This month’s episode of “News you can Use” on HealthcareNOWRadio features news from the month of January 2023
Opening up the new year and tackling the latest news and updates in the world of healthcare I am talking to Craig Joseph, MD (@CraigJoseph) Chief Medical Officer at Nordic Consulting Partners…..or am I? Has he been replaced by a ChatGPT agent?
Replacing a podcast radio show host with an AI – Drawing by DALL*E 2
ChatGPT
We spend some time diving into the latest phenomenon to sweep the internet – ChatGPT aka OpenAI. As most people will know unless they were knocked sideways with another dose of the latest variant of COVID-19 (more on that later) this toolset has taken the internet and bar discussions by storm.
We have seen plenty of examples of what it can do, both humorous and serious. It has been able to write programming code, answer questions, and produce essays and blog posts (Craig has tried the blog post idea, and as you will hear he was impressed). We disagree on the capabilities with Craig viewing the tool as simply presenting the next best word it can to the user to satisfy what they want. I see it with a little more insight but we both agree it is offering some interesting possibilities. It has created something of an online nuclear arms race for producing papers assigned by teachers and one creative student even created a tool to ingest content and tell if it was created by ChatGPT
Edward Tian, a 22-year-old senior at Princeton University, has built an app to detect whether text is written by ChatGPT, the viral chatbot that’s sparked fears over its potential for unethical uses in academia
In the healthcare world, it has taken and passed all three stages of the USMLE exams – the licensure exams for physicians in the United States. What we find more relevant is that this draws back the curtains on the poor nature of medical education (and many education systems in general) that are not teaching people to think or be creative and we lack “Range” as detailed in David Epstein’s book of the same name
COVID19 Going Stronger
Back by Unpopular Demand is COVID-19 with a rise in the number of cases and infections hitting individuals despite being fully vaccinated and even having acquired immunity from a first-round infection of the virus. Listen in to hear if Craig is still a COVID virgin (I am not for sure) and how we view protecting ourselves and the people around us in the current environment.
Listen in to hear our thoughts on the big layoffs from the various tech giants and how this may be impacting healthcare systems both positively and negatively
You can read more about the series here and the concept of keeping up with innovation in healthcare. Please send me your suggestions on topics you’d like to see covered. You can reach out direct via the contact form on my website, send me a message on LinkedIn or on my Facebook page (DrNickvT), or on Twitter by tagging me (@DrNic1) and #TheIncrementalist or you can click this link to generate a ready-made tweet to fill in:
Listen live at 4:00 AM, 12:00 Noon, or 8:00 PM ET, Monday through Friday for the next week at HealthcareNOW Radio. After that, you can listen on demand (See podcast information below.) Join the conversation on Twitter at #TheIncrementalist.
Listen along on HealthcareNowRadio or on SoundCloud
Raw Transcript
Nick van Terheyden
Today I’m delighted to be joined by our chief medical officer Craig Joseph who is working at Nordic consulting. In fact, it’s not really Craig. We’re just, we’re representing him with chat GPT and we’re reproducing his voice. Craig, thanks for joining me today.
Craig Joseph
It is a pleasure to be with you, Nick. Nick, that was me pretending to be Chet GPT Yeah.
Nick van Terheyden
Don’t Don’t Don’t Don’t call Hollywood it gets
Craig Joseph
really me. It’s really me, Craig.
Nick van Terheyden
So, as as we do each and every month, we’re focusing on news you can use and who could not have spotted what’s been going on with chat GBT. In fact, if chat GPT was a person, they all they needed to do was to put their underpants on the outside and they’d be a super super being. They’re able to do everything right.
Craig Joseph
Chat GPT is it’s pretty I you know, we were preparing for this. And I told you, it’s the most amazing thing and the stupidest thing all at the same time. And I say that, with all due respect to open AI who created
Nick van Terheyden
sorry, I never even says with all due respect means the complete opposite
Craig Joseph
of due respect, Nick? No, it’s, it’s really quite disturbing. It reminds me of Google, you know, when when one learned that you could type in this box and try to find information, and you could do a really bad job of telling it what you wanted. And it would still give you what you wanted much of the time, and it got a lot better. And that’s what I’ve chatted. GPT seems to be Now the key thing is it’s really, really dumb. And so all it’s doing is trying to predict once it writes one word, it’s it’s using its incredible database and learning to predict what the next word is that a human would want to read. And so I think it’s, it’s really good for some things, if you’re looking for facts, it’s really, really bad.
