Locums CME #7: How Physicians are using AI Tool ChatGPT in their Practice, News Year’s Resolutions for Locums Providers, Fastest Growing Specialties & More

In This Issue:

  1. How ChatGPT is Changing the Way Physicians Think about Healthcare
  2. 6 Simple New Year’s Goals for Locums
  3. 6 New Year’s Resolutions for Locum Tenens Providers
  4. 23 New Year’s Resolutions for Locum Tenens Providers in 2023
  5. 15 Resolutions to Help Your Finances Flourish in 2023
  6. 10 Things to Know about the Physician Workforce
  7. 3 Wishes: The Changes Health Professionals Want
  8. Physician Wellness & Financial Literacy Hybrid Conference
  9. Socially Speaking: Posts from All Star, NALTO, LocumStory, LocumTenens.com, Hayes, Jackson and Coker, and CompHealth
  10. How ‘Bout This: AI Passes US Medical Licensing Exam

How ChatGPT is Changing the Way Physicians Think about Healthcare

(From KevinMD, 1/12/2023)

ChatGPT, or Chat Generative Pre-trained Transformer, is a type of artificial intelligence with the unremarkable ability to generate human-like text. The program is free to use during the “research preview” time.

ChatGPT, launched in November by artificial intelligence lab OpenAI, gained 1 million users within less than a week of being released. Keep in mind that this technology is currently in the beta-testing phase.

ChatGPT Limitations

It is important to note the limitations. The quality of the responses depends on the quality of the prompts the user enters in ChatGPT. The answers are not always correct. The answers are to be created to “feel correct to humans.” If the user does not know the area in question, then the answer might be incorrect, and the user may not be aware that it is incorrect.

There are limitations based on the data ChatGPT has trained with. If the data entered is biased, then the data expressed by GPT can be biased. In the example below, the “medicine data” in certain fields may be limited. As a result, GPT may not be able to answer.

Another limitation is the data is accurate until the year 2021. Any events after that GPT will not have in its database. Also, note that GPT does not use the internet.

Let’s evaluate the potential of this technology. It has the potential to revolutionize medicine and healthcare and has already been used in several applications.

Applications for AI

One example of how GPT can be used in medicine is the creation of virtual assistants for patients. These assistants can provide personalized recommendations and advice to patients based on their medical history, current symptoms, and other relevant factors. For example, a virtual assistant could suggest over-the-counter medications or home remedies for a patient experiencing a cold or flu – or provide information on managing a chronic condition such as diabetes.

These virtual assistants can be accessed through various platforms, such as websites, mobile apps, or even voice assistants like Amazon’s Alexa or Google Assistant. This can be especially useful for patients who live in rural areas or have difficulty accessing healthcare, since they can get personalized recommendations and advice without physically visiting a healthcare provider.

Another potential use of GPT in healthcare is creating personalized treatment plans for patients. A GPT-powered system could generate a customized treatment plan that considers the patient’s specific needs and preferences by analyzing a patient’s medical history, current symptoms, and other factors. This could be especially useful for patients with complex or rare conditions that require specialized care.

For example, a GPT system could recommend a specific combination of medications or therapies most likely to be effective for a particular patient based on their medical history and other factors. This could help reduce the risk of adverse reactions or other complications and ensure that patients receive the most appropriate care for their needs.

GPT could also help healthcare professionals with daily tasks, such as transcribing medical records or generating reports. By using GPT to automate these tasks, healthcare professionals could save time and focus on more important tasks, such as caring for patients.

This could also help reduce the risk of errors in medical records, which can have serious consequences for patients.

ChatGPT Challenges

One potential challenge with using GPT in healthcare is the need for accurate and up-to-date data. For GPT to provide reliable recommendations and treatment plans, it must have access to accurate and current medical information. This could be achieved by regularly updating the data that GPT uses, as well as ensuring that the data is sourced from reputable sources.

Additionally, it will be important to consider privacy and security concerns when using GPT in healthcare, as sensitive medical information will be involved. Measures such as encryption and data-storage security will be necessary to protect patient privacy and ensure medical data security.

How Physicians Are Using ChatGPT

Physicians are already using this technology. I have seen posts indicating some have used GPT to help them create physician order sets.

