by timschmidt | 2025-05-30 11:47:40+00:00
I understand fully, and disagree strongly.

> [LLMs] don't learn on the job

Funny, the ones I work with get updated with new information all the time. No reason it couldn't happen after every single encounter.

> Empathy, by the way, is something that happens between 2 people.

People will anthropomorphize anything and that includes empathizing with a rock. A rock cannot empathize back. QED.

> If you start out with an LLM, you start out 100% convinced (and correct in that, btw) that they aren't worried about you. So it won't work.

See above. Your point is also undermined by the sheer volume of people currently using LLMs as therapists.

> Patients try to deceive doctors ... but within reason, because there's empathy the other way too. When patients have to deceive LLMs instead for a week off from work, there will be zero empathy, zero shame and zero limitations on behavior that from the patient side.

You seem to think people have limitations on their behavior now. I assure you they do not. Talk to a doctor or social worker about it. It wears them out. LLMs don't get worn out and are much better at calmly and kindly interacting for as long as someone needs.

> A doctor is trying to help you ... probably ... with maybe 10% helping the company. An LLM is 100% trying to help the company

Some doctors are. Some are more worried about their next golf game or maserati. You are fully pessimistic about LLMs but incredibly naive about people.

> Let's face it: the whole point of LLM medicine is that it's not what's best for you.

Hard disagree. Last I was in the hospital for a life threatening condition (pancreatitis caused by gall stones) I got to talk to a doctor for 5 minutes. I educated myself about my condition thanks to Wikipedia and medical journals. An LLM would have been incredibly helpful.

> do realize that if you apply that as a critique of LLMs, that are corporate controlled, it's going to be 1000x worse?

Good thing there are academic, open source, open weight, jailbroken, fine tuned, local LLMs I can run myself and even cross-check between multiple competing models and models from different countries with entirely different economic and political systems for nearly no cost for additional assurance.

> So I don't understand the critique. Yes doctors aren't perfect, flawed in many ways.

And incredibly expensive, unavailable without appointment sometimes months or years in advance, incredibly limited when it comes to any specialization, sometimes distracted, exhausted, grumpy, dismissive, disagreeable, and subject to all manner of human failings.

I'm not sure what Black Mirror episode you're drawing your outlook on life from, but it bears no resemblance to the reality I live in every day.

I don't think doctors will be wholesale replaced by LLMs.

I am already seeing LLMs lowering barriers to acquiring first-line medical advice and second opinions.

Will dystopic things happen? Sure, they're already happening every day without any help from LLMs. That'll continue into the foreseeable future. But having an LLM to ask for second opinions might have saved my Dad's life, and would have allowed me to better educate myself about my own life threatening condition. Good luck prying them out of my hands.