Partners in Diagnosis: ChatGPT, a Mother’s Intuition, and a Doctor’s Expertise with Courtney Hofmann and Dr. Holly Gilmer
40:06 Share

Both of our children are medical complex. I have two children. My son is eight, my daughter is six. My husband are both educated professionals. I think that's super important.

We also had gold level health care insurance at the time when all of this was going on, and we had the means to pay out of pocket for care. So we had what looks like everything to be perfect, to get the best health care in the best insurance. And we could not get an answer for three years.

Our son is adopted, and so because of that, he had a new warn exam at the time of birth and then he had another new warn exam in our home state. And both of those new warn exams missed what's called the sacramento ple. And that should have been a significant point of observation that they're something wrong. When he went for his kindergarten motor skills test, he failed the growth motor skills test. He had laughed right imbaLances and they dismissed IT as is just your every child develops at their own time.

Welcome to another episode of any jm AI grand rounds were delighted to bring you our conversation with cordy hofman and doctor holy gilmer. Corney is the amazing mother of a Young boy who was suffering with chronic pain. He saw seventeen doctors over three years without finding a diagnosis.

In desperation, he put his records into ChatGPT and a return to diagnosis of tethered cord syndrome. And then, crucially, there was a human in the loop. SHE took that diagnosis to a new physician, dr. Or holy gilmer, a pediatric neo search. And, and we were so lucky today to be able to speak with both of them on today's episode rush.

This has to be near the top of the list for one of my favorite episodes i've ever done, just like any time I hear a story about a parents is refusing to take no for an answer, doing whatever they can to get the diagnosis they need for their child, I just find that so inspirational.

I think it's interesting that A I was actually the key enabling factor for court tea and that had he had this issue ten years ago, i'm not sure that the story would have finished in the same way. So IT really is just like a truly inspirational story at the intersection of A I and medical diagnosis. And again, like I think what of my favorite that we've done so far?

Yeah, I totally agree. And I think corney also reflected on lessons about the health care system and her journey, her son's journey, why the diagnosis might have been missed and how the AI models able to take a holistic view of all the symptom signs and findings of her son and then provide diagnosis which was then acted upon. So really amazing to hear that side, and just how thought of you was about everything.

And yet, to be clear, all the information to make the diagnosis was there. What SHE needed was a new way to synthesize ze that information, to see what the physicians that he had been seeing missed, and her comments on what LED to that, how he tried to get different doctors to take her more seriously, and speaks volumes about structural issues in the health care system that shouldn't exist, but unfortunately do. The N G M A I grand round podcast is brought to by microsoft V I lyric and elements health. We thank them for their support.

And now we bring you a conversation with courtney hofman and doctor holy gilmer .

cordian holy. Welcome to A I. Grand rounds. Thank you both for being here.

Thank you for having yeah.

thank you very much.

So certainly, I think I first learned about your story through a news article. This article was published just over a year ago, september twenty twenty three. And I have the title of article here. IT is a boy saw seventeen doctors over three years for chronic pain. ChatGPT found the diagnosis.

So of course, I was immediately struck by the title because I think at the time, there was a lot of speculation about large language models in patient hands, but not really many prominent stories about cases where IT was being used, where we got to hear directly from the patients about how the models were being used in their own care or the care of their loved ones. And then I read the article, of course, and I ve got to learn about your sun story, how you use A I for help, and about doctor gilmer. And so we're so happy to have you both here and maybe corner. We could start with you maybe you can tell us about your family and about your son and you can begin, uh, by telling us about that. And then when you maybe started to notice that something was wrong.

Thanks so much again for having us. We really appreciate telling his story and just continue the patient advocate that you needs to happen for all of us, for our kids. So just a bit about our family, where a mid western family and for both of our children are medically complex.

I have two children, son and a daughter. My son is eight. My daughter is six. yeah. My daughter has three rare diseases, and my son has two.