An example that went viral occurred on December 13, 2022, when Dr. Clifford Stermer posted on TikTok about using “ChatGPT to save time with insurance denials. Get you the care they need.” In the video, he asked ChatGPT to write a letter to United Health asking them to approve an Echocardiogram on a patient with systemic sclerosis, reference supporting scientific literature, and list the appropriate articles. 

Here is a sample letter Chat GPT created for Dr. Stermer:

Dear United Health,

I am writing to request approval for an echocardiogram for my patient with systemic sclerosis. Systemic sclerosis, also known as scleroderma, is a chronic autoimmune disorder that can lead to damage and dysfunction in various organs and tissues, including the heart. Studies have shown that individuals with systemic sclerosis are at increased risk for cardiovascular complications, including hypertension, pulmonary arterial hypertension, and myocardial fibrosis.

Echocardiography is a non-invasive imaging technique that uses sound waves to visualize the heart and assess its function. It is a valuable tool for monitoring and diagnosing cardiovascular abnormalities in individuals with systemic sclerosis.

Supporting scientific literature suggests that echocardiography should be routinely performed in individuals with systemic sclerosis to detect early cardiac involvement and guide appropriate management. In a review of the literature, Riemekasten et al. (2013) found that echocardiography was useful for identifying myocardial fibrosis, left ventricular dysfunction, and diastolic dysfunction in individuals with systemic sclerosis. Similarly, a study by Guevara et al. (2010) found that echocardiography was useful for identifying early cardiac involvement and predicting prognosis in individuals with systemic sclerosis.

I believe that an echocardiogram is necessary for the proper management of my patient with systemic sclerosis and request that it be approved by United Health. Thank you for your consideration.

Sincerely, [Your Name]

References:

Guevara JP, Park H, Therneau T, et al. (2010). Echocardiography and cardiac involvement in systemic sclerosis: a population-based study. Arthritis Care & Research, 62(6), 767-774.

Riemekasten G, Distler O, Rhyner C, et al. (2013). Cardiac involvement in systemic sclerosis: current concepts and future directions. Autoimmunity Reviews, 12(8), 924-933.

It is important to note that he later posted a video telling healthcare providers to check the references GPT yields. He notes that it is better to cite your own known reference to use with GPT.

How ChatGPT can Improve Healthcare

Overall, GPT has the potential to greatly improve the efficiency and effectiveness of healthcare by providing personalized recommendations and treatment plans to patients and helping healthcare professionals with their daily tasks.

While there are challenges to overcome, the use of GPT in healthcare holds great promise for the future.

Some possible future healthcare applications of GPT include using GPT-powered chatbots to provide mental health support to patients or using GPT to generate personalized exercise and nutrition plans based on their individual needs and goals.

GPT could also be used to help healthcare providers with tasks such as scheduling appointments or managing patient records, making the healthcare system more efficient and effective overall.

The potential for GPT in healthcare is vast, and it will be interesting to see how it is used in the coming years to improve patient care and the overall efficiency of the healthcare system

Harvey Castro is a physician, healthcare consultant, and serial entrepreneur with extensive experience in healthcare. He can be reached on his website, harveycastromd.info, Twitter @HarveycastroMD, Facebook, Instagram, and YouTube. He is the author of ChatGPT and Healthcare: The Key To New Future of Medicine and Success Reinvention.

All News Is Locums

(From The Vista Voice Blog, 12/1/2022)

A new year is a time for resolutions and new beginnings.

Among common New Year’s resolutions are finding a better job, spending more time with loved ones, paying down debt, helping others, and traveling more. Working locum tenens can offer you a way to achieve all of these.   

If you’re a doctor looking to do things differently in 2023, why not consider locum tenens? Or, if you’re already taking temporary assignments, why not work even more locums shifts this year?

Take a look at these six, easy-to-hit New Year’s goals for 2023, and let us know if they pique your interest..

1. Take More Trips

There’s no doubt about it: The world is a big place, and there’s a lot to see out there. If you’re looking for a way to get paid to travel the country (or even the world), practicing medicine as a locums physician is the way to go.