Nick van Terheyden
Yeah, so I would have said, fax would be a basic thing for chat GPT. That’s just going off fetching, looking, finding relationships, not doing anything special. I mean,
Craig Joseph
what the problem is, it’s trained on the internet. And so there’s a lot of stuff on the internet, that’s just incredibly wrong. And so, yeah, it’s, it can’t discern at least at this stage. Right. It can’t discern what is is real from what someone said, it’s all the same. It’s all weighted the same. And so I think that’s, that’s part of the problem. It’s, it’s, you know, I think I asked it once to write it once like it’s been for years, maybe last month, I have to write a write a blog post for me, some healthcare IT subject that I consider myself pretty expert in. And it was pretty good. So I didn’t take it, but I think it’s a it’s a great tool to kind of starch in the direction and then, you know, for you to take it over. If you’re asking a specific question, oftentimes, which are, you know, which are factually based question, it’s, it might or might not get the right answer, but it’s going to sound like it knows exactly what it’s what it’s talking about. It’ll be very authoritative. But it doesn’t. It doesn’t shouldn’t hold any weight in anyone’s mind.
Nick van Terheyden
But you say that, but it took him past the USMLE. The medical examination, right, so we could trust it with medicine.
Craig Joseph
It did pass all three parts of, of the United States Medical License, Oh,
Nick van Terheyden
hold on. Before we go into this, let’s just put this in perspective. That’s a three part examination that takes place over years for medical students. In their first couple of years. They do part one in this third and fourth, they do part two, and then when they’re working as residents, part three, and it took all three of them, and
Craig Joseph
it did now let’s be clear, Nick, it didn’t get the top score. Okay, so
no, but it is so yeah, no going Ivy League then it was it’s, it’s scary.
Craig Joseph
So, again, you know, as I understand it, it’s there to predict what the words are that you that you want. And so it does have some ability to do that in an uncanny way. And it did get passing scores on these tests and the You’re right, like the first one is basic science. So it’s two years of medical school and you take a test and and this thing got I don’t think it did gloriously. Well, but it did. It did get above the minimum score. So I don’t I don’t know what to think I I do know this for sure. I’ve asked it questions that I knew the answers do and it was dead wrong. Just the opposite answer of what was I usual? Yeah, you’re not? You’re implying it was maybe me that was wrong?
Nick van Terheyden
Well, I guess the I always think there’s a distinct possibility. I’m just saying,
Craig Joseph
I’ve not been wrong before. But it might, it might happen sometime. Now, I know, these are things these were facts that you could find on Google. Actually, if you Oh,
Nick van Terheyden
right. Honestly, you got it from Google. Well, that settles it, then
Craig Joseph
therefore, not just from Google. Still, the fact that this this AI could could pass this test, and it writes quite well, whether you agree with what it says, The you know, it knows what a paragraph is, and it changes up the tempo. And it really is a huge tool. And I think there’s you know, there’s certainly been a lot talking about chat GPT not only with health, but also education. How can how can you know, if someone’s written an essay, you can ask it to write you a very complicated essay. And it will write that, again, some of it will be accurate, some of it will be insanely off. At this point, I was just listening to a program over the weekend that said, chat, or GPT. Four. So I guess chat. GPT is based on GPT, three GPT, four should be coming out in about a year or a little less than a year. And it’s, uh, apparently supposed to be significantly better than what we’re seeing what we’re seeing is pretty impressive. So I don’t Yeah, I don’t think doctors have to worry about getting fired and being replaced by a computer at this point.