He has a tether cord, and then he has borderline kari, which is also to do with this fine at the top of the base of the kull. My husband, I are able, educated professionals. I think that's super important.

We also had gold level health care insurance at the time when all of this was going, and we had the means to pay out of pocket for care. So we had what looks like everything to be perfect, to get the best health care in the best insurance, and we could not get an answer for three years. So when you look at what went wrong in our process, um our son is adapted.

And so because of that, he had a new morning exam at the time of birth, and then he had another new warn exam in our home state. And both to those new warn exams, miss what's called the sacco and simple. And that should have been a significant point of observation that they're something wrong and that got missed.

And we switched pediatricians during the process, and I got missed again. So that was one of our key messes on the diagnostic journey. A second one was, everybody assumed that was behavioral.

He was a five and six year old little boy. IT was in the pandemic. And I got told by so many different doctors, this is what little boys do, or it's because of the pandemic.

All children are changing. And we knew our son. This was not attention seeking behavior by him. Another thing that got missed was he had imbaLances. When he went for his kindergarten motor skills test, he failed the growth motor school task.

He had left and right imbaLances, and they dismissed IT as it's just every child develops at their own time. And I brought up even further. Well, you know, I noticed that he has an equal global muscles.

Oh, that's so minimal if I can affect anything. When we had what I feel was the biggest diagnostic miss was when we had the M. R.

I S. They were read by one percent. And you mention rage that we saw seventeen different doctors.

Nobody actually opened to the MRI and looked at IT until dr. gr. Everybody relied on the one person that read the radiology.

And SHE missed IT and was not her fault. SHE just missed IT on that one scan. And we saw orthoptera surgeons.

We saw room mental logic. We saw other neurosurgeons and neuro doctors that everybody didn't open the MRI. So if you're listening and you have a problem, make sure those doctors are opening those mas.

And then the fact checking, nobody was reading the reports that we were sending and nobody followed up with the P. T. And nobody was double checking anything that we were saying.

We were in our memory when we went into disappointments. So if you look at like, why did I finally go to ChatGPT? If you could hear the frustration of my voice.

I, I, I ve been retelling the story. IT was my son's seventh birthday, was about to be that birthday, and I went on, my mom really all wants to see pictures of her grandkids on their birthdays. And I was searching out like the best photos to show her.

And I could not find a photo where the smile at my son's eyes, like every single photo, there was something wrong. And I couldn't take IT anymore. I an educated person.

I have two degrees in university of michigan. I felt like I should also solve this problem. I've been an entrepreneur fifteen years.

I can do things, I can execute strategy, but I could not execute, figuring out what's wrong with my son. And ultimately, I SAT down, and I took his entire health file. I went through all eight of the electronic health record systems. He had put them into one file.

I went through all of my nose and put together one symptom list, and I put all of that in a ChatGPT, and I said, what is wrong with him? And I came out with three different results, and I went through, and I kept asking back and forth, I tell me more about this, tell me what this means and ultimately ended up going through into um social media and reading parent stories and figuring out that IT probably is to the cord. And there's two doctors, one doctor gr, who can do this with almost exactly certainty every time we found her and we're lucky enough to get them with her two weeks later. And he had surgery six weeks. And when I use ChatGPT and he is a new kid now.

wow, I was just going to hop in and follow up on some stuff. So when I think that your example is what, as parents, we all hope that we would do if we were in your situations, I just want to say, you know, i'm astounded by the courage and the dataset that you had to get to the bottom of this. And I think we all hope that we would react similarly in a situation like that.

I think the second thing that I i'd like to like dig in on is one of the recurring themes of this podcast is systemic issues with the health care system and ways in which we think A I might address some of those issues. So do you have some sense of what cause your son to go through this diagnostic dacy, where clearly the pieces of information were there, but they were missed or ignored? Is IT a overwork health care force? Is that some Peter naled tic hangover from previous generations of doctors? What is your sense of the things that LED to this casket failures that left you are undiagnosed for three years?