Agency consultants will work with you to figure out where you want to go, how long you can stay, and who (if anyone) you might want to bring along for the adventure.

Whether you’re looking for a short-term placement or a long-term assignment, they’ll do their best to find the perfect match for your skills and interests.

2. Make Educated Decisions

A career is a big commitment, and it can be challenging to know if you’re choosing the right path. Luckily, there’s a way to test out a few options before you commit to anything permanently. 

Locums work, or temporary positions, can give you a taste of different practice environments, locations, and specialties. 

This can be a great way to figure out what you like and don’t like and what career will suit you best. And if you want a particular position or area, you can often convert your locums position into a more permanent role.

3. Pad Your Income

The average medical school graduate has more than $200,000 ($203,062 in 2021, according to the Association of American Medical Colleges) in student loan debt.

While there is several ways to repay your loans, working as a locum tenens physician can be a great option.

Locum tenens physicians fill in for other doctors on vacation, out of town, or otherwise unavailable. As a result, they often have more schedule flexibility. And because locum clinicians are paid by the hour (without receiving employee benefits), they often make more money than their full-time counterparts.

Padding your income while working as a locum tenens physician can help you pay off your loans faster.

4. Gain New Experience

Working as a locum tenens provider is a great way to gain new experience. You’ll have the opportunity to work in various medical facilities, each with its unique culture and patient population.

This can be a great way to learn about different aspects of medical practice that you might not be exposed to otherwise. Working as a locum tenens provider can also give you a competitive edge in applying for jobs. Employers and residency programs often look favorably upon candidates who have stepped outside their comfort zones.

5. Balance Your Life

One of the best ways to combat feelings of exhaustion and burnout is to live a more balanced life. That means knowing your limits and taking it easy on yourself. You have a lot of responsibility on your shoulders, but with locum tenens work, you have the flexibility and freedom to control your schedule. You can choose when to take on extra shifts and when to cut back. So resolve to live a more balanced life this year. It’s good for you!

6. Give Back

As a physician, you can make a difference in people’s lives. This year consider using your skills to help those in underserved communities, like those living in rural America, who may not have adequate access to medical care. Not only will you make a positive impact on the lives of others, but you will also gain invaluable experience that you can use throughout your career.

(From All Star Healthcare Solutions, 1/4/2023)

What are your new year’s resolutions? Well, if you wish for more scheduling control, greater work/life integration, and unique work opportunities in 2023, we suggest considering the following five resolutions. Each one will help pave the way toward a successful locum tenens journey this year.

Resolution #1: Contact a Locum Tenens Agency

A locum tenens agency recruiter can tell you what to expect in working locum tenens assignments.

A recruiter can answer your questions, discuss available opportunities, and review your CV and work/location preferences. Also, can walk you through credentialing, licensing if applicable, travel arrangements, and what to expect with orientation at the facility. (S)he can help you complete paperwork to get started and should remain accessible throughout the contract, ready to answer questions or provide support if needed.

Resolution #2: Collect documentation

Preparing to accept a contract, especially your first locum tenens job, entails multiple steps like verifying your education, previous employment, licenses, board status, and other background details. Compiling the required documentation (hard copy as well as electronic) before applying for assignments helps get you to your assignment as seamlessly as possible.

Resolution #3: Take a “test drive”

Working locum tenens doesn’t have to be an ‘all-or-nothing’ proposition. Many physicians and advanced practitioners opt to work locum tenens assignments solely on weekends or during vacation breaks. Accepting a few short-term assignments can help you determine whether locum tenens practice is something you would like to pursue and, if so, whether you want to do it on a full- or part-time basis.

Resolution #4: Pack appropriately and travel efficiently

What you bring on a locum tenens assignment varies from what you might pack for a vacation. To make it easy, consider an expandable carry-on suitcase. Not only will it allow for more items, but it should fit into a plane’s overhead bins so you can skip right past baggage claim upon arrival for shorter contracts.

To get ready for each successive assignment, store a separate, fully stocked toiletries bag in your carry-on extra phone and device chargers or even a travel charging station.

Skip the long lines at general airport security check-ins for the faster PreCheck station by registering for a TSA PreCheck. A quality travel pillow or compression socks can also help minimize travel fatigue.

