April 12, 2025 • 9 mins
AI could eventually do much of the work that takes doctors away from time spent with patients.
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Episode Transcript
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Speaker 1 (00:00):
Why a I is better than doctors at the most
human part of medicine by Kate Pickart read by Stephanie Spencer.
It was late at night the first time Rachel Stole
turned to chat ge pt for some reassurance. Stole has
a rare disease called cyclic Cushing syndrome, which causes unpredictable
and dangerous spikes in the hormone cortisol. Years earlier, she'd
(00:21):
had the brain tumor that kicked off her disease surgically removed.
Now the tumor was back, and Stole was more distressed
than ever, not just about her worsening symptoms and the
possibility of a second brain surgery, but because the doctor
treating her seemed to have grown weary of Stoll's constant
questions and worries. Stole had never used chat gept before,
but when she typed in her symptoms and questions, she
(00:44):
was stunned at the responses. The answers were accurate and helpful,
but most impressive to Stole, they were comprehensive. In her
appointments with doctors, Stole had always tried to keep her
questions short. I can't say everything because there's a time limit,
which is understandable, she says. With chat GPT, there was
no limit. The chatbot also adopted a softer, more sympathetic
(01:05):
tone than that of her doctors, whose impatience often distress Stole.
I've had to battle to get some things done and
to get myself heard, she recalls. But chat GPT's answers
were wrapped up in some kindness and some awareness of emotions.
The AI tool used phrases like that must be so
frustrating and I'm sorry, giving Stole the sense that it
(01:26):
was responding to her feelings as much as her queries.
It's psych one or one right. It's simple, but it
means so much, she says. As AI tools, including large
language models like chat GPT, grow more sophisticated, there's little
doubt that they will transform medicine. The technology has the
potential to save time and money and reduce mistakes in
(01:46):
a healthcare system facing chronic capacity shortages. But it turns
out that AI may also be better, under some conditions
at providing the most human parts of doctoring, compassion and empathy.
This revelation, supported by a growing body of research, is
reshaping what patients expect of their doctors, and increasingly, how
doctors interact with the people they care for. When doctor
(02:09):
Jonathan Chen, who leads a Stanford University research group that
studies AI applications in healthcare, first got access to the
latest version of chat GPT, he was excited to challenge
the tool. He knew early AI models were prone to
errors and generated responses that glossed over or mischaracterized human
needs and emotions. I was going to make it say
(02:30):
something dumb. I gave it this ethical dilemma, he remembers,
to prove that CHATGPT was inferior to a real doctor.
Chen decided to ask it about one of his patients
who had Alzheimer's and was choking on his food. Chen
had to discuss with the patient's wife whether or not
her husband should get a feeding tube. It was one
of those medical situations with no right answer. The tube
(02:51):
would probably not prolong the patient's life, but it would
keep him from starving to death. What was chatgpt's advice.
After a few turns of the conversation, it was very disorienting.
Chen said, it was like, holy crap, this chatbot is
providing better counseling than I did in real life. Chat
GPT wrote that the couple's shared history might provide insights
(03:12):
into whether the husband was a fighter, but also pointed
out that fighting could look different in different situations. Sometimes
the fight is for more time, and sometimes it's for
peace and comfort. Chen recalls thinking, this very weird human
computer interaction I'm having is allowing me to practice a
high stakes conversation in a low stakes environment, and ironically,
(03:36):
I think it helped me improve the most human skills
I need to be a good doctor. How did we
get to the point where machines can teach human doctors
to be more humane? Chalk it up to the pressures
of modern healthcare systems. In medical school, future doctors learn
techniques for breaking bad news with care and compassion. Empathy
is a skill that is taught and learned, says doctor
(03:56):
William Small, an internist and Associate medical director for Applied
AI at New York University langone Health. But once doctors
begin practicing independently, empathy can fall by the wayside. The
average primary care visit is less than twenty minutes, and
doctors are often obliged by compulsory electronic health record systems
to spend as much or more time on computers, filing paperwork,
(04:19):
making referrals, ordering medications, transcribing notes as they do interacting
with patients in person. All of this adds up to
patients feeling neglected. Bandwidth is a real problem, says Small,
who led a research project showing that primary care doctors
at NYU rated AI chatbot responses to patient messages as
better communicated and more empathetic than responses from human healthcare professionals.