So I think it's multiple variables. S that you mentioned, there was definitely a moment where we talk about the pretty nalini viewpoint. I acted for some of our appointments, you know, appointments and some appointments that I would go in as the working mom.

And they will tell me I didn't know I can times I would just like a stay at home mom. And then they didn't seem to take me seriously. So then I brought my father with me because I thought, maybe two generations are here.

They'll take us seriously. And so IT will we play whatever game we could to try to get them, to have a Better conversation with us? And then the last piece was an M I.

We had several m eyes, and they were all right by one percent. And then those emrys are sent to doctors. And this is so important, I just assumed that doctors that we're treating my son, we're opening the eyes and looking at the cama ize.

And in reality, they're reading the MRI report and the person that read the MRI ze was missing the tethered court every single time. So I thinking that of having six mr. Eyes and IT was missed each one of those times.

And then the fact checking, no doctor was ever looking at what was happening anywhere else. They were all relying on our memories. And when you have two kids with health issues, you can remember which kid is witch.

Doctors are overwork. They have no time to actually review everything. Nobody could look at our files before we got into the room with them.

They have twenty two minutes and we're spending eighteen getting to the same page. So we're having a four minute appointment where you can't make movement on a treatment plan or diagnosis. And then the last thing is there's so pigeonholed into their space because of the lack of time that they can't see B, M. What they specialize.

I want to point out one flood symmetry here. So when we get alms to answer questions often, we have to do this protracted series of things that are often called prompt engineering. And if you ask the L, M, to pretend that you're the smartest person in the world, IT will actually give you more accurate information. And that just strikes me that you were prompt engineering the doctors that the way that you presented yourself to them make them take you more seriously and therefore be more likely to give you high quality information. And as far so this is one of the first instances of like prompt engineering for doctors, but that seems like a kind of like goes both ways.

So that's really funny. I've not heard that before. I like that. I'm going to keep that court.

I think something that you just said that really stuck out to me is that you feel like each of the individual conditions will sort of focused on their own domain.

And I think when you are typing your son's records into ChatGPT, putting everything you knew and handle the notes and other things like that, you were really trying to get out of that mold, right, of looking at your son only through one lands or with one potential set of problems in mind, but instead trying to prompt this kind of general reasoning model into helping you come up with a potential diagnosis that considers everything together, that considers your son holistically, sort of considers the full boy and everything that's going on. And it's also startling to me. I think you didn't actually use the images themselves, right? I don't know if ChatGPT was multi model at this point.

I don't think IT was. And so you just use the text that came out of the notes, right, and your own notes as I understand that. And using all of this sort of general information, the model was able to come up with the chord.

You're right. I could not use the imaging. I use the words on the MRI, and I went line by line, and anything that they said, anything they called out in the report, but yet wasn't underneath the things to look at area I copied and put that in visually and said, what else could this be? IT called that something at the s.

To join. And I said, what else could this be at the s. To join? Or what diseases are wrong at the s.

To join? And so, like, I got that whole list and started looking through everything. IT was a kite full of medical rabid holes.

Can I ask what your experience or even awareness of A I was before this moment? I know that you like obvious ly, you're executive and hard charging. But like, have you heard of ai? How did you even come to know of ChatGPT and that this might be an option to you?

So I have a background in the H. R. industry. So was something that we are watching carefully as IT comes to, like interview bias and hire ing bias, and how A I was going to be used.

So I was pretty up to speed on A I in general, was I A medical person before my kids? Absolutely not. I passed out in every single biology class every single year. Year sounds fourth grade. So no, the irony is complete.

It's interesting that, that your entry points to AI because obviously, like with hr, you're worried about propagating biases against unrepresented groups. And if I was in your head space, IT would not be a natural reflects for me to go to something that my main exposure to has been negative. And like that IT could be harmful. So how did you what flip for you to make you think that this might be a tool for medical discovery?

I was desperate, honestly desperate. But I will say, I put the age of my son in at several different ages, and I never called him a White mail.

