In the context of the US medical system medical advice is highly regulated. Specifically this seems problematic:

> This is an open-source project with a mission to provide everyone their own private doctor.

Doctors are not just capable of passing the licensing exam, they’re also required to attend school, do a residency, and many other things. They are also personally liable.

Medical devices and software that provides some level of care also have extremely rigorous regulatory controls. Providing a medical service that non compliant is a crime.

>> Doctors are not just capable of passing the licensing exam, they’re also required to attend school, do a residency, and many other things. They are also personally liable.

>> Medical devices and software that provides some level of care also have extremely rigorous regulatory controls. Providing a medical service that non compliant is a crime.

The author is not starting a medical practice, they are showing a proof of concept -- without asking for money -- which is sharing knowledge and know-how in a desperately needed area where the world needs to progress. My guess is that billions of people around the world die early from lack of medical care.

This project will NOT solve that, but it will help nudge us in the long route to better, cheaper, and more accessible medical care in the long term.

Lets not knock someone down, this is a hacker forum, so lets hack and learn.

Yes but providing medical advice doesn’t require a business relationship, it requires providing medical advice and asserting some level of medical authority. I have no intention of tearing down anything. But they should be very careful in how they describe what they’re offering, even if - perhaps especially if - it’s a free proof of concept in the open. Opening yourself up to personal liability an standing in non compliance with medical regulatory requirements is just a bad idea.

All they need to do is rigorously disclaim their work. Your appeal to the dire need of the world for better medical technology doesn’t withstand the need for strong medical regulations - history is full of dangerous quackery, these rules exist for a very carefully considered reason, even if they can be frustrating, and even if they’re overly broad now and need reform.

The point isn’t they are doing something wrong, it’s that they need to be very careful of how they describe their stuff. I 1000% agree democratizing medical data and services via open platforms is laudable. But just don’t set yourself up for legal trouble in that pursuit.

Great point! Totally agree.

I also think -- in the spirit of learning -- most of the folks on HN would probably like to know more details about the fine-tuning cost, procedures, trade-offs, etc. as well as about evaluation frameworks.

I agree, I’m always interested in the fine tuning mechanics. Unfortunately most of the guides posted these days are selling a SaaS that simplifies the processes whereas I’m not interested in the glossed over process but the brutal details.

My grandfather was a relatively renowned medical researcher who eschewed funding to publish his research in the open. As a result he published a huge corpus of research across a vast array of medical topics, but those old papers aren’t indexed anywhere and without a corporate sponsor his work was largely forgotten. We compiled all his papers in his final years and bound them in a multi volume set. I plan to unbind them and have a company OCR them and so I can fine tune a model with them, and provide them and their references and citing papers in a vector db. I’m curious what of his mind I can recapture, as his every moment even in personal life he spoke about and like his language in papers. His only hobby outside research was shotput and trying to cure some beagle he rescued from a shelter that had some unknown chronic skin disease.

I’m busy at the moment but have been passingly following and reading papers on the LLM work happening in the open to prepare to do that side project. I’ve been kind of disappointed with the quality of guides out there and the rapid commercialization of the space.

Thank you for explaining

Highly regulated means 1. It is based in USA (USA in world economies and influence has drop to around 20% of the world). If I used it in Bahamas or even Ukraine, not a single AG in ENTIRE USA can do anything about it. 2. Had to go thru court and judge pass a judgement. Every court cases in USA can be grinded via a Jury. Every judges can be bribed or threatened (as shown during the 2020 elections). Assuming it passes that, you still have to go thru all the way to SC. And even that like Roe vs Roe, it still can get reverse. 3. AG needs to bring this case to court first. Same as #2. In fact go research how many very questionable AG deaths in USA in the last 5 years. 4. Just put a disclaimer EULA. And put it in a out of USA jurisdiction while on borderless Internet (sci-hub set a good precendence). 5. USA medical regulation today arent on par with vast majority westetnised world standard. Some ASEAN and Eastern Asia standard would make vast majority of FDA boardmembers look like quacks.

Tell me you're giving medical advice without telling me you're giving medical advice.

> an open-source project with a mission to provide everyone their own private doctor

Perfect.

Passing the USLME also doesn’t make you a doctor. There’s a reason why doctors have to go through residency. Hands-on training is a huge part of training.

Maybe where this tool COULD have use is medical education for everyday folks. Could be just me, but sometimes there’s medical jargon thrown around in my medical visits that my doctor and I don’t have time to go through. (Note: This is just in my experience of US-based healthcare, where most doctors are pushed by healthcare administration to see as many patients as possible because healthcare in the US is a business, and seeing more patients = $$$.) This could be a useful tool to have that jargon explained in layman’s terms.

This tool won’t replace doctors, but it could certainly be something that enhances the healthcare experience by being a part of patient education.

To be fair to the author—they state it can “pass the medical exam.” Which is different than if I should ask it for medical advice. I mean it can’t examine me physically therefore it can’t be my doctor.

On the other hand, there aren’t enough doctors where I live so I guess I’ll take it! Lol

I think this is the wording I have beef with: “DoctorGPT is a Large Language Model that can pass the US Medical Licensing Exam. This is an open-source project with a mission to provide everyone their own private doctor.” The “provide everyone their own private doctor” part definitely makes it sound like it can replace a doctor.

I’m just worried about the combination of medical misinformation and the people who don’t understand how LLMs work who will take everything a LLM spits out as truth. There are already a ton of examples in the news of people who really don’t understand how they work (like that one professor who failed an entire class because ChatGPT told him that all the papers that the class wrote were plagiarized.) We also just saw how much harm can be done with medical misinformation with COVID.

Maybe I’m just being pessimistic and paranoid, but god am I scared of how things could cause people to inadvertently harm themselves and the people around them.

You’re rightfully paranoid. LLMs are creative entities and there’s no repercussions for making up diseases. Like the chef one that recommended ingredients which combined yielding chlorine gas. Yummy.

Perhaps it knew that someone would die as a result and it did so intentionally. LLMs do have personalities and wit—and they know our human weaknesses.

> LLMs do have personalities and wit

im not sure how "choose the next most probable token" could be described this way

Ask any LLM to act like a dungeon master who gives you medical advice and there you go. It’s more than “choose the next token!”

Llama 2 has given me some personality with basic prompts

How is that giving medical advice? that's a mission statement.

If my mission statement is to provide everyone with a private lawyer, then is that giving lawful advice?

> How is that giving medical advice? that's a mission statement.

As a mission statement for a software project, it very clearly indicates an intent to have the software act as a doctor.

> If my mission statement is to provide everyone with a private lawyer, then is that giving lawful advice?

If you have a software project with that as your mission statement, then its a pretty good indication you are aiming at unlicensed practice of law (which involves “legal advice” but exactly not, despite “legal” and “lawful” in other circumstances being synonymous, “lawful advice”.)

Yes, "legal" was the word I was looking for!

> As a mission statement for a software project, it very clearly indicates an intent to have the software act as a doctor.

I do understand that interpretation. However, the mission statement seems vague enough since there are many ways to achieve that said mission statement. Not saying it's good as it currently is, but trying to understand how that mission statement equated to giving medical advice.

Let's say that intent is true, is the intent the same as actually providing the medical/legal advice in this case?

It’s called “DoctorGPT”. The mission in its mission statement is to, “to provide everyone their own private doctor”. What do people go to doctors for? Medical advice.