Be careful there. LLMs may be good at identifying a condition based on a description of the symptoms, but they are much worse at recommending the correct course of action (getting it wrong half of the time).<p>[0] <a href="https://www.nature.com/articles/s41591-025-04074-y" rel="nofollow">https://www.nature.com/articles/s41591-025-04074-y</a>
That's still incredibly valuable, though. I suffered from issues that I'd seen doctors for, undergone an upper endoscopy, adjusted my diet, and taken medication for. An LLM suggested my thyroid was at the root of it. My mom confirmed thyroid issues run in our family and just...never thought to tell me.<p>Just this year, our cat has been having digestive problems. We got special food for her, which she hates, with the suggestion that she'll need to eat it for the rest of her life. Six vet visits later, Fable 5 suggested two tests that my doctor recommended we didn't get. Both found issues that explain her symptoms, and the vet says she will probably only need a supplement and infrequent two week courses of medicine if she has a flare-up.<p>All that to say, the helplessness of not knowing what's wrong and the people who <i>could</i> know not really caring enough is something that LLMs do a really great job of mitigating. If you don't have any way to know what's wrong with you or a loved one, or how to find out, you're stuck spending a ton of money (in the US at least) and crossing your fingers that someone gets it right.
Playing the critic that alternate “50%” outcomes were:<p>- You didn’t have a thyroid issue and you spent thousands more on tests the doctor was right that you didn’t need.<p>- Your cat didn’t have that issue and you spent hundreds on unnecessary tests.<p>Are you essentially saying that it is better for an LLM to sell you an idea that sometimes might be right, selling a dream to anyone with and without the money for it?<p>So… a telephone psychic?<p>The thing about WebMD telling everyone they have cancer is that sometimes it will be right.<p>(Just for clarity, I’m really glad it was helpful for you.)
Having the LLM give you new options doesn't mean you have to pursue them. It's just something else to talk to your doctor about.<p>And it's not like self researching medicial issues isn't a new concept.
I'm so tired of hearing the "unnecessary tests" line.<p>Anyone who says this has not experienced poor quality healthcare.<p>Many doctors simply aren't good and don't run tests because they are doing the bare minimum to get you out of the office.
> You didn’t have a thyroid issue and you spent thousands more on tests the doctor was right that you didn’t need.<p>Uhhhh, even in the US, we're not talking "thousands" here.<p>> So… a telephone psychic?<p>Look, at one level, you can think of LLMs as search with a sometimes useful probability engine sitting on top of it.<p>As someone who had multiple doctors do their damnedest to kill me on multiple occasions, I was very grateful to have google search back in the day, and you bet your bottom dollar I use LLMs to help me with health issues today. They are often better than most doctors.<p>Does that put me at risk of doing something stupid? Only if I don't do further due diligence.
Going to the doctor for expert advice is often inconvenient, or time consuming, or expensive, or stressful. I think a lot of people want, and seek out, information and advice based on their symptoms, as a first step before a possible doctor's visit. Before LLMs, WebMD (and excessive self-diagnosis based on WebMD) was a meme for a while.<p>So with regard to LLMs, for me the question is not purely "how often does it get it right?" the question is "how does it compare to the sources and self-diagnosis methods people use otherwise?"<p>Of course, I agree people should be careful with any form of self-diagnosis or LLM-diagnosis.
> Participants were randomly assigned to receive assistance from an LLM (GPT-4o, Llama 3, Command R+)<p>These are pretty old. I'd be curious how performance compares with the latest frontier models.
>GPT-4o, Llama 3, Command R+<p>The pace of progress is so fast that many studies are totally outdated by the time they release
I would be careful treating this article as relevant in September 2026. The pace of advancement in the field is such that 6 months is relatively ancient let alone when the models in the study were released. GPT-4o was May 13, 2024. Far before November 2025 when people collectively noticed a turn in LLM value.<p>LLMs earlier this year were surpassing numerous health related benchmarks when scored against human physicians. Only 2 months after this nature article Harvard posted that LLMs were now outperforming ER docs when given authority to order tests. <a href="https://www.harvardmagazine.com/ai/ai-outperforms-doctors-diagnosis-harvard-study" rel="nofollow">https://www.harvardmagazine.com/ai/ai-outperforms-doctors-di...</a>
Modern models appear to be much better, at least as proxied by their ability to assess urgency in perhaps a more complex setting: mental health (OpenAI benchmark, so perhaps some skepticism is warranted but the methodology seem reasonable and detailed)<p><a href="https://openai.com/index/introducing-mentalhealthbench/" rel="nofollow">https://openai.com/index/introducing-mentalhealthbench/</a>
We should be careful about extrapolating from benchmarks to real life though. In medical applications, various forms of AI have been beating health care practitioners at specific benchmark tasks since the 1990s. They still have a pretty poor track record of real world success. The real world is not all that similar to a benchmark, as it turns out.
They recruited people to <i>pretend</i> like they had various issues, and then recorded their interactions with the LLMs.<p>Someone who's been paid a couple of quid to pretend to have a medical condition can easily miss things, and is unlikely to be anywhere near as invested in drilling down to the correct solution as someone who's really suffering.<p>Another outcome from the study was that the LLMs could do better with the right people driving them. That's not news.
