Docs Get Clever With ChatGPT

Alok S. Patel, MD


February 03, 2023

This transcript has been edited for clarity.

Do you ever wish you had a 24/7 scribe, an overly ambitious medical student, or a clone who could do all your research, writing, and, essentially, paperwork for you? Don't we all? Dishing out scut work feels inhumane…to a human, but not a computer.

Let's talk about this chatbot, ChatGPT, which has gotten a large amount of hype on Twitter and in the news over the past couple of months. It can do anything from write movie scripts to antibiotic scripts. It can write research papers. It can do many really cool things, and I'm sure we can think of ways it can improve our workflow.

In this episode of the Hospitalist Retort, we'll take a closer look at how ChatGPT is being used to reduce physician burnout.

Chatbot technology has the potential to help alleviate some of the causes of burnout by handling routine tasks such as scheduling appointments and answering frequently asked questions. It can also automate patient triage and provide patients with self-help resources. Additionally, chatbot technology can provide physicians with more efficient communication and coordination in between healthcare providers, allowing them to make more informed decisions and improve the overall patient experience.

Fun reveal. The entire paragraph above was written by ChatGPT. I typed in a quick prompt and there it was — full sentences and complete thoughts. I read through it to make sure I agreed with everything, and we were good to go. Are you already brainstorming the many ways we can use this? I am.

A quick overview: ChatGPT is a natural language processing model. ChatGPT stands for Chat Generative Pre-trained Transformer. I am not going to pretend to understand the computer science behind this, but you can research it and nerd out.

You can type in a detailed question, request a specific format — get as creative as you want — and you will get a natural-sounding answer that is applicable. The Internet has given us some awesome examples, such as creating a piano piece in the style of Mozart or making a Harry Potter text-based video game, whatever that is.

I started messing around and trying to find creative ways that I could use this as a pediatric hospitalist. I typed in "Provide instructions for giving albuterol at school." I then typed "Explain how to monitor blood glucose in type 1 diabetics in Spanish." I was amazed at how thorough these instructions were. I then typed in "Write an Instagram post explaining winter sports safety in children," and I swear what I saw looked exactly like a generic post you would see from a children's hospital.

Now, someone may wonder, how is this different from just searching for something on Google? Well, ChatGPT will give you complete sentences and thoughts. The other day, I actually used it to answer a specific patient question. I typed in "How much radiation is in an x-ray compared to flying on an airplane. Include citations," and it typed out this eloquent answer, including a citation from the National Council on Radiation Protection and Measurements, and explained how a 5-hour flight gives you roughly the same radiation dose as one chest x-ray.

I read about someone who used ChatGPT to write a cover letter and almost got hired, but apparently the letter lacked personality. Sounds like an easy fix.

There is a famous internet story about a urologist who used it to write to an insurance company requesting that a prostate MRI be covered in a patient with an elevated prostate-specific antigen who had never had a biopsy. People have also used it to write abstracts, and apparently, ChatGPT may be able to pass the United States Medical Licensing Examination — all three steps.

Members of the medical community started to think about ways that we can use this tool to offload some of our writing-based workload. I started to think about all those generic emails and notes I have to write: the clinical summaries, the patient instructions, the background research for presentations and articles, and then there are hospital notes.

We already use note templates. For example, if I pull up a template for bronchiolitis, the outline of it is there, so I just hit F2 and fill in the details.

Sooner or later, we're going to figure out how to use ChatGPT to do the work, where you type in symptoms, location, duration, physical exam findings, you hit enter, and you get a complete note that's accurate and has the necessary lingo for medical coding in much less time.

I even had a colleague recently joke with me about using the program to write an Institutional Review Board proposal, and I bet you could pull that off if you had the right prompts.

It's not that surprising, but this all sounds like a setup for a sci-fi movie in which some nefarious healthcare company uses artificial intelligence to brainwash the masses to put profits over patients. It doesn't sound that farfetched. There are some limitations and ethical concerns about using chatbots in healthcare, with the big question being whether these tools will be used to further academic progress or be abused.

Compared with a physician, chatbots can't take individuality or hidden context clues into account to provide a detailed assessment. It's more black and white. They're only as good as the information that they receive. There's also a concern about excessive patient-directed care if many people start using these tools for symptom management. Computers are more accessible, and some people may feel more comfortable typing their problems out to a computer rather than talking to a person.

In the end, I'm on team "use technology to reduce the amount of paperwork we have to do and fight burnout," and I'm not alone. According to Medscape's Physician Burnout and Depression report in 2022, 60% of respondents cited bureaucratic tasks as a major cause for burnout. Maybe ChatGPT and its successors are the answer.

Do you like where this is all going? Why or why not?

In consideration of your practice and your workflow, you may have some creative ideas for how we can use a 24/7 unpaid employee like ChatGPT. Share those ideas.

Alok S. Patel, MD, is a pediatric hospitalist, television producer, media contributor, and digital health enthusiast. He splits his time between New York City and San Francisco, as he is on faculty at Columbia University/Morgan Stanley Children's Hospital and UCSF Benioff Children's Hospital. He hosts The Hospitalist Retort video blog on Medscape.

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