Probably better solution is to upskill nurses + AI to do handle all the simpler tasks like prescribing standard treatments, etc. There's already a concept of mid-level practitioner which can be expanded.
There's basically no need for GP to be a doctor.
This is so hilariously false and completely inverted that it shocks me that people not in medicine can believe it.
Out of respect for you as a fellow intelligent HN commenter — you are deeply misinformed, and I would urge you to reconsider your perspectives on this.
Every study shows that utilization of APPs and nurse practitioners Leads to decreased quality of care and a significant increase in utilization of other healthcare resources, like the emergency department and imaging, that better-trained physicians don't need.
Less-trained providers misdiagnose cancers, refer patients to the wrong specialists, overprescribe antibiotics, and generally cost the system significantly more in overall health load than if we had better-paid general practitioners.
There is an argument that not enough physicians go into general practice, which is true, but it's because subspecialties are in such high demand that they're generally better paid. The unfortunate fix is that we need to find a way to better compensate primary care, even though Medicare physician reimbursement rates continually decline and our health insurance system is not well structured to support this kind of primary care model.
I've left a few links below if you'd like to read them:
General burden of NPs higher than physicians even with lower appointment cost: <a href="https://static1.squarespace.com/static/615326dd2c363f1e2a5c8fc8/t/65fb41dcfee3eb7db180e3d1/1710965212680/Hattiesburg%2Bstudy_MiACCT_web_update.pdf" rel="nofollow">https://static1.squarespace.com/static/615326dd2c363f1e2a5c8...
Skin cancer misdiagnosis: <a href="https://www.ovid.com/journals/jaderm/abstract/10.1001/jamadermatol.2018.0212~accuracy-of-skin-cancer-diagnosis-by-physician-assistants?redirectionsource=fulltextview" rel="nofollow">https://www.ovid.com/journals/jaderm/abstract/10.1001/jamade...
There are several papers demonstrating AI is at least as good at diagnostics as fully qualified doctors. So why would NP + AI be worse? AI should compensate for the lack of knowledge.
And I'm not saying NP + ChatGPT - it should be properly calibrated system which would defer to a 'proper doctor' in more complex cases.
> AI is at least as good at diagnostics as fully qualified doctors
If the prompt is an expert-written board question! Not so with inferior prompts [0]. Critically, you need deep medical knowledge to interact correctly with the agent.
What you're asking is basically: "If we take someone out of a three month dev bootcamp, and have them prompt Claude, why can't they be as good as a four year CS grad?"
I doubt that you would feel similarly about expertise in your own field.
There have been a huge progress in AI reasoning in the past 2 years. GPT-4o mentioned in the article would struggle with high-school math problems, OTOH GPT-6 can solve problems beyond capability of professional mathematicians.
I'd wager GPT-6 would not depend on high-quality prompts, although it might still be good to get a trained person to enter information and do a sanity check.
Yes, point taken. I am well aware of the intelligence explosion and I am very AI pilled.
But the core problem still exists based on the clarity of the prompt and the prompter.
Seeing my wife's depth of intuition and expertise as a physician, compared to my comparatively caveman-like prompts when asking for health advice, there's a massive delta in accuracy.
Have you ever had a significant health issue and tried to get help from a model? Even something like GPT 6 Pro? The firehose and confusion you will generate trying to figure out answers are far less helpful than having directed interaction with a physician.
Following up on this because I've been thinking about why this is. I believe a big part of it is just that the intuitive parts of medicine are learned essentially by internship and therefore are not well encoded into the models. Unlike software, where you can have deterministic output that the models can train on, medical outputs are very fluid and dynamic. What works well in a paper, even though we claim to do evidence-based medicine, may be very far from what a "good" physician does in practice.
The issue is that the AI is at best what's in papers and medical records, which often forgoes the core thing that might lead a physician to uncover something or take a different approach with the patient.
estearum · · focus · HN ↗
There's no solution other than training a lot, lot, lot, lot more doctors.
Their salaries need to be lower, training needs to be cheaper and faster, and we need a lot more of them.
killerstorm · · focus · HN ↗
There's basically no need for GP to be a doctor.
sebmellen · · focus · HN ↗
Out of respect for you as a fellow intelligent HN commenter — you are deeply misinformed, and I would urge you to reconsider your perspectives on this.
Every study shows that utilization of APPs and nurse practitioners Leads to decreased quality of care and a significant increase in utilization of other healthcare resources, like the emergency department and imaging, that better-trained physicians don't need.
Less-trained providers misdiagnose cancers, refer patients to the wrong specialists, overprescribe antibiotics, and generally cost the system significantly more in overall health load than if we had better-paid general practitioners.
There is an argument that not enough physicians go into general practice, which is true, but it's because subspecialties are in such high demand that they're generally better paid. The unfortunate fix is that we need to find a way to better compensate primary care, even though Medicare physician reimbursement rates continually decline and our health insurance system is not well structured to support this kind of primary care model.
I've left a few links below if you'd like to read them:
General burden of NPs higher than physicians even with lower appointment cost: <a href="https://static1.squarespace.com/static/615326dd2c363f1e2a5c8fc8/t/65fb41dcfee3eb7db180e3d1/1710965212680/Hattiesburg%2Bstudy_MiACCT_web_update.pdf" rel="nofollow">https://static1.squarespace.com/static/615326dd2c363f1e2a5c8...
Skin cancer misdiagnosis: <a href="https://www.ovid.com/journals/jaderm/abstract/10.1001/jamadermatol.2018.0212~accuracy-of-skin-cancer-diagnosis-by-physician-assistants?redirectionsource=fulltextview" rel="nofollow">https://www.ovid.com/journals/jaderm/abstract/10.1001/jamade...
Antibiotics overprescribed: <a href="https://pmc.ncbi.nlm.nih.gov/articles/PMC5047413/" rel="nofollow">https://pmc.ncbi.nlm.nih.gov/articles/PMC5047413/
killerstorm · · focus · HN ↗
And I'm not saying NP + ChatGPT - it should be properly calibrated system which would defer to a 'proper doctor' in more complex cases.
sebmellen · · focus · HN ↗
If the prompt is an expert-written board question! Not so with inferior prompts [0]. Critically, you need deep medical knowledge to interact correctly with the agent.
What you're asking is basically: "If we take someone out of a three month dev bootcamp, and have them prompt Claude, why can't they be as good as a four year CS grad?"
I doubt that you would feel similarly about expertise in your own field.
[0]: <a href="https://www.nature.com/articles/s41746-026-02428-5.pdf" rel="nofollow">https://www.nature.com/articles/s41746-026-02428-5.pdf
killerstorm · · focus · HN ↗
I'd wager GPT-6 would not depend on high-quality prompts, although it might still be good to get a trained person to enter information and do a sanity check.
sebmellen · · focus · HN ↗
But the core problem still exists based on the clarity of the prompt and the prompter.
Seeing my wife's depth of intuition and expertise as a physician, compared to my comparatively caveman-like prompts when asking for health advice, there's a massive delta in accuracy.
Have you ever had a significant health issue and tried to get help from a model? Even something like GPT 6 Pro? The firehose and confusion you will generate trying to figure out answers are far less helpful than having directed interaction with a physician.
sebmellen · · focus · HN ↗
The issue is that the AI is at best what's in papers and medical records, which often forgoes the core thing that might lead a physician to uncover something or take a different approach with the patient.