Resolution #5: Protect your privacy

Smartphones, Wi-Fi connections, and tablets or laptops add a level of convenience and connection while away from home on locum tenens jobs. However, they also present the potential for security breaches. Before heading out on your next assignment, invest in a portable virtual private network to build firewalls around your private electronic information.

Resolution #6: Remain flexible

As a locum tenens physician, nurse practitioner, physician assistant, or certified registered nurse anesthetist, you are walking into an established work environment. An open mind and willingness to adapt to the facility’s systems and processes will help you acclimate more quickly and establish rapport with your peers.

(From Cross Country Locums, 1/4/2023)

Ready for a fresh start? There’s nothing quite like flipping the calendar over to a new year to make a change! Here are 23 New Year’s resolutions to help you build a rewarding and exciting career as a locum tenens provider in 2023.

Maybe you’ve decided to make the leap to locums for the first time this year. Or perhaps you’ve already been living the locums lifestyle but want to revamp your approach and craft a long-term career plan. Whether new to locums or a seasoned veteran, these New Year’s resolutions can help you launch the next phase of your career.

2023 New Year’s Resolutions for Locum Tenens
  1. Decide whether you’d like to work close to home or travel nationwide.
  2. Think about the environment you’d prefer – inpatient, outpatient, private practice, rural health, telemedicine, government health, etc.
  3. Consider what schedule best suits your lifestyle – days, nights, weekdays, weekends, short stints or longer assignments.
  4. Think about where you want to stay – corporate housing, hotels, Airbnb, etc. – and how you’d prefer to travel.
  5. Talk with your family to decide whether you’ll bring them along and consider whether you will bring a pet.
  6. Research what it’s like to work as a locum tenens physician or advanced practitioner.
  7. Listen to podcasts to learn about the locums life.
  8. Pursue licensure in the states you want to work in or see if you are eligible through interstate licensure.
  9. Figure out how much you want to earn annually and work backward to determine how often you’ll need to work and how much time you can take off.
  10. If one of your goals is to maximize income, research hotspots in different locations, specialties and work environments that pay more.
  11. Build up your emergency funds – a cash reserve you can draw on if needed. A general rule for most Americans is to have savings to cover three to six months of living expenses.
  12. Make a plan to secure health, life and disability insurance.
  13. Visit IRS.gov to read about being self-employed. Learn what business-related deductions you can take and what forms you’ll need to file during the year.
  14. Consult an accountant to decide whether you want to structure yourself as a sole proprietor, limited liability corporation, independent contractor, etc.
  15. Research the states you will work in and whether/how you will pay state income tax.
  16. Prepare and gather your CV, licenses, DEA registrations, education, work history, malpractice history, references, etc.
  17. Ensure your social media presence is professional – avoid posting inappropriate content and friending/following patients.
  18. Research online to find a couple of locum tenens or healthcare staffing agencies to try out.
  19. Introduce yourself to a locum tenens recruiter to set up a discussion for a few months before you’d like to begin working.
  20. Be prepared to tell your recruiter about your interests and goals. If you’ve been working locums assignments but haven’t been satisfied, tell your recruiter, ask for another recruiter, or switch companies. You deserve to enjoy the people you work with and love what you do!
  21. Get excited about making new friends, building professional networks, and learning from colleagues on assignments.
  22. Set aside time to plan adventures during your off hours. Plan to visit parks and natural areas, check out restaurants and nightlife, and get to know the communities in the places you visit.
  23. Carefully consider each step of your locum tenens career. Use each assignment to build upon the next. You can always just go where the locums road takes you, but imagine the possibilities if you put some thought into crafting your journey.

(From Physician on Fire, updated for 2023)

Now three years into the COVID-19 pandemic, most workplaces have settled into a “new normal” that may include some work from home. While you might not be able to do your professional job from home, you can take on the job of improving your personal finances from the comfort of your lounge chair or home office.

Choosing at least one of the following 15 ideas below will put you in a better financial position by this time next year.

#1. Calculate Your Net Worth

This is a great place to start. If you want to set financial goals for yourself, it helps to know where you are first. It’s not a complicated equation. You add up your assets, subtract your liabilities, and the result is your net worth.