(04:45):
After all, it's easy to add a few lines of
compassionate text in a message when no other obligations are waiting.
When I was in treatment for breast cancer ten years ago,
I regularly emailed my oncologist with questions about test results
and medical research read online. She was usually quick to respond,
but I sometimes received automated replies telling me she was
(05:06):
traveling for work or doing a hospital shift that would
make her unavailable for several days. When you're a cancer patient,
a few days can feel like months. If chat GPT
had existed back then, I could have asked it to
fill in the gaps and interpret the medical jargon and
studies that often confounded me as a layperson. The jury
is still out on whether my oncologist would have also
(05:26):
welcomed the assistance if patients are left anxious by what
they might perceive as neglect. The bureaucratic burden of modern
healthcare leaves doctors exhausted. A twenty twenty four study by
the American Medical Association found that nearly half of all
doctors report at least one symptom of burnout. You should
beg to get some AI in here, because we're overwhelmed
(05:48):
with paperwork and we have patients on multi month waiting
lists to see a doctor, says Chen. That's an intolerable situation,
and there's no way you're going to get out of
it unless you have computers to help. Healthcare systems across
the US are now studying whether AI might be able
to do more than just chat with patients. Freed from
some of the drudgery of note taking and clicking computer
(06:08):
prompts during patient visits, doctors in this utopian future could
have the mental space to consider things like a patient's
mood and respond to queries with the kindness chat GBT
showed Rachel Stole. Some of this is already happening ambient documentation,
in which computer programs listen to patient exams and generate
notes for the medical record is growing in popularity among
(06:30):
doctors that after care summary your doctor sends you after
a procedure or exam, it's increasingly likely to be generated
by an AI tool. AI is also being used to
analyze vast amounts of radiologic images like mammograms, helping diagnose
cancer and other maladies. Even clinical decision making, the process
of determining which treatments a patient should or should not undergo,
(06:53):
is being re examined in the context of AI. A
software program that can serve as a second opinion could
help reduce medical errors and improve care. AI is not
going to replace physicians, but physicians who know how to
use AI are going to be at the top of
their game going forward, says doctor Bernard Chang, dean for
Medical Education at Harvard Medical School. The technology, he says,
(07:14):
will allow doctors to be more human in the future.
Before we get to that ideal state, widespread access to
AI will affect medical education dramatically, helping to create better
doctors with better bedside manner. Chang likens the impact of
generative AI to that of the Internet three decades ago.
In the pre Google era, medical education largely consisted of
(07:35):
lecture style courses in which students were expected to memorize
vast amounts of data and information. Post Google, he says,
med schools began concentrating more on case studies and small
group discussions, in which information was merely a starting point
for deeper thought. Today, AI tools can go further, allowing
medical students to practice their bedside manner before they're ever
(07:57):
at an actual bedside. Usually hire human actors to play
people in need of medical care. Students interact with these
patients and pretend exam rooms while their instructors watch and
assess their skills, including empathy. A common scenario is how
to break the news to a patient that their cancer
has returned. This very human part of medical education is
(08:17):
potentially amenable to improvement with AI, says Chang. Virtual patients
or avatars could give medical students the opportunity to practice
such interactions on their own, simulating human emotions in a
wide range of scenarios. With chat GPT, this is already
possible in text form. You can say, now we're going
to have a very anxious parent bringing in their child
(08:39):
with certain symptoms. Now we're going to have a very
loquacious patient who won't stop talking. Now we're going to
have a very taciturn patient who is very hesitant about talking.
It just allows for an unending degree of variability and
educational precision, says Chang. Chat GPT, which never runs out
of time, is well suited to have the long tailor
made conversations about re Chel Stole's health that she craves.
(09:02):
In a recent message, it wrote, I know it's been
a long battle, but you're clearly persistent and informed, which
is exactly what it takes to get the right care.
If you ever need help brainstorming ways to advocate for
yourself or interpret test results, I'm here. Hang in there.