Nick van Terheyden
Well, and, you know, joking aside, I mean, let’s talk about some of the specifics. I mean, there’s I, first of all, I I’m not sure I agree with you that it’s just trying to predict the next word that you want to see, I think there’s a little bit deeper capabilities. And, you know, I picked it to try and pull together some programming for me and Python, which did a, I want to say a bang up job. Now, let’s be clear, that’s maybe because I’m woeful at programming these days, because my programming skills have have weathered a little bit on the vine, but it was it was very impressive. I think it answers some pretty useful questions, you brought up the issue of education. And I think people are concerned, you know, we should come back to the USMLE. Because that whole medical education thing, I think raises a different issue in my mind, but let’s talk about the plagiarism or, well, no, it’s not plagiarism anymore. I think that’s the beauty of this, write me an essay for you know, whatever, 5000 words, and it was starting to become the educational tool for people to bypass the work that was being required. That was right up until I think it was Edward tear, TN I think his name was he was at Princeton, who decided that, you know, he was going to make himself super popular, and create an app that would detect whether whatever you submitted was produced by chat GPT. And I’m just thinking, wow, I just even if I’d done that, I don’t think I would have published it. But okay. So now there’s a an app to detect the app. Yeah, feels like we could keep on going. But it raises the issue. And this is true in medicine, as well, as just generally we’re trying, we’re asking people to do this rote stuff. It doesn’t require thought and intelligence. And, you know, if you’ve read the book, I think David Epstein range which talks about, you know, this, this narrow specialization and the way that we teach, and that’s not what we’re good at. We’re good at this range. And in fact, when you stop people from learning, and force them to make errors in a whole testing environment, this was you know, and he gives lots of examples. They actually remember and do much, much better in the long term, but not in the short term. And that, for me, is what I draw out of all of this. And I would say the same for medicine. You know, what do we teach our physicians to do? It’s all this rote memorization of you know, Krebs cycle and all these things that do apply, but it’s about memorizing it and then reproducing it quickly, which is not what we want humans to be doing. So maybe it’s going to create a conversation about what we should be teaching and how we should use These tools to augment versus to replace.
Craig Joseph
I, someone wrote that, chat GPN. I don’t think this is an original thought. But I love to chat GPT is not going to replace physicians, chat GPT is going to replace physicians with physicians who use chat GPT. So again, it’s to your point, and I’m sure I didn’t say that as smoothly as it was written. It’s a tool. And if you’re not going to use the tool in an effective way, you are going to be replaced by people who will, and it will take the lift off of a lot of, of the work that you do, that doesn’t really bring a lot of benefit. And I agree it’s the same with the we’ve often said, Well, it’s often been said that that radiologists and pathologists who stare at images all day long, are on their way out. Because AI and other tools can find problems and identify them better than the human eye. I think that is it as a tool, it will probably help them to focus on the things that are really important and things that are obvious and don’t need specialized skill, those are going to be less, those are going to be you know, let the computer do that work. And same thing I you know, I don’t have any problem, especially with, you know, creativity, like, I want to write about something, I have this idea and have to have some tool that says hey, well, let’s, let’s start you off and give you some ideas and point you in some direction.
Nick van Terheyden
Yeah, no more writer’s block, right. I mean, that’s one of the things that even some of the most established brilliant writers of our time talk about, or at least I’ve heard them talk about the challenge of creating something I think the good news is, it will create content that you can potentially use. And you know, you could probably fob it off as your own content. I haven’t actually tried that yet. I was thinking about doing it. But I wasn’t really sure how to sort of approach it. But anyway, I think overall, very interesting. We’re definitely going to see more. It reminds me a lot in the speech world when Siri showed up. And every said, Oh, my God speech actually works. And you know, we’re really starting to use it. Even my wife uses it in the house. And that’s a pretty significant step in the technology direction. I’m sort of, although I was downstairs listening to her issuing commands that weren’t being followed. So I actually pulled up the app and made it happen. And she was completely unaware. But
Craig Joseph
anyway, wow. Like as
Nick van Terheyden
I was behind the curtain, but I was just I didn’t want to upset the progress, the technical progress I think we were making. Anyway, for those of you just joining, I’m Dr. Nick the incrementalist today. I’m talking to not chat GPT Dr. Craig Joseph, the Chief Medical Officer of Nordic consulting, we spent the first part of the program really diving into the potential for this AI this interactive element. And I think, you know, as Craig eloquently described, it is augmenting, not replacing and I think if you don’t use it, you’re going to struggle because you’ll feel left out. The calculator is one of those areas, I remember when the calculation, oh, no carp will all lose our math capabilities. And if you look at testing, as it was long time back to how it is now actually, I would have trouble with testing. Because everybody’s Elevate, you know, we’ve elevated and, you know, we perform better functional use of all of these tools. So leaving that behind us, let’s talk if we could briefly. I know we’re gonna Well, at least I’m going to be unpopular depends on what you say, but I’ll just be unpopular and say, I’m sorry, but COVID seems to be on the rise again. And just to be clear, it’s not just a regular condition. And I’ve seen it happen actually, you know, personally closely with a friend of mine, another physician who not only was fully vaccinated, but got it actually got it, you know, in one of the cycles, and then got it a second time and he’s been really really unwell, despite the fact that he’s had all his vaccinations and he’s got a dose of his own antibodies from having COVID We’re now seeing it again. I’m wearing a mask in certain situations. How about you?