#2. Track Your Portfolio

Again, we just want to determine where we are. What do we own? In which accounts? How are these investments performing?

#3. Track Your Spending & Consider a Budget

Once again, if you want to know how you’re financially, you need to keep track. Since spending is a crucial component of your savings rate and your journey toward financial independence, it’s important to know how much you spend monthly and yearly.

If you consistently spend more than you want to or more than you’ve planned, a budget might help get you on track. (“You Need a Budget” is a popular budgeting and forecasting tool that many people swear by.) If you haven’t before, start tracking your spending in 2023!

#4. Write an Investor Policy Statement (IPS)

It sounds complicated, but this is something you should be able to complete fairly quickly. It can be as simple as you’d like it to be: Start with a desired asset allocation. List the accounts you’ll invest in. And build it out from there.

#5. Increase Your Savings Rate

When physicians ask how much they should save annually, I recommend trying to live on half their take-home pay. In other words, save and invest as much as you spend.

The White Coat Investor recommends a savings rate of 20% of your gross income, which works out to about a 30% to 35% net savings rate for most of us.

Tracking spending helps you identify waste. At the same time, look for ways to increase your income (like working locum tenens assignments on the side). Doing this allows you to go from broke to financially independent in about 15 years, depending on market conditions.

#6. Max Out All Available Tax-Advantaged Accounts

If you haven’t done this before, perhaps 2023 is the year to take full advantage of the current and future tax savings that can result from contributing the maximum to every tax-advantaged account available to you.

Maximum contributions rise with inflation, and we’ve seen a lot of that lately, so you’ll be able to contribute more than ever in 2023.

#7. Understand Your Taxes (and what you can do to lower them)

Do you understand the difference between effective and marginal tax rates? Have you looked over your 1040 line-by-line? Do you understand Section 199A’s 20% deduction for qualified business income?

When you understand how your taxes are calculated, you’ll be better equipped to pay less.

#8. Optimize Debt Paydown Plans

If you’ve got debt, make plans to pay down that debt sensibly. Debt-free is the best way to be, and you should pay down the highest-interest debt first (usually credit card debt). 

The interest on student loan debt can be moderately high, and the balances are often well into the six figures. 

Consumer Debt–like loans for cars, motorcycles, boats or RVs–should be postponed until you can afford to pay cash, in my opinion. However, if you take on this type of debt, ensure it’s low-interest and always pay on time.

Mortgage Debt isn’t as ‘valuable”’ as it once was. With the increased standard deduction as of 2018, only about 10% of Americans will reduce their taxes based on itemized deductions, including mortgage interest. Instead of, or in addition to, itemizing, pay down the principal faster by paying extra each month.

#9. Earn Easy Travel Rewards.

There are a number of websites and forums devoted entirely to the world of credit card travel rewards. The amount of information can lead to analysis paralysis.

However, the Pareto principle definitely applies here. You can get at least 80% of the results with 20% of the effort. To learn more about earning and redeeming rewards, visit my guide to Credit Cards for People Who Love Free Travel and Money.

#10. Read a Personal Finance Book (or Five).

A common mid-career sentiment about money management is, “I don’t know where to start.” I’ve written a two-part Investing Basics series, which is a decent brief overview, but you really need a good book.

The best book available today for med students, residents, and early-career physicians is The White Coat Investor. The book is well-organized, and you can read it in a few short hours.

#11. Join a Q&A Forum.

I’ve learned a ton from reading threads on various online forums and, more recently, Facebook groups. I strongly recommend checking these out:

  • Physicians on FIRE Facebook group (Physicians only)
  • fatFIRE Facebook group
  • Dentists on FIRE Facebook group (Dentists only)
  • Passive Income Docs Facebook group (Physicians-only)
  • White Coat Investors Facebook group
  • Bogleheads Forum
  • White Coat Investor Forum
#12. Complete a Legacy Binder

When a death occurs (particularly when it’s unexpected), sorting out the finances can be a monumental challenge. Sadly, this was the reality for many unprepared Americans in 2020.

