E- ISSN: 2709-5533
Vol 4 / Jan - Jun [2023]
globalrheumpanlar.org
Columns
Farewell to the handbook, welcome to ChatGPT
By: Elias Forero Illera: Rheumatologist internist E-mail: eforero64@gmail.com
DOI: https://doi.org/10.46856/grp.22.et166
Cite as: Forero Illera E. Farewell to the handbook, welcome to ChatGPT [Internet]. Global Rheumatology. Vol 4 / Jan - Jun [2023]. Available from: https://doi.org/10.46856/grp.22.e166
Date of receipt : March 25, 2023
Date of acceptance: April 5, 2023
Date of publication: April 14, 2023
The times are not far away when the minimum items needed for a shift as resident, intern or student were, in order: a pen (in my country there was a very popular one called Kilometric), a phonendoscope and the therapeutic handbook. Any other implement could be considered a luxury. Today, thanks to technological advances, the minimum necessary to be on call in the emergency room is reduced to carrying a cell phone with internet connection and a good cup of coffee.
The frantic development of information technology has erased the pen from hospitals. Today, even the smallest procedure requires typing so that every medical act can be properly counted, audited and charged. Just how difficult it can be to get a prescription pad and this element to handwrite a note in today's emergency departments. The famous illegibility of the physician's handwriting will soon be a thing of history.
The stethoscope, a symbol of medicine, which still refuses to disappear, will soon be replaced by hand-held ultrasound scanners displayed on a cell phone screen. In a few years’ time, a diagnosis of heart failure or heart murmur will be visible on the screen of a cell phone and not in the ear of the physician.
Not to mention the therapeutics handbook, already part of history in its text format. For some years now, cell phones have been able to download texts, management guides and all the revisions you need to solve your doubts about the cases under study.
Still, the icing on the cake was missing. A technological advance that will facilitate the practice of medicine and that will perhaps leave aside professions and professionals who do not adapt quickly to change. This is artificial intelligence (AI) (1,2) and OpenAI (3), the most recent development of chatbots. This is a computer program designed to simulate conversations with human users through text or voice.
It works through a combination of algorithms and databases that allow it to process, interpret and respond to users' questions and comments. ChatGPT is the most developed so far.
This new technological resource could provide healthcare professionals with real-time assistant with the following advantages:
- Quick access to medical information: providing up-to-date and accurate medical information, enabling healthcare professionals to make informed decisions based on scientific data.
- Diagnostic assistance: assisting healthcare professionals in the diagnostic process by analyzing symptoms and medical history, and suggesting possible conditions and diseases that fit the clinical picture.
- Patient follow-up: support monitoring patients’ progress and health status by providing analysis and summaries of their medical history.
- Interpretation of results: assist in the interpretation of test results and medical examinations, generating information on normal and abnormal values.
- Personalized care: helping to improve patient care by providing specific and personalized information about their medical situation, which helps physicians address concerns and questions.
- Workload reduction: alleviating some of the workloads of medical professionals by automating some routine tasks, such as report writing, data entry, or appointment scheduling.
- Clinical decision support: helping clinicians evaluate therapeutic options and consider possible drug interactions and side effects.
Due to this technology, doctors in the practice and in training would have, at the click of a button, all the data they need to reach a diagnosis and propose a treatment.
The question then becomes: will AI be able to replace doctors?
For the time being, I think the answer is no, but there is no doubt that technology should be made to work in favor of all professions. Otherwise, we also run the risk of leaving the key ring, like the pen, the phonendoscope, and the therapy handbook, with no return.
Colleagues of the future will have to develop certain skills that appear to be more than necessary, those in which AI encounters the greatest difficulties in their implementation, such as, for example:
- The ability to communicate and establish an empathic relationship with the patient: physicians must develop the ability to communicate effectively and establish empathic relationships with their patients, which will facilitate a better understanding of their needs and concerns.
- Develop semiology skills to the fullest extent possible: semiology is the science of diagnosis. In any setting, to be successful in the care of a patient, one must start with a correct diagnosis. The professional should be able to do thorough questioning and a complete physical examination that provides the highest and best quality of data.
- Learning to make decisions in complex scenarios: although AI can process large amounts of data and provide recommendations, medical decisions are often made under conditions of uncertainty. Physicians must learn to weigh the risks and benefits of different treatment options and make decisions considering emotional, social, economic, and environmental patient information.
- Develop flexibility and adaptability skills: AI follows a specific set of rules and algorithms, and its ability to adapt to unforeseen or unusual situations is limited. In contrast, humans often face changing and complex situations that require certain flexibility and adaptability that machines do not yet have.
- Develop critical reasoning and good clinical judgment: The development of these two competencies allows physicians to evaluate, among other things, the veracity of medical and non-medical information. Because not everything is rosy in the use of technology and the practice of medicine.
The problem lies in the fact that in order to obtain that longed-for or elusive diagnosis and then formulate a correct treatment, chatbots must have been fed valid facts and figures. Chatbots, including the recently launched ChatGPT, base their responses on the information they have been trained with. If they are fed false, misleading, or biased information, they will likely generate incorrect or misleading responses. Algorithms work the same with correct or invalid information. Therefore, before making clinical decisions, the information provided should always be evaluated, contrasted, and validated by qualified health professionals.
In summary, technological advances have radically transformed the way in which health professionals conduct their daily practices, providing new tools and resources that facilitate the diagnosis and treatment of diseases. Despite the benefits offered by AI and chatbots, it is essential that physicians do not neglect to develop human skills, such as empathetic communication, critical reasoning, and adaptability, as these are areas in which AI cannot yet match the human touch. In addition, it is important to remember that the quality of the answers provided by chatbots depends on the accuracy and reliability of the information with which they were trained. Therefore, it is the responsibility of healthcare professionals to carefully evaluate and validate the information obtained from these sources before making clinical decisions.
By combining human wisdom and experience with the data processing capabilities of AI, clinicians will be better positioned to meet the challenges of the 21st century and deliver exceptional care to their patients.
References
1. Fajardo E, Graf C. Artificial Intelligence, the transformation of rheumatology? – Part I [Internet]. Global Rheumatology. Pan American League of Associations of Rheumatology (PANLAR); 2022.. Available from: https://doi.org/10.46856/grp.21.et115
2. Fajardo E, Graf C. Artificial Intelligence, the transformation of rheumatology? Part II [Internet]. Global Rheumatology. Pan American League of Associations of Rheumatology (PANLAR); 2022.. Available from: https://doi.org/10.46856/grp.26.et125
3. Available at https://openai.com/blog/chatgpt