Craig Joseph
Well, I’ve continued to wear a mask whenever I hit the front door of an airport and, and keep it on during much of the airplane ride but I haven’t started wearing masks in other places. And I think that might be because I don’t generally go where there’s huge crowds of people. You know, coughing on me, I might wear a mask there to decrease my chances of Getting any kind of respiratory disease. And, again, let’s emphasize decrease my chances. It doesn’t mean if I’m wearing a mask, even if it’s really good one, that I am not going to get anything, it just means that I’m decreasing my chances. And I think oftentimes that’s that that makes a lot of sense that we’re getting though I think, differing perspectives like dueling data, you know, the numbers of, you know, the different COVID strains, and the numbers of infection are going up. That is true. However, we’re seeing not significant increases, but even sometimes decreases in hospitalizations, and death. Right? And so, and it depends on what you’re looking at, and over what period of time and it changes from week to week, but we are not seeing hospitals filling up in the United States, at least, with patients with COVID. And so how do you? How do you kind of think about it when a you hear about people getting sick, who are fully vaccinated and have gotten their boosters and they’ve even had that in your that your friends case had the disease and still just got knocked on on his butt. And, and we always worry about long COVID still something we don’t really understand very well, why some people not even sure how many, but some people get it, and whether they’re vaccinated or not, whether they’re young or not. Some people seem to have problems for months and months and months. And we don’t know enough to be able to predict who that is, or I don’t think we have great treatments for it. We’re supporting them. But it’s, it’s scary, it is scary. But there’s not, the option is not really there to sit in your house anymore. I guess that’s always been an option. But it’s not one that I want to want to enter.
Nick van Terheyden
That’s not survivable for the human race. We’re very social animals, we need that interaction. I think one of the papers that I saw, I wish I could place my finger on the precise title and journal but actually looked at the virus presence in post mortems and discovered it in innumerable body systems. And by the way, still active, infective, not just, you know, residual pieces of it. And I think, you know, the reason I bring that up, because you raise rightly, this long COVID, I have a number of friends who’ve both suffered it and continue to suffer from it. So you know, not to be discounted as in their head, which, you know, sadly, I know, some people experiences some of the pushback, but, you know, it’s a significant problem. And it seems like this particular virus hangs out in a lot of different places. So if you’ve had it, it may still be hanging out. Now, Craig, feel free to answer this in, you know, your best Monty Python voice. But I’m going to ask you, are you a COVID? Virgin?
Craig Joseph
Oh, that’s a that’s a very sensitive question.
Nick van Terheyden
A very personal question. Are you doing all right?
Craig Joseph
I’m not going to do it when I’m on a on a on a show with a honest to goodness, X Brit? Who can do the accent better than me? That is a personal question. I will answer it though. I think so. That’s my answer. I think I’ll tell you this, my back when it was hard to get tests. I had some home tests. I had like one or two, my wife had a my minor mild cold that she was just well, it’s just a cold it couldn’t possibly anything else. So I said, Well, let’s let’s test and I had done many rapid strep tests as a pediatrician, but never a rapid COVID test. So I read the instructions very clearly, it said you have to do this and then put the Q tip in and put the liquid in and then wait 15 minutes and then read it. And I did all those things, except for the waiting 15 minutes because I watched the liquid move across the little screen. And before it even hit the control. It was positive. It was the blue as you can this was for her for her. And I had at the same time a post nasal what I would call like, a little post nasal drip. Right? I didn’t. I said I don’t want to waste a test on myself. Because Lauren, I didn’t know if I was so I think I did have it but I’ve never proven that I had it. That’s where I’m at. And what else are there any other personal questions?