Very .

interesting.

So I think a very critical element of this story is that you put everything into ChatGPT, into the AI model IT suggested to the courts n drome. And then we had this sort of nerdy phrase and machine learning, which is there was then a human in the loop. And that human in the loop is doctor gilmer, who are also so pleased to have here with us on the podcast.

And so you took this diagnosis, you took this suggested diagnosis first, as I understand IT, to an online support group where you found doctor gilmer. And then you took your son and the imaging and all the data, of course, the story to doctor. And so maybe dr, or gma, we can turn to you. And could you tell us about what your reaction was and also how you navigated this information in the case?

Well, so when I met courtine and alex, he had these symptoms, scattered symptoms, some often on backpack IT wasn't entirely clear. But then as I got to know them between the first visit, the second visit, his book pain became more frequent and more constant. Um IT was interfering with him attending school.

IT wasn't helped with physical there. B and there was the known sick real dimple. So then we got imaging uh, lumber spine and marine lumber spine city and was .

IT from the original imaging itself that you were able to confirm the diagnosis of teddy cord. And then that prompted sort of a new .

imaging study. He had never had a lumber spine in eye. He had often on her backpack, and he had the abNormal motor function that was found in kindergarten. And courtney had asked for imaging of his entire neural axis over three years. IT was never done.

And could you tell us about tethered court syndrome, how IT presents typically, how I can present a typically, and maybe give us a sense, and especially for the sort of non medical listeners, how difficult this is to pick up and why IT might be missed .

and practice? Well let me first say most of the time um when pediatrician see a saco temple in a newborn they are aware of IT we'll get at least an to sound which is a screening study. If the ultrasound is not ready of showing at other cord, then the child may be kind of lost to diagnostic.

Follow up in the alter sound is a screening study. So if it's positive for other court, the person has likely a to the court. But if it's negative, that doesn't mean they don't.

So you know, IT presents in a variety of ways. Very commonly, children will have a sc temple and abNormal gluteal clift, late terms black rack. Okay, that should be straight. And sometimes is what we call biff IT, which means IT straight.

And then IT has two, like A V at the top, two limbs at the top like A V but if one limb is longer than the other, if the crack is curved, if the butts are, is metric that can indicate a curator bone underneath IT can indicate a pala um underneath that may be connected to the final court. Anything in the midline uh of the spine is suspicious for a other cord, uh, a tough of hair temple hya a mongolian spot. A lot of babies have a mongolian spot but if it's in the middle of the spine then that may be a sign of the other cord, uh, defect that you can feel on exam.

And so those are in babies. In older children. We may see any of those signs, what we call neuropathy, ea signs or signs on the skin. The abNormal global cleft leg length discrepancy.

I have frequently seen one leg longer than the other older patients may describe, always having to get shoes in different sizes, very high arches or one high arch in the foot, and a Normal on the other side. Anything that says metric suggest a problem with this final cord. Then, as far as symptoms at when children are a little older, they frequently will have delayed milestones.

They may walk late, greater than sixteen months old. They very frequently have abNormal bile and blood function, in fact, urinary urgency, frequency, frequent batter infections, particularly in a mail, constipation, those all maybe signs of the other court in a lot of the time, we see more than one of these findings and symptoms and signs. Some kids have no signs until they are getting towards teenage years.

They might start developing scholia sis, because some children are symptomatic with other court as babies. Others have to grow in the spinal cord because it's tethered, it's stuck down at the bottom of the spine. So instead of growing up with the final column, IT stretches, and that causes symptoms and neurological deficit. So in some children, we start to see frequent blood infections, urinary urgency and catches as older children, and maybe scoliosis. Sometimes it's backpack nominees tingling in the feet, cane in the back, radiating down the legs.

If I could happen in, ask the component to the sociology question that asked courtine. So my wife is a pediatrician in the anthologies.