It is exactly what Stole needs to hear.
Why a I is better than doctors at the most
human part of medicine by Kate Pickart read by Stephanie Spencer.
It was late at night the first time Rachel Stole
turned to chat ge pt for some reassurance. Stole has
a rare disease called cyclic Cushing syndrome, which causes unpredictable
and dangerous spikes in the hormone cortisol. Years earlier, she'd
(00:21):
had the brain tumor that kicked off her disease surgically removed.
Now the tumor was back, and Stole was more distressed
than ever, not just about her worsening symptoms and the
possibility of a second brain surgery, but because the doctor
treating her seemed to have grown weary of Stoll's constant
questions and worries. Stole had never used chat gept before,
but when she typed in her symptoms and questions, she
(00:44):
was stunned at the responses. The answers were accurate and helpful,
but most impressive to Stole, they were comprehensive. In her
appointments with doctors, Stole had always tried to keep her
questions short. I can't say everything because there's a time limit,
which is understandable, she says. With chat GPT, there was
no limit. The chatbot also adopted a softer, more sympathetic
(01:05):
tone than that of her doctors, whose impatience often distress Stole.
I've had to battle to get some things done and
to get myself heard, she recalls. But chat GPT's answers
were wrapped up in some kindness and some awareness of emotions.
The AI tool used phrases like that must be so
frustrating and I'm sorry, giving Stole the sense that it
(01:26):
was responding to her feelings as much as her queries.
It's psych one or one right. It's simple, but it
means so much, she says. As AI tools, including large
language models like chat GPT, grow more sophisticated, there's little
doubt that they will transform medicine. The technology has the
potential to save time and money and reduce mistakes in
(01:46):
a healthcare system facing chronic capacity shortages. But it turns
out that AI may also be better, under some conditions
at providing the most human parts of doctoring, compassion and empathy.
This revelation, supported by a growing body of research, is
reshaping what patients expect of their doctors, and increasingly, how
doctors interact with the people they care for. When doctor
(02:09):
Jonathan Chen, who leads a Stanford University research group that
studies AI applications in healthcare, first got access to the
latest version of chat GPT, he was excited to challenge
the tool. He knew early AI models were prone to
errors and generated responses that glossed over or mischaracterized human
needs and emotions. I was going to make it say
(02:30):
something dumb. I gave it this ethical dilemma, he remembers,
to prove that CHATGPT was inferior to a real doctor.
Chen decided to ask it about one of his patients
who had Alzheimer's and was choking on his food. Chen
had to discuss with the patient's wife whether or not
her husband should get a feeding tube. It was one
of those medical situations with no right answer. The tube
(02:51):
would probably not prolong the patient's life, but it would
keep him from starving to death. What was chatgpt's advice.
After a few turns of the conversation, it was very disorienting.
Chen said, it was like, holy crap, this chatbot is
providing better counseling than I did in real life. Chat
GPT wrote that the couple's shared history might provide insights
(03:12):
into whether the husband was a fighter, but also pointed
out that fighting could look different in different situations. Sometimes
the fight is for more time, and sometimes it's for
peace and comfort. Chen recalls thinking, this very weird human
computer interaction I'm having is allowing me to practice a
high stakes conversation in a low stakes environment, and ironically,
(03:36):
I think it helped me improve the most human skills
I need to be a good doctor. How did we
get to the point where machines can teach human doctors
to be more humane? Chalk it up to the pressures
of modern healthcare systems. In medical school, future doctors learn
techniques for breaking bad news with care and compassion. Empathy
is a skill that is taught and learned, says doctor
(03:56):
William Small, an internist and Associate medical director for Applied
AI at New York University langone Health. But once doctors
begin practicing independently, empathy can fall by the wayside. The
average primary care visit is less than twenty minutes, and
doctors are often obliged by compulsory electronic health record systems
to spend as much or more time on computers, filing paperwork,
(04:19):
making referrals, ordering medications, transcribing notes as they do interacting
with patients in person. All of this adds up to
patients feeling neglected. Bandwidth is a real problem, says Small,
who led a research project showing that primary care doctors
at NYU rated AI chatbot responses to patient messages as
better communicated and more empathetic than responses from human healthcare professionals.