Nick van Terheyden
That no no, I and you know, in fairness, having asked you I will say that I am clearly not and in fact, interestingly I this was later in the experience and it’s made me I’ve got to be honest, a little bit leery of going to, I saw I actually took and passed and became a professional contact tracer. So I did my own contact tracing when I got COVID That was proven out by the time Yes. And in fact, I had the same experience that your wife did. I didn’t need to wait, I watched my line. And it was, well, solid is anything and very quick. But it was from a restaurant. And, you know, there was nothing extraordinary. But of course to eat without protecting yourself is kind of difficult. And this was something of a challenge. So I’m absolutely not. But I do know, you know, based on that experience, and I had a number of really awful symptoms, you know, unrelated or in other body parts that I just, I would not have expected that seem to be all attributable to that, that I would say, gosh, you know, it, I definitely lay there. And one day, I never got out of bed, never wanting to have this again. So I’m definitely a bit leery and doing everything that I can, but it’s out there. So a couple of other things. So we’ve seen that a lot of layoffs going on. And you know, I love to talk about the technology. I don’t know if there’s this is the same in in healthcare, but a lot of layoffs. And you know, first of all, let me say I’m, I feel bad for anybody that’s been laid off at any point in time having been through that experience. That’s no fun for anyone. But you know, life is like a river. It keeps flowing past and good things will come down the track. But any thoughts about that for healthcare and where we’re going?
Craig Joseph
Yeah, well, it’s, it’s a little scary, from the tech standpoint, because it’s always been hiring, hiring, hiring. And when the pandemics first started, and everyone was at home and needed technology to facilitate staying at home, you know, you couldn’t be hired fast enough if you had some tech experience. And now, it seems like there’s a lot of companies are like, Yeah, we don’t need that many people. And so I think, for some, it’s a, it’s for sure, they’re kind of readjusting, and getting back to levels that are probably needed. I suspect and and it’s not an original thought that there might be some companies out there that are just like, this might be a good time to offer to decrease our, the number of our employees, our workforce, and not take any bad press because everyone’s doing it. So it’s not to be blamed. So I think there’s a little bit of that as well. You know, kind of just cut when you can, in terms of healthcare? Well, there are some hospitals that are that are cutting some people. But by and large, if you’ve got healthcare experience, it’s a it’s a pretty good time, you may not be working where you want or making the money that you want. But there’s work out there for for clinical folks, which is, which is good. And I think also that a lot of the people that are being laid off, not all for sure, but a lot of them are finding work and other tech jobs in a reasonable amount of time. So but I agree with you, it’s a horrible thing to happen. And, and it really feels badly when it’s happening to you.
Nick van Terheyden
Yeah, I good point you make there, I’ve seen that in other instances where it’s, Hey, this is an opportunity. What I did see in the news number of articles I read actually suggested that whilst there, you know, those are pretty substantial numbers for even those large organizations. But they’re actually still up on where they were prior to the pandemic. So it’s not as if this is a complete shrinkage. And gosh, things are, you know, it’s this big negative turnaround. I don’t think that’s the case. I, you know, in the healthcare space, obviously, the challenges that we’re seeing shortages of workers across, you know, different areas. I’m very troubled by the continued pounding that rural healthcare takes, and, you know, the struggle to attract and, you know, anytime that a rural healthcare facility is closed, or change to something lesser, that kills the community, or at least it seems, through in my experience, and, you know, we want to expand and, you know, increase that we have to find ways to sort of turn that around, that’s going to really deliver community as well as healthcare into these rural settings. And it’s not just about telehealth, and, you know, virtualization and, you know, refer to the big mothership, in my view, it needs to be creating something in that community. But anyway, as as we do each and every week. We’ve run out of time. So as usual, it just remains for me to Thank you Craig for putting up with my cheeky remarks and poor accent, and impersonations and accusing you of being Hey chat GPT Craig thanks as always for joining me today
Craig Joseph
hanging out and I’m asking Chet GPT to say something sarcastic let’s get another Alright fine it was a pleasure it was a pleasure
Nick van Terheyden
oh that was perfect Thanks Thanks Greg
