Turning to ChatGPT When You Can't See a Doctor?

How ChatGPT will Revolutionize Medical Access in Underserved Areas.

Introduction

Healthcare access in the United States is marked by stark disparities, particularly in rural and underserved areas. More than 60 million Americans—about one-fifth of the U.S. population—live in rural areas, where access to quality healthcare is often limited (source). These challenges are even more pronounced in reservations, low-income communities, and among uninsured populations (source). Long wait times for specialists, hospital closures, and a shortage of healthcare providers have created a healthcare crisis that disproportionately affects vulnerable populations (source).

I’ve always advocated using ChatGPT for your health, and I’ve even written a book about how to do so. If you are interested you can watch a recent interview I did below:

In the face of these healthcare challenges, ChatGPT has emerged as a potential game-changing replacement to "googling symptoms", or doing nothing at all. GPT-4o, which is now free for everyone on ChatGPT's site, stands out as the world's smartest model with the potential to revolutionize various aspects of healthcare for underserved populations. With genius level intelligence, it is a promising tool for addressing some of the most pressing issues in healthcare access and quality (source).

This blog explores the potential of ChatGPT as an alternative to doing nothing, or googling symptoms, with a particular focus on its capabilities in diagnosing, triaging, and recommending treatments/remedies for those who can't see a doctor (source). 

The Need for AI in Medicine

Current healthcare disparities are profound and multifaceted, affecting access to medical professionals, financial barriers, and geographic and logistical challenges. These disparities are particularly pronounced in rural and underserved areas, where populations often face a lack of healthcare providers, limited financial resources, and significant geographic obstacles to accessing care. For instance, many residents in these areas experience long wait times for specialist consultations and struggle with transportation issues, further exacerbating their health outcomes (source, source).

ChatGPT holds the promise of addressing these disparities by improving access to medical information, reducing wait times, and alleviating the pressure on healthcare systems. By enhancing decision-making and patient outcomes, AI has the potential to transform healthcare delivery, making it more equitable and efficient for all populations (source, source).

Comparison with Googling Symptoms or Doing Nothing

When faced with health concerns, many people turn to the internet to search for symptoms, a practice often referred to as consulting "Dr. Google."  Studies show that a substantial percentage of individuals misdiagnose themselves after searching online, with 43% of Americans having done so and 74% reporting increased worry as a result (source) (source). The information found online can be misleading, as search engines prioritize well-optimized content over credible medical advice, often resulting in exaggerated or incorrect conclusions (source) (source). With the average wait time to see a specialist being around a month (source) in the US, is it safe to do nothing at all for that long?

Overview of GPT-4 Technology

GPT-4o, the latest iteration of OpenAI's Generative Pre-trained Transformer models, represents a significant advancement in natural language processing and artificial intelligence. Developed to handle more complex tasks than its predecessors, GPT-4o is a large multimodal model capable of generating human-like text from both textual and visual inputs such as photos. It builds upon the foundation of previous GPT models by incorporating a vast number of parameters, rumored to exceed one trillion, which enhances its ability to understand and generate nuanced and contextually appropriate responses (source, source).

Applications of ChatGPT: Diagnosing, Triaging, and Treating

GPT-4's applications in medicine are diverse and impactful:

1. Symptom Checking and Diagnostics

Success Rate: GPT-4 has demonstrated a high success rate in diagnosing complex medical cases. A study published in JAMA Network Open examined GPT-4's ability to analyze medical records of patients with extensive investigations and delayed diagnoses. GPT-4 achieved 66.7% accuracy for primary diagnoses and 83.3% accuracy when including differential diagnoses, outperforming both clinicians and a medical diagnostic decision support system (source, source).

Rare diseases:

2. Triage Services

Comparative Performance: A study by UCLA Health found that GPT-4 can diagnose and triage patients as well as physicians. The research compared GPT-4 to three board-certified physicians in diagnosing and triaging health conditions using 45 clinical vignettes. GPT-4 performed comparably to the physicians in categorizing cases as emergency, non-emergency, or self-care (source).

Predictive Triage Outcomes: A single-center prospective observational study evaluated GPT-4's ability to predict triage outcomes based on local emergency department rules. The study, which included 758 patients, found almost perfect agreement between GPT-4's triage decisions and the gold standard set by an emergency medicine specialist (Cohen's Kappa 0.899, p < 0.001) (source, source).

Accuracy in Emergency Triage: A study published in JAMA Network Open found that an AI model can accurately prioritize the sickest patients 89% of the time in emergency room triage (source).

Comparative Diagnostic Accuracy: Another study compared GPT-4 with GPT-3.5 and resident physicians in diagnostic accuracy across multiple disease subgroups for emergency patients. GPT-4 outperformed both GPT-3.5 and resident physicians in several categories, including cardiovascular diseases, endocrine or gastrointestinal diseases, and infectious diseases (source).

3. Treatment Recommendations

Evidence-Based Treatment Options: Beyond diagnosis, GPT-4 can recommend treatment options by referencing the latest medical guidelines and research. This can be particularly beneficial in rural and underserved areas where access to specialist consultations is limited. GPT-4's ability to provide evidence-based treatment recommendations can enhance decision-making and improve patient outcomes (NCBI, JAMA Network).

Antidepressant Recommendations: A study found that GPT-4 provided generally reasonable medication recommendations for pharmacotherapy of major depression after initial antidepressant nonresponse. It correctly identified optimal treatments in 76% of vignettes presented, outperforming human clinicians who selected optimal treatments in 36% of cases. However, GPT-4 also advised less optimal or contraindicated approaches in all but one vignette (source).

Orthopedic Treatment Recommendations: A pilot study on common knee and shoulder conditions found that GPT-4 could produce valuable treatment recommendations that were largely up-to-date, consistent, clinically useful, and aligned with current clinical and scientific evidence. The recommendations were rated as good or better for both knee and shoulder conditions (source).

Dermatological Treatment Recommendations: A study evaluating GPT-4V's performance in dermatology found that it demonstrated promising capabilities in generating treatment recommendations for common dermatological conditions. While not at expert level, its performance was considered competent when evaluated by board-certified dermatologists (source).

Conclusion

ChatGPT, particularly the GPT-4 model, has the potential to significantly improve healthcare access in rural and underserved areas. By offering accurate symptom checking, diagnostic assistance, triage services, and treatment recommendations, GPT-4 can mitigate issues such as limited access to healthcare professionals, long wait times for specialists, and financial barriers. Studies show GPT-4's capabilities in diagnosing complex medical cases, effectively triaging patients, and providing evidence-based treatment recommendations, often surpassing human clinicians in accuracy and efficiency.

Integrating AI like GPT-4 into healthcare can enhance accessibility and quality, reducing misdiagnoses and improving patient outcomes. Embracing this technology can bridge the gap in healthcare access and quality, creating a more inclusive and efficient healthcare system for all, regardless of geographic location or socioeconomic status.