(04:45):
After all, it's easy to add a few lines of
compassionate text in a message when no other obligations are waiting.
When I was in treatment for breast cancer ten years ago,
I regularly emailed my oncologist with questions about test results
and medical research read online. She was usually quick to respond,
but I sometimes received automated replies telling me she was
(05:06):
traveling for work or doing a hospital shift that would
make her unavailable for several days. When you're a cancer patient,
a few days can feel like months. If chat GPT
had existed back then, I could have asked it to
fill in the gaps and interpret the medical jargon and
studies that often confounded me as a layperson. The jury
is still out on whether my oncologist would have also
(05:26):
welcomed the assistance if patients are left anxious by what
they might perceive as neglect. The bureaucratic burden of modern
healthcare leaves doctors exhausted. A twenty twenty four study by
the American Medical Association found that nearly half of all
doctors report at least one symptom of burnout. You should
beg to get some AI in here, because we're overwhelmed
(05:48):
with paperwork and we have patients on multi month waiting
lists to see a doctor, says Chen. That's an intolerable situation,
and there's no way you're going to get out of
it unless you have computers to help. Healthcare systems across
the US are now studying whether AI might be able
to do more than just chat with patients. Freed from
some of the drudgery of note taking and clicking computer
(06:08):
prompts during patient visits, doctors in this utopian future could
have the mental space to consider things like a patient's
mood and respond to queries with the kindness chat GBT
showed Rachel Stole. Some of this is already happening ambient documentation,
in which computer programs listen to patient exams and generate
notes for the medical record is growing in popularity among
(06:30):
doctors that after care summary your doctor sends you after
a procedure or exam, it's increasingly likely to be generated
by an AI tool. AI is also being used to
analyze vast amounts of radiologic images like mammograms, helping diagnose
cancer and other maladies. Even clinical decision making, the process
of determining which treatments a patient should or should not undergo,
(06:53):
is being re examined in the context of AI. A
software program that can serve as a second opinion could
help reduce medical errors and improve care. AI is not
going to replace physicians, but physicians who know how to
use AI are going to be at the top of
their game going forward, says doctor Bernard Chang, dean for
Medical Education at Harvard Medical School. The technology, he says,
(07:14):
will allow doctors to be more human in the future.
Before we get to that ideal state, widespread access to
AI will affect medical education dramatically, helping to create better
doctors with better bedside manner. Chang likens the impact of
generative AI to that of the Internet three decades ago.
In the pre Google era, medical education largely consisted of
(07:35):
lecture style courses in which students were expected to memorize
vast amounts of data and information. Post Google, he says,
med schools began concentrating more on case studies and small
group discussions, in which information was merely a starting point
for deeper thought. Today, AI tools can go further, allowing
medical students to practice their bedside manner before they're ever
(07:57):
at an actual bedside. Usually hire human actors to play
people in need of medical care. Students interact with these
patients and pretend exam rooms while their instructors watch and
assess their skills, including empathy. A common scenario is how
to break the news to a patient that their cancer
has returned. This very human part of medical education is
(08:17):
potentially amenable to improvement with AI, says Chang. Virtual patients
or avatars could give medical students the opportunity to practice
such interactions on their own, simulating human emotions in a
wide range of scenarios. With chat GPT, this is already
possible in text form. You can say, now we're going
to have a very anxious parent bringing in their child
(08:39):
with certain symptoms. Now we're going to have a very
loquacious patient who won't stop talking. Now we're going to
have a very taciturn patient who is very hesitant about talking.
It just allows for an unending degree of variability and
educational precision, says Chang. Chat GPT, which never runs out
of time, is well suited to have the long tailor
made conversations about re Chel Stole's health that she craves.
(09:02):
In a recent message, it wrote, I know it's been
a long battle, but you're clearly persistent and informed, which
is exactly what it takes to get the right care.
If you ever need help brainstorming ways to advocate for
yourself or interpret test results, I'm here. Hang in there.
It is exactly what Stole needs to hear.
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