[avree]

No, no, no. You can change your doctor, and get one that listens to you - you can't change the fact that ChatGPT has no skin in the game - no reputation, no hippocratic oath, no fiscal/legal responsibility. Some people have had miracles with Facebook groups, or WebMD, but that doesn't change where the role of a doctor is or mean that you should be using those things for medical advice as opposed to something that allows you to have an informed conversation with a doctor.

[noosphr]

Neither do most doctors. No gp will get disbarred for giving the wrong diagnosis on a first consult.

They have 15 minutes and you have very finite money.

Medical agents should be a pre consult tool that the patient talks to in the lobby while waiting for the doctor so the doctor doesn't waste an hour to hear the most important data point and the patient doesn't sit for an hour in the lobby doing nothing.

[raincole]

Doctors have no skin in the game too. Our society is built on the illusion of 'skin in the game' of professionals like doctors and lawyers (and to a lesser extent, engineers), but it's still an illusion.

[clickety_clack]

Engineers to a _lesser_ extent? Maybe software engineers, but for every other engineer, theres very tangible results and they absolutely get sued when things go wrong, and the governing bodies strip engineers of their licenses for malpractice all the time.

Source: I used to be a geotechnical engineer and left it because of the ridiculous personal risk you take on for the salary you get.

[derefr]

In countries with public healthcare + doctor shortages (e.g. Canada), good luck even getting a family doctor, let alone having a request to switch you family doctor "when you already have one!" get taken seriously.

Everyone I know just goes to walk-in clinics / urgent-care centres. And neither of those options give doctors any "skin in the game." Or any opportunities for follow-up. Or any ongoing context for evaluating treatment outcomes of chronic conditions, with metrics measured across yearly checkups. Or the "treatment workflow state" required to ever prescribe anything that's not a first-line treatment for a disease. Or, for that matter, the willingness to believe you when you say that your throat infection is not in fact viral, because you've had symptoms continuously for four months already, and this was just the first time you had enough time and energy to wake up at 6AM so you could wait out in front of the clinic at 7:30AM before the "first-come-first-served" clinic fills up its entire patient queue for the day.

[Spooky23]

The US has the same issue.

Because the republican party turned out to be a bunch of fascist fucks, there's no real critique of Obamacare. One of the big changes with the ACA is that it allowed medical networks to turn into regional cartels. Most regions have 2-3 medical networks, who are gobbled up all of the medical practices and closed many.

Most of the private general practices have been bought up, consolidated to giant practices, and doctors paid to quit and replaced by other providers at half the cost. Specialty practices are being swept up by PE.

[throwaway173738]

Indeed you might have to for a variety of reasons that have nothing to do with your quality of care. I’ve had to do so a few times now.

[thewebguyd]

> no reputation, no hippocratic oath, no fiscal/legal responsibility.

To say nothing of giving your personal health information over to a private company with no requirement to practice HIPAA, and just recently got subpoenaed for all chat records. Not to mention potential future government requests, NSA letters, during an administration that has a health secretary openly talking about rounding up mentally ill people and putting them in work camps.

Maybe LLMs have use here, but we absolutely should not be encouraging folks to plug information into public chatbots that they do not control and do not run locally.

It is a recipe for disaster.

[bergutman]

> No, no, no. You can change your doctor

As an American on ACA this made me chuckle.