A legacy binder, or “In-Case-of-Emergency” Binder, will not only contain information on insurance policies and brokerage and retirement accounts, but also on how to access them, who to call, and where to find important documents. Usernames and passwords for emails, social media accounts, and more are a part of this.

#13. Make Your First Real Estate Investment

Crowd funded real estate platforms have made it easier for people like you and me to access commercial real estate and other investments.

Those who qualify as accredited investors (those with a net worth of $1M, excluding primary home, or an income of $200,000/individual or $300,000/couple) have the most options, but there are options for everyone regardless. Examples include eREITs from FundriseDiversyfund, and RealtyMogul, in each of which you can invest without being accredited.

#14.  Shift to an Abundance Mindset with Charitable Giving

Since the pandemic started, more people than usual have worried about how they would eat and pay their utility bills. It hasn’t been a normal time; many small businesses and individuals have suffered.

People with “scarcity mindsets” see a limited amount of money and want to keep as much of it as possible. You want the biggest pie slice, or better yet, the whole pie. Transitioning to an “abundance mindset,” helps you realize that as the pie grows, so does your slice.

Do put on your own oxygen mask first, but once you’re breathing easy, see what you can do to help others around you.

#15. Start Your First Side Hustle

I still think of side gigs as optional, but in a world where physician jobs and incomes are less stable than ever, some consider creating additional income streams mandatory, even for doctors and other high-income professionals.

There are good reasons for doctors to have side hustles, and there’s no time like the present to start yours! You can stick with what you know, picking up additional work as a locum tenens physician to get started.

Learn about other ideas for creating additional income streams by reviewing my suggested New Year’s financial resolutions in their entirety.

The Healthcare Staffing Story

(From Becker’s ASC Review, 1/20/2023)

The Association of American Medical Colleges laid out physician demographics in its “2022 Physician Specialty Data Report.”

The report is based on data from the American Medical Association, the US Census Bureau, and a national resident database and tracking system. Overall, the AAMC report covers about 950,000 physicians and physicians in training among 48 of the largest specialties in 2021.

1. The specialties that saw the highest five-year-jump in number of active physicians: 
  • Sports medicine — 42.5 percent
  • Pediatric anesthesiology — 37.7 percent
  • Interventional cardiology — 32.6 percent
  • Critical care medicine — 30.1 percent
  • Sports medicine (orthopedic surgery) — 26 percent
2.  The specialties with the largest numbers of active physicians:
  • Primary care specialties of internal medicine — 120,342
  • Family medicine and general practice — 118,641
  • Pediatrics — 60,305
3. Practicing physicians identified as the following races and ethnicities:
  • White — 63.9 percent
  • Asian — 20.6 percent
  • Hispanic — 6.9 percent
  • Black — 5.7 percent
  • Multiple races —1.3 percent
  • Other — 1.1 percent
  • American Indian or Alaska Native — 0.3 percent
  • Native Hawaiian or other Pacific Islander — 0.1 percent
4. Percentage of practicing physicians who are women since 2007:
  • 2007 — 28.3 percent
  • 2010 — 30.4 percent
  • 2013 — 32.6 percent
  • 2015 — 34.0 percent
  • 2017 — 35.2 percent
  • 2019 — 36.3 percent
  • 2021 — 37.1 percent
5. Specialties with the highest percentages of physicians older than 55:
  • Pulmonary disease — 92.4 percent
  • Preventive medicine — 71.4 percent
  • Anatomic/clinical pathology — 70.9 percent
  • Cardiovascular disease — 64.9 percent
  • Thoracic surgery — 62.7 percent
6. Specialties with the highest percentages of physicians younger than 55:
  • Sports medicine — 91 percent
  • Pediatric anesthesiology — 89.4 percent
  • Interventional cardiology — 83.9 percent
  • Internal medicine/pediatrics — 83.3 percent
  • Sports medicine (orthopedic surgery) — 79.3 percent
7. Specialties with the highest numbers of first-year residents and fellows:
  • Internal medicine — 11,257
  • Family medicine/general practice — 4,856
  • Pediatrics: 3,143
  • Emergency medicine — 2,820
  • OB-GYN: 1,483
8. Percentages of women in the 48 top specialties:
  • Ranged from a high of 65 percent in pediatrics to a low of 5.9 percent in orthopedic surgery.
9. The specialties with the highest percentages of active physicians practicing in the same state where they trained:
  • Child and adolescent psychiatry — 57 percent
  • Family medicine/general practice — 56 percent
  • Psychiatry — 55.5 percent
10. In 2021, 47.3 percent of residents and fellows were female. 
  • Percentages of women in the 48 top specialties ranged from a high of 86.4 percent in OB-GYN residencies to a low of 10.7 percent in sports medicine (orthopedic surgery) residencies.

