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Ryan McCormick, M.D.'s avatar

Great interview thank you.

I have to comment as a doctor, because your letter references us several times, and because I naturally feel defensive when this AI stuff starts breathing down our backs. As of right now, in primary care, the juggling of biological, psychological, and social components of someone’s health is just too human of a task. When I coordinate the care of someone with 20+ problems, there are all sorts of levers being pulled in terms of priorities, hierarchical decisions, diagnostic possibilities and treatment recommendations... all delivered with a modicum of charisma and compassion. I think the estimate that 99% of what we do is not diagnostic is a gross underestimation... but it’s true that perhaps 80% of what we do is creative or algorithmic thinking within the boxes of patients’ established diagnoses.

ChatGPT does really suck at citing real sources. It’s one of the biggest Achilles heels, and undermines its reliability and trustworthiness. And trust is at the very foundation of the doctor patient relationship!

Nonetheless, here are a few questions I have typed in live, during the past 2 weeks, while seeing a patient, just to get some quick ideas before double checking veracity:

“is hemochromatosis carrier state associated with an increased risk of pancreatic cancer? Estimate the increased risk in percentage / relative risk.”

“please compare and contrast Interstim procedure versus sling procedure for the treatment of urinary incontinence and overactive bladder.”

“can D-mannose cause candida infection in the esophagus?”

“what could cause swelling of the fingernail beds and toenail beds, with tenderness, associated with blood clots and pulmonary embolus?”

“What are some possible diagnoses for a postpartum woman, presenting with Purpura, petechiae, swollen toes, erythematous skin on the toes, thrombocytopenia and history of antiphospholipid antibody syndrome Who is experiencing generalized abdominal pain?”

“How do statin drugs affect macular degeneration? Include at least 5 medical journal article references”

*

Most of these queries led to helpful ideas and discussions back and forth, except for the last one asking for references which was a confabulation of sources that were not real. I think I’m in a very small minority of primary docs experimenting with this, so I’m not a typical case. But thought you would like to see some of the trench work😊

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Matt Thomas's avatar

Wow this was fun. I read Deep Work last year, so it was really exciting to see you interviewed Newport. I hadn't seen his New Yorker article until you linked to it, and I'm really glad you did. I was struck by (1) how amazingly smart humans have been to figure out the problem solving and ingenuity behind LLMs and ChatGPT and (2) how terrific Newport is at explaining it. I especially love his analogies like the Plinko one you pulled (shoutout to Kepler, our analogical king).

You noted that one of your favorite approaches is going through the historical development of an idea. I'd love to read another example of this. Do any come to mind that either written by you or someone else? Also, if you have the time/energy to explain your master list, I'm all ears. And I'll be sure to check out the other Newport books you recommended. Thanks again!

Ps - just curious: what was the prompt you used to get the cover illustration?

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