Patients using AI

[BeaverBlade]

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I'm convinced a lot of my patients use AI. I'm not sure if anyone else has this feeling. Some of the questions I get are more informed than you'd expect or even different than when I began practicing on my own just three years ago. I feel like this can be a good and bad thing. It's almost as if you're questioned more as far as your decisions. A lot of patients seem more anxious than in the past as well. I've had some patients come to me with their own zebras "Is it (insert super rare thing that it isn't?"

I'm just wondering if anyone else feels this is happening to them in their practice, or just me.

I know it totally depends on your patient population too. I do have quite a bit of younger/educated patients than a typical podiatry practice.

I just wonder as someone who will likely still be practicing in 20+ years what our future will look like in regards to this... It can only get worse I imagine. All of your decisions/x rays/etc will be put into the cloud for claude or chatgpt to have an opinion on.

 

[Boba Foot]

Some degree of internet doctoring has been going on for a while... WebMD, Google, etc. Sometimes having an informed patient isn't a bad thing, and they can be more compliant than some who don't give af and generally don't listen. If they show interest in actual physiology and pathology behind stuff, it's usually better to lean into it rather than getting offended by it. They can input symptoms and imaging into LLMs but there are subjective and objective parts of exams for a reason and AI can't fully replace physical exams on everyone.

Also, we'll never be replaced because Claude can't cut toenails. The thing we all complain about is probably the main thing that will save us. LLMs probably can replace a lot of urgent care work (you have the flu! drink more fluids! get some rest!), which may not be a bad thing because I've seen a lot of uselessness coming from urgent cares.

 

[BeaverBlade]

I mean at a certain point do the plantar fasciitis patients just get the treatment algorithim from Claude and not show up? I agree it’s already existed as far as finding the diagnosis/treatments online it’s just more advanced now. I just wonder what longterm that means for podiatry… which I do agree is probably more safe than other fields in medicine since we do a lot with our hands…. I do feel the shift on it though in my practice based on the more “abnormal” discussions with patients.

 

[Stormblest]

A few of my PF patients come in having already tried stretching, rolling arch on tennis ball, poor quality inserts, etc.

I assume there are lots out there who never come in because they managed it themselves.

 

[Adam Smasher]

On the optimistic side, AI-powered search results are ultimately going to be based off of good evidence. Just like how anyone can edit wikipedia but it somehow tends to be pretty accurate, I think the amount of good information on the internet drowns out the bad info. When the AI summarizes good evidence for the patient, it serves to reinforce whatever our recommendation is going to be for them as long as we're practicing the standard of care. The only reason you would want this information withheld from a patient is if you're not filling your schedule and you want every single low-level complaint you can get, rather than have them try things out on their own at home.

I suppose it could be annoying if patients want to micromanage your surgeries, "why are you doing X when you could do Y," but I haven't seen that yet. They may just want to have an informed conversation about their surgery. Personally, I enjoy those conversations because it shows they understand we're not just popping open the hood and fixing the issue, it's more nuanced than that.

I tried to test Gemini to see if it will give "bad" surgical advice.

I find Gemini tends to hedge its bets, basically saying "I'm not a doctor, go ask your podiatrist these questions."

 

[Boba Foot]

I mean at a certain point do the plantar fasciitis patients just get the treatment algorithim from Claude and not show up? I agree it’s already existed as far as finding the diagnosis/treatments online it’s just more advanced now. I just wonder what longterm that means for podiatry… which I do agree is probably more safe than other fields in medicine since we do a lot with our hands…. I do feel the shift on it though in my practice based on the more “abnormal” discussions with patients.

They're not going to inject their own plantar fascia, and they're probably still going to have pain when they buy the same crappy Dr Scholl's inserts from the grocery store.

I find Gemini tends to hedge its bets, basically saying "I'm not a doctor, go ask your podiatrist these questions."

Claude tells me to ask my attorney after basically anything it replies to me about. Sometimes I wonder if my attorney has a referral deal with it.

 

[BeaverBlade]

I find that AI tends to be more cautious which can lead to more anxious patients which is pretty much what I’m seeing. I was just curious with this thread if anyone has noticed a change in patient behavior over the last few years as it’s becoming more popular