Everyone worries about AI replacing doctors. After 24 hours in the hands of the NHS, I think they’re looking in the wrong direction.
GP, A&E, then other parts of the hospital. Every shift, a new doctor. Every new doctor, the same questions. The same story, retold from the top. Every single one of them then took a picture of my rash with their phone.
The first GP I saw actually had an AI assistant. It recorded our conversation and drafted a letter, which he printed on that grey recyclable paper the NHS uses for everything and which absolutely no one in the chain that followed ever read.
Meanwhile, I had Claude in my pocket. It knew my whole story from the first symptom. It could interpret the blood results before the doctor did, and flag a couple of things worth asking about. By the third doctor, I was essentially a transcription layer between Claude and the NHS.
My whole situation could have easily be baked into a Claude skill, easy to interpret by any LLM based diagnostic software.
I’m not going to argue AI should replace doctors. Mine were careful, kind, and correct. But AI replacing the patient? That part is ready now. The doctors get a well-organised history, an accurate timeline, current medications, no retelling. The patient gets to rest.
The hard part in medicine is context. The context of the whole field is enormous and probably beyond what current AI can carry reliably. But the context of one specific patient, with one specific problem, unfolding over a few days? That’s hard, but achievable with today’s tech. Mine was, all things considered, a relatively simple case. Cases at this level of complexity still make up the bulk of what the system handles every day.
Which brings me to the bigger point. The waste I watched from the inside over 24 hours was remarkable: the same story told six times, the same photo taken six times, the same pieces of information gathered again and again because no one had time to read what the previous shift had written. If we can shift even part of that burden onto the patient’s side, with the patient’s own AI carrying their story cleanly from one clinician to the next, it starts to look like a real contribution to the sustainability problem that every public health system is wrestling with.
And once we have that down, the Doc AI will get much better too.
Not today. Tomorrow for sure.
Are you OK?
Yes, everything is fine, thanks for asking. Just a rash that suddenly appeared and is already slowly disappearing.
This is an interesting idea. I’m a retired GP in Canada. I’ve worked in hospitals, small clinics in various settings for 40 years and followed some patients for more than 20 years. In the family medicine clinic, you get a natural retelling of stories and evolution of chronic disease over many visits over, literally, years. You get to know the person, their life situation, their values, as well as the medical condition.
Treatment for a broken leg or appendicitis, conditions often seen in urgent care/ER, is fairly straightforward. When it comes to serious and chronic illness and planning treatment, knowing the patient is just about as important as knowing the disease. Treating infertility in young couple or cancer in an elderly patient is much more complex and nuanced by personal values and life goals.
While Claude might organize the facts of the patient’s story well, I suspect it would miss the ‘essence of the person’ that is so important in many cases. On the positive side, perhaps it would free caregivers from collecting the same factual data over and over (and the patient reciting it). It could give them time to sit with the patient and discuss the issues, not just the ‘facts’ of the case. On the negative side, having the medical history available in a concise and organized way might have the caregiver sitting in front of a screen, reading the history and thinking, “This is so much faster! Why do I even need to talk to the patient face-to-face?”
In my career, I enjoyed ‘knowing the patient’ as much as ‘knowing the disease’. I think this combination or balance allowed me to treat patients better than if I had just listened to (or read) Claude. Let’s hope the ‘balance’ remains.
Thank you for your insights David. My grandfather was a doctor, I do understand the value of knowing your patient and investing the time necessary to achieve this. But in the pressure of a busy hospital (which is also a teaching hospital), with shifts changing, new people every few hours, incredible high flow of patients of all types, there’s simply no way to establish a relationship.
And while in my experience everybody in the NHS does an amazing job at showing care and empathy, I have the feeling that a lot of time and effort is spent collecting the same basic data which could be handled by AI. This might actually leave more time for meaningful and nuanced understanding which still requires human sensibility.
I agree. I don’t think I have ever seen a nurse, doctor or anyone else in a hospital or clinic who didn’t ‘care’. I did see some who cared more than others! Financial pressures to cut staff, have staff work faster, etc. make it harder to ‘care’ – in all the senses of that word.
Sadly, in my experience, the use of technology in health care, so far, has not been used to unburden staff but has actually given them more work to do. Some studies have shown docs spending more than 50% of their time in front of screens. Let’s hope AI (and other technology) can release staff from certain aspects of work and give them more time to provide the ‘person to person’ care that only people can provide.