(From Medscape.com, 1/18/2023)

As physicians know, magic wands don’t exist. If they did, every patient would recover in the exam room, prior authorization wouldn’t exist, and continuing medical education credits would be printed on bearer bonds.

But in the spirit of suspended disbelief, we asked physicians and other contributors what their three wishes would be for their patients, practice/hospital, and health systems. Because, hey — we all need to dream.

Capping off this collection of clinicians’ dreams were the wishes of Locumpedia colleague and friend Dr. Andrew Wilner, podcast host and producer for “The Art of Medicine with Dr. Andrew Wilner” and author of The Locum Life: A Physician’s Guide to Locum Tenens:

Let’s put patients first! Too many extraneous considerations other than the patient’s best interest obstruct optimal patient care.

Here are just a few examples of patients coming last instead of first.

If a patient needs to start a new medication in the hospital, we shouldn’t have to wait until the patient is an outpatient because “that’s when insurance will pay.”

If there’s a new medication that’s better than the old medication, we shouldn’t be forced to choose the old medication and provide inferior care because “that’s when insurance will pay.”

If patients need to stay in the hospital, we shouldn’t be pressured to discharge them because the hospital has decided that decreasing ‘length of stay’ is its highest priority.

Dr. Francis Peabody said it best in 1927: “The secret of the care of the patient is in caring for the patient.” How hard is that?

In 2023, why don’t we follow Dr. Peabody’s sage advice from nearly 100 years ago and see what happens?

Tools to Try/News to Use

The Physician Wellness & Financial Literacy Conference is for professionals who want to…

  • Increase their financial knowledge.
  • Improve their well-being.
  • Network with like-minded professionals.

To encourage you to invest in your future, here’s $200 off your in-person ticket to WCICON23 (use code: WCICON200).

In-Person & Virtual Registration Now Open

Socially Speaking

From LinkedIn

From Twitter

From Instagram

How ‘Bout This?

Two papers show that large language models can pass the USMLE

(From MedPage Today, 1/19/2023)

Two artificial intelligence (AI) programs — including ChatGPT — have passed the US Medical Licensing Examination (USMLE), according to two recent papers.

The papers highlighted different approaches to using large language models to take the USMLE, which is comprised of three exams: Step 1, Step 2 CK, and Step 3.

ChatGPT is an artificial intelligence (AI) search tool that mimics long-form writing based on prompts from human users. It was developed by OpenAI and became popular after several social media posts showed potential uses for the tool in clinical practice, often with mixed results.

The first paper, published on medRx in December, investigated ChatGPT’s performance on the USMLE without any special training or reinforcement prior to the exams. According to Victor Tseng, MD, of Ansible Health in Mountain View, California, and colleagues, the results showed “new and surprising evidence” that this AI tool was up to the challenge.

Tseng and the team noted that ChatGPT could perform at >50% accuracy across all of the exams and even achieved 60% in most of their analyses. While the USMLE passing threshold does vary between years, the authors said that passing is approximately 60% most years.

The second paper, published on arXiv also in December, evaluated the performance of another large language model, Flan-PaLM, on the USMLE. The key difference between the two models was that this model was heavily modified to prepare for the exams, using a collection of medical question-answering databases called the MultiMedQA, explained Vivek Natarajan, an AI researcher, and colleagues.

Flan-PaLM achieved 67.6% accuracy in answering the USMLE questions, about 17 percentage points higher than the previous best performance conducted using PubMed GPT.

Natarajan and team concluded that large language models “present a significant opportunity to rethink the development of medical AI and make it easier, safer, and more equitable to use.”

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