And one of the things that we often encounters in her practice is activated parents who are trying to make sure their child gets the best care possible, but are waiting through the literature themselves in a very and a random walk kind of fashion, where the'd see something and IT targets in the whole sense of the body of evidence. How do you think about the role of ChatGPT in patient activated decision making? In this case? I think it's clearly maculate.

But what is the holistic picture from your perspective, especially someone who treats rare diseases frequently? Are we is this something we should be encouraging? Or is there an optimal way that we should be thinking about getting patients access to these tools? Or i'm .

curious how you think about that. So ChatGPT is not going to help you guide your diagnosis and terminally eliminating things. I think the value is mentioning everything, every possibility.

And just as current he was saying, he went down every level. What could this be? It's going to give you a lot of options of what IT could be.

And then hopefully, you'll go to a specialist are your primary with these possibilities and they'll be further testing to either rule IT in or rule IT out an explanation as to why it's not that if it's ruled out, which a GPT gaper that no one else gave her was the possibility. And that's where you bring in the bias, like you said, activated parents from a professional bias standpoint at the time. People don't want to mention a possible diagnosis.

Well, I don't wanted to worry about that. You know, dealing with this for three years, let to worry about IT. Do you trying to find an answer for a kid, mention anything that could be, and then work IT up, and that's where a ChatGPT will help.

This is interesting point that A I will not navigate around difficult to diagnosis just for the sake of navigating that. And perhaps I am more willing to be Frank about a tough diagnosis when you're speaking to N A I versus name d, and I hadn't really considered that. But that seems like an excEllent point to keep in mind.

I think is really important. The broad range of what will be mentioned and hopefully, the models will not be altered to discriminate in that way and remove possibilities because that's that's really the value.

Maybe I can ask a question that related to the one that just ask. So IT seems like the doctor patient relationship, the doctor patient died is now becoming a triad with AI. We have this new entrant into the relationship.

And i'm curious, holy, there's obviously this profound case and use of ChatGPT here and alex uh and and courtney, but do you feel like A I is changing the way patients are approaching you generally in your practice as yet like we have? Like how common is this course? Amazing SHE was activated. SHE used that. But are a lot of parents, are a lot of patients putting this in into their own hands and using this for for their care.

Not yet. Corny is a pheno. Corny is not. You're the person that you meet everyday. It's coming, I think, particularly with Younger patients who are more comfortable with the technology.

But patients who had problems and not had a diagnosis for years will make themselves comfortable with the technology, right? And I think they're gonna start to surprise us. They're onna start chAllenging us and doctors. We need to not dismiss what they bring us, whatever the source is if its social media, if it's a facebook group, if it's ChatGPT. However they are being pointed in a direction you may need to evaluate IT and either you know definitively rolled IT and or rule IT out.

Maybe one more question for court day before we go to the lightning ground. So like in a cattle of weird coincidence, I was ragged in this today that com article where he first earned about your story and about half fly down. There's a quote for me and about the technology news.

So there's like a lots of like cosmic energy happening here, which is really fun. But as as how you mentioned, you're kind of like on the van guard of power users of this technology from a patient. And I imagine that there will be lots of parents and patients like you listening to this. So is there do you have any wisdom that you might share about what was successful and you successfully leveraging this technology that like an average, not courtney level, but maybe like an average patient level, may may be able to get some more results to what you did.

So I think utilizing ChatGPT and then utilizing the power of the parent groups, oh, I see that now in the parent groups that i'm in because of the number of diseases my children have. So i'm starting to see IT at our level where people are using ChatGPT on a very regular basis. My daughter, like I mentioned, has a lot of different things happening, including allergies.

And many the parent groups will have allergies to, let's say, soy, corn, oat and so theyll utilize ChatGPT to go find recipe and eliminate all of those allergies and create a recipe guide for the week. And they'll put a budget in, and IT will do IT for in them. So like I am seeing that on a regular basis in our groups.

So I think it's just it's coming. And I would say if your apparent who has you, this is important to story. I didn't know that my kid had chronic issues.

