero improvement to diagnostic accuracy or treatment effectiveness. Doctors already consult with other doctors, and it makes no sense for them to have to consult with ignorant patients or treat their AI psychosis on top of their disease. It doesn't increase patient autonomy any more than adding a steering wheel for child car seats would help toddlers learn to drive.
I asked a clanker about symptoms I was having. (I'm not an idiot, I was already on my way to hospital, clanker was just to take my mind off symptoms during the drive.)
The clanker said I'd be fine, I just needed some rest and OTC meds.
The medical staff immediately turfed me to surgery because the same set of symptoms I told the clanker were enough to concern them that I needed emergency surgery.
Had I have listened to the clanker, I'd be dead because I did need emergency surgery. (Hell, I almost kicked the bucket because I waited for someone to wake up to give me a lift because.my insurance probably doesnt cover an ambulance ride.)
Very curious what made you run to the emergency first thing in the morning that an LLM understood as "just normal, take some OTC meds and wait".
Not OP but wanted to note that you're also likely to get different results based on the language you use (it'll respond differently to dialects of English, for example) and the RNG seed of the current session. These things are still probability engines and even if you know the exact symptoms, this might not be reproducible
It’s funny every profession deals with customers making their own guesses at diagnosis.
I told my mechanic the film flam is broken but he said it was the rim ram. He fixed it and we all went in with our lives.
But doctors insist on this God like status so it’s a “nightmare” when patients try to help themselves.
I dunno man, it's one thing to have your car still be broken because you were wrong, it's a different thing poison yourself on the basis of having done your own research. The mechanic can laugh at you, it hits a doctor differently.
you are literally taking sleeping pills ..
Nightmare because they're always right and the A.I second guessing is always wrong, or because they just don't like to be second guessed?
There’s more than two options here. It was already difficult to deal with self diagnosis for doctors, now we have a machine that outputs recommendations, and does it with confidence whether it’s correct or not.
The same issues that were present with search-engine self diagnosis are still present with LLMs. If you provide Google with an incomplete list of symptoms and can’t interpret the information you find correctly, you will likely get an incorrect diagnosis. The same is true for LLM output.
The A.I is only gonna get better , and fast. Doctors should simply double check themselves by using A.I.
Everyone on the internet loves to put doctors on a pedestal, but I think upwards of 30% of my doctor visits have been misdiagnosed.
There's a reason I ask AI about absolutely everything medical and there's a reason I keep extra quantities of prescription medications around for emergencies. I've saved my own ass a lot more times than the doctors have, thanks to good doctors not being available.
There are quite a few disclaimers everywhere that soften confidence: "always ask a medical specialist", "I'm not a doctor", "this could have been this or that but really not sure", etc.
No one cares about this, especially those who believe the machine. It's just there for the provider to avoid responsibility.
Well it was a nightmare for my mother's do-nothing GP surgery in the UK. She had several conditions which were being handled completely separately without central coordination, and her health was in serious decline. We went in with a list of 20 AI-generated questions based on her conditions and treatment (which I was able to screen as I have a bio postgrad, but not medical training), including those related to NICE guidelines and procedure, and, frankly the GP bricked it and ordered a load of new interventions. My mother started to get proper treatment.
I wouldn't trust AI to make a diagnosis, but I would absolutely trust it to notice where procedure hasn't been correctly followed, where a treatment is counter-indicated because someone has missed a line on a health record, or where there's a clear potential alternate diagnosis which has been missed for spurious reasons. Also, unfortunately, where doctors aren't doing a decent job - often because they're overworked or underfunded.
Nightmare because users approach LLMs with the false confidence that they're always right, and present LLM outputs as fact to Doctors who have to waste time explaining that it's wrong most of the time. It hurts more than it helps.
Its a nightmare because it erodes trust. Doctors are not "always right" which is why "always get a second opinion" is codified in culture.
But AI's problem is that its completely full of shit, sometimes, and the people most qualified to evaluate whether its full of shit are the doctors, not the patients, but just like OP's original article, patients are left feeling like their second opinion from AI might be more trustworthy than their doctors opinion.
The notion that only doctors can verify is false! Doctors are better at verification but normal people can also verify. This is just empirically true.