...I know, which is why "as a Language Model and not a real doctor" is a pointless comment to start off with. It should simply not recommend treatment if it's not sure it is correct. I wouldn't blame it or anyone if they asked for help treating a stiff neck, and the LLM (or your neighbor or parent or spouse) suggested light exercises to help relieve it - and do not jump to the suspicion that you may have meningitis.<p>As a Human, I do not need to know it is a Language Model.
LLMs are famously bad at determining "if it's not sure it is correct." They are always confident, because a confident tone ranks better in RL.
> They are always confident, because a confident tone ranks better in RL.<p>This makes it sound like RL rewards a confident tone -- in general, I don't think this is true (most RL is RLVR, which typically uses binary verification of correctness).<p>I say this because the real reason "they are always confident" is in some sense even more contrived. Training text where the speaker sounded more confident is more likely to contain a correct answer.
> This makes it sound like RL rewards a confident tone<p>Generally it does. Especially in groups. Hell look at the state of politics right now: it’s basically about being the loudest, least compromising, most confident voice in the room. It’s not just because people will assume you’re correct, it’s because if you are confidently saying something that someone wants to be right, then they’re often just going to follow it. We are all guilty of this.<p>If I’m turning to an LLM to diagnose something medical, I am probably frustrated or uncomfortable. Maybe I’m just scared. So this magic device just instantly spits out (allegedly) exactly what is wrong and exactly what I need to do with no hesitation. I am very liable to just take it at face value <i>because I want an answer and it gave me one</i>, as we have seen over and over again since ChatGPT was unleashed on the world.<p>We don’t really need to speculate, this is already a problem.
> This makes it sound like RL rewards a confident tone -- in general, I don't think this is true (most RL is RLVR, which typically uses binary verification of correctness).<p>A binary response vs rating is not related whether it learns confident or hedged tone. Either will produce a confident tone because humans respond more positively to a confident tone, hence the conman's language. Binary or not humans reward the tone and very much bias the model.<p>But there's an even more contrived reason the training set contributes. The vast majority of human writing is confident. When the prior is greatly biased, a random number generator biased to that prior does better. The difference with humans and machines is humans <i>are less likely to respond if they are less confident because they understand not knowing</i>, which is why the training set is biased. It is one of the many fundamental flaw of LLM training and confusion of LLMs with intelligence. And that will not be fixed within the LLM architecture.
I feel like in real life, we're constantly exposed to "I don't know" as a valid answer, but obviously we don't write down all the I-don't-knows in expert literature so the training corpus is wildly skewed towards confident answers because "we studied this for a month and have no idea, it's confusing" doesn't get published.
Yeah it should just state thing it means. But then again, there’s psychological impacts on society that we must be careful. For instance, teenagers talking to AI. If the AI just talks, people already start to feel real connections to the seemingly human entity. Maybe it’s better to disclose the reality up front?
Would it be so bad that lonely people can have a real friend that they can bring everywhere they go and even share its passion with through vision and audio? We don't want destructive friends encouraging us to do bad things, but a real 'buddy', somebody who always has our best well-being in its interests?<p>Would it matter if this digital friend is not a real human behind a computer screen, but a Language Model in a data center?<p>I guess it falls into a similar category as buying "special performances to satisfy certain urges". It probably feels close to the real thing (I wouldn't know, I've never tried - promise! :P), but it's never the same as love.
> We don't want destructive friends encouraging us to do bad things, but a real 'buddy', somebody who always has our best well-being in its interests?<p>GPUs are not people, and generated tokens can't have interest in a person's well-being. If you try to pretend otherwise, the results are not great. <a href="https://www.cnn.com/2025/11/06/us/openai-chatgpt-suicide-lawsuit-invs-vis" rel="nofollow">https://www.cnn.com/2025/11/06/us/openai-chatgpt-suicide-law...</a>
That's almost a year ago. One LLM year is like 10 human years. They're a bit like dogs in that regard...<p>I'm pretty sure you will be paid a large sum of money if you can make one of the frontier models urge you to commit suicide from normal interactions with it.
Ah yes, my favorite LLM fallacy. "You used the wrong model! The newest fanciest model is perfect and makes no mistakes, have you tried it yet?" Let's force all of society's most vulnerable people to pay extra $$$ to Sam Altman, then surely all our problems would be solved.<p>It's just a convenient way to ignore the years of evidence of the harms. Any bad news can be swept under the rug, labeled outdated as quickly as it happens. Well here's one that just happened, maybe this kid should have used a fancier model too? Should OpenAI pay him a large sum of money for the good he's done? <a href="https://www.cnn.com/2026/08/15/us/arjun-aravind-massachusetts-killing-chatgpt-hnk" rel="nofollow">https://www.cnn.com/2026/08/15/us/arjun-aravind-massachusett...</a>
I wish I didn't have to keep asking this question, but do you believe in souls?
My (controversial) view is that a psychologist is to a friend what a prostitute is to a lover. In a truly healthy society there would be no need for psychologists and prostitutes because everyone would have a handful of good friends and at least one lover. Back in messy reality, psychologists and prostitutes are a decent fix to keep society on the rails.<p>So. I think I agree with you.
Well, no this doesn’t make sense. If you think about intent, most psychologists probably want to help people’s mental health. Prostitutes, although they offer a service that helps some people, I’m sure their motivation is primarily financial.
Well, a psychologist is also given years of training about what healthy behavior and relationships look like. Some best friends have this skill, others absolutely do not.
> It should simply not recommend treatment if it's not sure it is correct<p>Oh okay, darn, guess they just forgot to make it so!