Know that word when i'm living off in my land and my silo over, there is something wrong with my son. I had no idea that to use the word complex, medical child or chronic child or patient advocacy. I was just mad because my son wasn't well. And so if you know somebody like this, key them into those words so they can find where to go and get them in the parent groups on social media because there's so much knowledge in there to help push them further.

awesome. thanks. So I think we are ready for the lightning ground.

okay. So the first one is for courtine and maybe give you a little bit more liberty to answer this with a little bit longer link that we typically do. I think I know the answer, but but maybe not. So the question is, well, large language models, which is the AI technology behind ChatGPT, will they be net positive for patients over the next five years or net negative.

They will be that positive. But there does have to be some controls put in its certain points because you do have statistics driving everything. So bias is in ChatGPT, too. So we do have to acknowledge that and we've got to be careful of how IT gets developed, but ultimately, its positive for patients.

And then more like many static electricity question is not quite a full lighting bult. What concerns you the most when IT comes to patient use of large language models?

I fear for the hypo contracts who will think that they have everything wrong with them and they don't have that wrong with them. But I think for those people that struggle with things like a soy allergy, like my daughter, when IT does seem like everything is bothering you, they're going to figure that out.

All right? The next question is for holy holy, will A I and medicine be driven more by computer scientists or by clinicians?

Oh, computer scientists. And we have got to be involved with the development. We won't be driving IT, but we should be involved in the development of IT because we have the patient experience and we know what the ds are, but the doctors are little afraid of technology.

So it's interesting because every computer scientists we have on hears, like all the doctors, but I think they maybe they don't want to get in trouble. So it's always bny how the other side assumes that the other side going to have more impact. okay.

So cordy, this is another one for you. This is much more in the get to know you category of questions. So this one is shamefully sly, copied from an N, P.

R. Podcast called wildcard, where they pick these cards and then asked them answer questions. So what is the thing that you have changed your mind the most about since you are Younger?

wow. Probably medicine. I think, as I remarked earlier, I was not a very good study.

I didn't study very well, biology, all of IT. I was really good at figuring out how to how to make myself sick. I could leave the classroom.

Has your faith in the medical establishment change significantly since you were Younger?

So that really interesting question, because what your listeners can see is that I was also a, now I know the word medical complex child, so I have a class plot. And that was back in the eighties when I was going through this with my son. My mom was like, it's okay.

Just keep doing the research. It's okay. It's gonna OK. And I think with time, I now understand how to navigate our very fractured health care system. So it's it's a little restored right now, which is surprising.

The next one is for holy holy, if you weren't in medicine, what job would you be doing?

Oh my god.

if I were no wrong answers.

My god, if I were not in medicine, what job? I can't imagine not being in medicine. We ask me if I weren't in surgery, then i'd be a different type of doctor, but not in medicine at all.

oh. My goodness, I wasn't ready for that. An entrepreneur, right?

I could see that I will start acknowledged this.

Next question is a little maybe a little mean to ask a parent of two kids being one of these myself. But what's an example of something that you do just for fun? What is your hobby?

What is my hobby? I am really an involved parent right now. I have Graceful fully acknowledge that I only have a certain one of years at home with my kids.

So I do a lot with my kids. And I recently did just started doing diamond art because my daughter wants me to make her something to go on her wall. And I did not understand the investment of time that diamond artist.

excEllent. holy. We have the same. This is our last lighting wrong question with the same question for you. What's an example of something you do just for fun? What's your hobby?

Um I like to play golf. golf. Golf looked me and I know it's so there your typical but IT sucked me and IT comes at you .

fast like I was a golf hater for a long period of my life and rosh nose is is I built like a golf simulator my backyard to get Better yeah, IT does speak up .

on that for sure also .

so you both have survived and passionate round of flying colors. So we just have a few kind of last questions here for you. And i'd like to start with courtney, and I think we touched upon this earlier with one of the questions in ne s.