Examples of things normal people can verify
- procedural errors that Claude can capture like some blatantly high dosage (grams instead of milligrams)
- outdated treatment plan, maybe there’s a credible new treatment plan that’s been used for years but the doctors were not updated
- literally being injected homeopathic drugs (takes no smart person to flag this)
Let’s stop talking as if doctors have a divine right here. And let’s accept some agency.
Nightmare because the AI is just generating a random text that fits the question.
This is not a fair assessment of what AI is doing.
Studies have found that newer reasoning AIs are about as good at diagnosing illness from a written description of symptoms as doctors are.
Granted, it cannot actually examine a patient, so we're not replacing doctors anytime soon. But your view is obsolete.
They are using the “gold standard for the evaluation of expert medical computing systems” not a proxy for what a doctor actually does when diagnosing someone.
It may have some utility after diagnosis, but this test doesn’t demonstrate utility for patients.
[flagged]
But I, SCP-426, am a toaster.
I feel the same when visiting a doctor in Canada. In that 2 minutes I have with they in one appointment per year I hear a standard text.
Not quite. An LLM generates text that would likely follow. The sky is… “blue”. A patient in pain with a bone protruding from their shin has a… “broken leg”.
The more training data, the more questions it can answer with a reasonable degree of probability of accuracy.
Throwing away a potentially useful analysis just because it’s probabilistic seems a bit like throwing the baby out with the bath water.
This is a very peculiar use of the word "random".
Indeed. I don’t even get what OP thinks they are getting out of this other than doubt.
This is obviously going to happen. But sub-par and sloppy doctors are a thing too. Medicine has been using semi-intelligent systems for years that were nevertheless found to improve outcomes.
We need studies that quantify error rates from each source type, then we need to account for the fact that the artificial type will keep improving.
It can be helpful in your understanding the choices made by asking questions and thus in reassurance, but it requires something most people lack: understanding you are likely wrong since you are just collecting information without understanding it.
Pretty much the like most manager these days, so I understand the frustration of the GPs.
People should've googled their symptoms and especially the prescriptions they got. It has always been a good practice. If[0] AI proves to be the new google then people should ask AI too.
[0]: IF.
Do you know how many life threatening illnesses I’ve diagnosed myself with by googling symptoms?
And say it's true because the AI said so.
No, this flow is actually very good.
Like any domain, when you have questions or need a solution, you make research first, then you ask a specialist.
If you explain well the symptoms and context you can have proper advices and then decide on the path next:
Case A) It looks benign and advices / information that you collected seem reasonable, then you go your way.
Case B) You need second opinion of a specialist because the subject is too complex, or there are medications that you need approval.
At home you have the time to assess the options, pros and cons of each approaches, the possible questions to ask and then challenge the doctor.
Shared decision-making is an actual evidence-based model of care, and patients who arrive understanding their condition and carrying specific questions tend to get better attention and better outcomes.
Some doctors get annoyed, because they have big ego and choose to be patronizing, but it is exactly their job to answer such questions.
With LLMs, it's quite good, you get nuanced and rather useful answers.
Before LLMs, no matter the topic you searched for, the answer was the same: "you have cancer / an [obviously deadly] rare disease"
• The doctors are not affordable
• They are too busy for you (< 15 minutes)
• You may need to wait months to get an appointment
• They are not good (country-side is an example, and sometimes even country-level)So, you have something deeply bothering you, your only appointment is in 4 months. It would be insane not to take the time to explore different solutions and not to come informed about the topic.
If you express your prompt properly and do not rely on imagery, you can absolutely have top-tier advices.
Agreed. This gets worse in cultures in which Doctors have no habit or haven't been trained that educating the patient is part of the job. Whenever I am back to my birth country, I specifically avoid doctors that are older than mid 30s, because they all have the same, terrible bed manner. They might be good at diagnosing and treating, but they never, ever explain anything, even when asked. Some even have "helpful pamphlets" to hand to the patient - anything to avoid explaining. It seems that in their view their job is not helping the patient, but completing a task - running a scan, performing a procedure, administering medicine etc. The human, that is subject of the task, is invisible.
It's so much worse than some Google results: people see LLMs as a trusted friend who never talks back and never questions you, who is excellent at convincingly communicating their bs, reeling you in with "tell me more so I can really lock this down", continuing to fool you
A con artist, a fraud