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PaperclipPerfector  10d ago (text post)   32483 thread views

Culture War Roundup for the week of March 24, 2025

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Do keep in mind how terrible most medical research is, and that includes research into our replacements. This isn't from lack of effort but from the various systems, pressures, and ethics at play.

How do you simulate a real patient encounter when testing an LLM? Well maybe you write a vignette (okay that's artificial and not a good example. Maybe you sanitize the data inputs and have a physician translate into the LLM. Well shit, that's not good either.

Do you have the patient directly talk to the LLM and have someone else feed in lab results? Okay maybe getting closer but let's see evidence they are actually doing that.

All in the setting of people very motivated to show the the tool works well and therefore are biased in research publication (not to mention all the people who run similar experiments and find that it doesn't work but can't get published!).

You see this all the time in microdosing, weed, and psychedelic research. The quality is ass.

Also keep in mind that a good physician is a manager also - you are picking up the slack on everyone else's job, calling family, coordinating communication for a variety of people, and doing things like actually convincing the patient to follow recommendations.

I haven't seen any papers on an LLMs attempts to get someone to take their 'beetus medication vs a living breathing person.

Also Psych will be up there with the procedurealists in the last to be replaced.

Also also other white collar jobs will go first.

Do you have the patient directly talk to the LLM and have someone else feed in lab results? Okay maybe getting closer but let's see evidence they are actually doing that.

I expect this would work. You could have the AI be something like GPT-4o Advanced Voice for the audio communication. You could record video and feed it into the LLM. This is something you can do now with Gemini, I'm not sure about ChatGPT.

You could, alternatively, have a human (cheaper than the doctor) handle the fussy bits. Ask the questions the AI wants asked, while there's a continuous processing loop in the background.

No promises, but I could try recording a video of myself pretending to be a patient and see how it fares.

All in the setting of people very motivated to show the the tool works well and therefore are biased in research publication (not to mention all the people who run similar experiments and find that it doesn't work but can't get published!).

I mean, quite a few of the authors are doctors, and I presume they'd also have a stake in us being gainfully employed.

Also keep in mind that a good physician is a manager also - you are picking up the slack on everyone else's job, calling family, coordinating communication for a variety of people, and doing things like actually convincing the patient to follow recommendations.

I'd take orders from an LLM, if I was being paid to. This doesn't represent the bulk of a doctor's work, so if you keep a fraction of them around.. People are already being conditioned to take what LLMs take seriously. They can be convinced to take them more seriously, especially if vouched for.

I haven't seen any papers on an LLMs attempts to get someone to take their 'beetus medication vs a living breathing person.

That specific topic? Me neither. But there are plenty of studies of the ability of LLMs to persuade humans, and the very short answer is that they're not bad.

I mean, quite a few of the authors are doctors, and I presume they'd also have a stake in us being gainfully employed.

Nah most of us Get Too Excited About Making A Difference.

Sidebar- I was watching "In Good Company" at lunch today (podcast in which the manager of Norway's sovereign wealth fund interview the most successful people in the world) and the CEO of Goldman asked Nicolai about the best features in leaders - empathy was one of them! And this was noted in the context of LLMs taking over other parts of the job for many things!

Empathy and leadership are core to being a physician (at least in the U.S.) and if two of the world's most successful people are going to emphasize the importance of that I'm going to imagine we will be well positioned lol.

Nah most of us Get Too Excited About Making A Difference.

That's why I'm quite candid about my opinions here, it doesn't make a difference what I tell people on a niche underwater basket weaving forum.

Empathy and leadership are core to being a physician (at least in the U.S.) and if two of the world's most successful people are going to emphasize the importance of that I'm going to imagine we will be well positioned lol.

I looked up studies about LLMs and empathy, including in medical settings and vs human doctors, and there plenty. Can't vouch for them.

But I had a quasi-transformative experience that involved one today (in a significant role), and I might write that up and tag you.

Please do!

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