But i'm hoping you can give us parting words to especially for parents and for patients navigating their own care, care of their loved ones in this age of A, I know the models are change, and we know what, to some extent, what these models are capable, love. We have your story. We know where they can hallucinate and confabulating.

You know, those things are widely appreciated now. So considering what you've learned and it's been now a year since the the story came out and sure, this has been on your mind and something that you've even seen change over time, what message do you have for patients and for parents who are navigating care for themselves or for their loved ones? In the stage of AI.

I think share the load where you can because IT gets very heavy. And in the second part is if you're going to use A I the hlubis ation you mention that was partly why when I was using A I, I was cross referencing and asking the question multiple ways to ChatGPT to make sure that if I was giving me fake answers, I could find IT. And then if IT reference material, I would google the material to make sure exist.

And then after that, right, you acted upon that information by joining an online community caborn against the stories that they're sharing and then bringing alex to holy right. So there there's sort of again that it's are coming back to that human in the loop that cross referencing and just really pressure testing the suggestions made by the model we might describe IT as maybe I don't if you would agree, open minded that I was willing to considered things that hadn't been considered before, but still knowing that errors that can make the problems that IT has. You took that information that sounds like always with a grain of salt, and then involved humans and human experts and other parent experts, and in this condition before you acted upon IT.

Oh, absolutely.

All right.

Thank you. So last question to you, holy yes. How, given your experience, do you think medicine will change over the next five to ten years as more more patients, and you know something else we haven't really spoken about today, more and more physicians begin to integra I into both their lives and practice.

How's medicine gonna change? Well, so it's going to A I is gonna be intervals just gonna a part of everything. It's going to get involved from the administration of side too in terms of what maybe surgeries are approved or not approved, what treatments are approved based on the algorithms that are set up.

And again, we have to have part of the patients are going to have you know more education faster. People will be able to research faster and come to us with more wealth. Thought out detailed questions.

Just as a side note court, he didn't actually mention to their cord to me. He found the answer on ChatGPT. And then we had gotten the lumber spine R R, I in the C. T, because he was having back pain. And I looked and said, he's got to the court and he said, okay, ChatGPT is your right?

You pass the test, correct? Yes, there was a test.

Yeah, doctors are going to be dragged into a kicking and screaming, but they're going to use IT for two reasons because patients will demand a faster answer, a faster differential diagnosis that ChatGPT can provide, but also when they see that their work is decreased. You know, i'm using a type of A I and clinic now to help with dictations when I see patients. And so I can do the notes faster and that means I moved to the next patient faster. And so I think that's how it's going to evolve. But I mean, we just the human component has to be .

there can can ask you a specific follow to that so often in A I papers and impressed announcements. The specific promise they're making is that IT will democratize access to expert diagnostic information. Do you think that, that's a realistic goal in then IT will be fulfilled over like a five to ten years time horizon?

yes. But I think when you're given a broad range of diagnoses, yes, you can get somewhere clearly wrong and it's going to have to be verified. But that's okay because perhaps you reading on something you never would have heard of otherwise come across, you know, I think it's fine.

There's some interest on the other side in medicine, particular neurosurgery, of minimizing incidental findings. So I mean, people have had whole lectures and talks about this how to address incidental findings on M. R.

I. And to me, the answer is to address them, not to ignore them, not to call the incidental without meeting the patient, without talking to the patient, examining the patient. But this is why patients go through. So I think using A I is a, is a Better option than dismissing people.

awesome. thanks. What I would just like to say thank you to you both for taking the time to chat with yesterday. I think an amazing combination of death use of A I that really, I think, delivered a truly inspirational and up plating stories. I thank you both again for coming on.

That was amazing. Thank you. Very amazing.

Yeah, thank you. thanks.

This copyright ted podcast from the massachusets medical society may not be reproduced, distributed or used for commercial purposes without prior written permission of the massachuset medical society. For information on reusing N G M group podcasts, please visit the permissions and licensing page at the N G M website.