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Wednesday, May 10, 2023

Foundation Models are exciting, but they should not disrupt the foundations of caring

Morley, Jessica and Floridi, Luciano
(April 20, 2023).


The arrival of Foundation Models in general, and Large Language Models (LLMs) in particular, capable of ‘passing’ medical qualification exams at or above a human level, has sparked a new wave of ‘the chatbot will see you now’ hype. It is exciting to witness such impressive technological progress, and LLMs have the potential to benefit healthcare systems, providers, and patients. However, these benefits are unlikely to be realised by propagating the myth that, just because LLMs are sometimes capable of passing medical exams, they will ever be capable of supplanting any of the main diagnostic, prognostic, or treatment tasks of a human clinician. Contrary to popular discourse, LLMs are not necessarily more efficient, objective, or accurate than human healthcare providers. They are vulnerable to errors in underlying ‘training’ data and prone to ‘hallucinating’ false information rather than facts. Moreover, there are nuanced, qualitative, or less measurable reasons why it is prudent to be mindful of hyperbolic claims regarding the transformative power ofLLMs. Here we discuss these reasons, including contextualisation, empowerment, learned intermediaries, manipulation, and empathy. We conclude that overstating the current potential of LLMs does a disservice to the complexity of healthcare and the skills of healthcare practitioners and risks a ‘costly’ new AI winter. A balanced discussion recognising the potential benefits and limitations can help avoid this outcome.


The technical feats achieved by foundation models in the last five years, and especially in the last six months, are undeniably impressive. Also undeniable is the fact that most healthcare systems across the world are under considerable strain. It is right, therefore, to recognise and invest in the potentially transformative power of models such as Med-PaLM and ChatGPT – healthcare systems will almost certainly benefit.  However, overstating their current potential does a disservice to the complexity of healthcare and the skills required of healthcare practitioners. Not only does this ‘hype’ risk direct patient and societal harm, but it also risks re-creating the conditions of previous AI winters when investors and enthusiasts became discouraged by technological developments that over-promised and under-delivered. This could be the most harmful outcome of all, resulting in significant opportunity costs and missed chances to benefit transform healthcare and benefit patients in smaller, but more positively impactful, ways. A balanced approach recognising the potential benefits and limitations can help avoid this outcome.