I have long argued that AI is well on the way to providing a Universal teacher, one that can teach anything, anywhere at any time, on any level, sensitive to any accessibility issue, personalised and in any language. AI is making gains in all of these areas and, for me, the idea is firmly on the horizon. The big win here is massive scaling to both reduce costs and increase efficacy.
Universal Doctor
Another corollary idea is that of the Universal Doctor’. This is, in some ways easier to achieve as the tasks – clinical decision making, investigative methods, diagnosis and treatment are much more defined in protocols and agreed approaches. With a misdiagnosis rate of around 4.8%, sound worse when you say 1 in 20, if AI gets this down to even 3% or below, why would you want to deal with a Doctor, Unless they were a specialist.
As AI makes astounding progress in medical science, with Alphafold not only saving a billion years of human research by identifying the 3D structure of 20O million proteins, drug discovery is falling from 5 years to two years using the same software. Deepmind, through Isomorphic Labs has closed deals totalling $3 billion with Eli Lilly and Novartis. It takes up to a decade and on average $2.7 billion to develop a new drug. That time and cost will new slashed. MIT has already had success with Halacin, hailed as a super-antibiotic. The same has happened in material science with millions of new potential materials being discovered through AI.
Back to the Universal Doctor. After a false start using older AI techniques, from IBM, their famous ‘moonshot’, the idea of the machine outperforming Doctors is fast becoming a reality. The concept is simple, cheap healthcare through a Universal Doctor, one that can diagnose, investigate and treat anyone, anywhere at any time, on any level, sensitive to any accessibility issues, personalised and in any language. It will have great benefits, especially in rural areas, with access by the poor and decrease workload for healthcare systems globally.
Existing services
We already have Glass AI, which provides AI-Powered Clinical Decision Support. This is a platform that empowers clinicians to develop differential diagnoses and draft clinical plans.
Dr Gupta is different and making waves an AI driven chatbot that provides personalized health information and suggestions. You have to input your medical information, symptoms, signs, allergies, and medications, to enable the chatbot to give more informative and personalised suggestions. You can choose between Imperial and SI metrics and it allows you to input lab test results related to albumin, ALT, AST, BUN, calcium, creatinine, glucose, HbA1c, potassium, sodium, triglycerides, LDL, HDL, and eGFR. Free to start, it then charges a fee. An interesting development.
Early research
In Ayers (2023), some actual research was conducted comparing a chatbot to a real Doctor.
Astoundingly, the chatbot outperformed the human Doctor, rated significantly higher (79%) for both quality and empathy. And that was only months into ChatGPT. It is getting better.
Articulate Medical Intelligence Explorer (AMIE)
In a more recent paper, by Google Research (2023), the results are even more astonishing, across a broader front.
When a patient presents, the Doctor has to balance a number of different factors, first clinical decision process that aims to reduce uncertainty and increase diagnostic accuracy but also effective communications along with empathy and establishing a relationship.
The dialogic approach was adopted by the chatbot, which never gets tired, performs consistently and can be massively scaled. Here is an example of a typical dialogic conversation with the bot.
In the criteria measured, both clinical on the left-hand side and interpersonal on the right-hand side, shows that AMIE the bot outperformed the board-certified Primary Care Physician (PCP).
Even when used as an assistant by Doctors, the Chatbot on its own outperformed all.
Direction of travel
So what is the direction of travel here? AMIE is an AI service based on a trained LLM, designed to help doctors and patients talk through medical diagnoses just like they would in real life. It's built to understand and improve the way these conversations happen. To make sure AMIE can handle all sorts of health issues and different medical situations, they designed special training methods, where it could practice conversations over and over, getting better each time through helpful feedback. They also gave AMIE some reasoning ability (an inference time chain-of-reasoning strategy), to think through problems step by step, which makes it even better at figuring out what might be wrong health-wise and making the chat feel more natural. To put AMIE through its paces they tried it out with real-life conversations by having back-and-forths with professional actors pretending to be patients.
A number of different techniques were used, with a real focus on the training of the model. This is not simply a LLM answering questions, it is a trained Doctor bot. What will happen here, and on this I am increasingly certain, is that a new model, say ChatGPT 5 will be precisely this, capable of more carefully processed training data, that has far more reasoning. Doctor diagnosis is a specific task in a specific domain – your body. It is well defined and we have tons of data on good clinical decision making and practice. It is dialogic, exactly what a Doctor must be. What’s not to like?
Conclusion
TWe must be very careful in not accidentally eliminating progress through ill-worded legislation that prevents key medical advances through biometric data. We may be on the verge of solving two of the world’s biggest problems – education and healthcare through a Universal Teacher and Universal Doctor, that is consistent, accessible, personalsied and can scale.
Bibliography
https://glass.health/
https://www.drgupta.ai/
Ayers et al. 2023. Comparing Physician and Artificial Intelligence Chatbot Responses to Patient Questions Posted to a Public Social Media Platform
Karthikesalingam A. and Natarajan V., Research Leads, Google Research (2023) AMIE: A research AI system for diagnostic medical reasoning and conversations.
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