A father is worried about his toddler, who has been running a fever for two days and pulling at one ear. A 65-year-old woman has been getting winded on her morning walks and feeling more fatigued than usual. Both reach for their phones and type their symptoms into an AI chatbot.
“Your child likely has an ear infection,” the father learns. “Your symptoms could indicate a cardiac condition,” the woman reads. Those are helpful answers – and there’s a good chance they’re correct. Artificial intelligence is approaching, and in some cases exceeding, doctors’ ability to make accurate diagnoses.
An April 2026 study found OpenAI’s o1 model had a 78% accuracy rate on complex diagnostic cases published in the New England Journal of Medicine and also outperformed experienced doctors when diagnosing actual emergency room patients. Similarly, ChatGPT, working on its own, outperformed physicians in diagnosing complex cases, a 2024 study found.
Making a correct diagnosis, though, is only half a doctor’s job. The other half is knowing what to do about it – in other words, deciding how to manage a patient’s health condition.
Diagnosis categorizes, but management prioritizes
Experienced doctors do not assess each patient from scratch. Over years of practice, they build mental shortcuts called illness scripts. Illness scripts are more than symptom checklists. They capture what a disease typically looks like, who tends to get it and how it most often progresses. When a doctor sees a new patient, they match what they observe against these mental scripts – a process of categorization and pattern recognition.
It’s not surprising that AI is good at this pattern-matching process. Large language models like ChatGPT work in a similar way. They predict what word should come next in a sentence based on patterns learned from enormous amounts of text, including the medical literature.
But deciding what to do next – what tests to run, what treatments to try, what to monitor and what to follow up on – works differently. Instead of one right answer, a doctor faces multiple reasonable options. The art of medical management is prioritizing which among these options is best for the patient in front of you.
The human advantage
Consider two men, Marcus and Tomás, both 68, both just diagnosed with early-stage prostate cancer. Their biopsies show the same thing: a slow-growing tumor confined to the prostate. Both are offered the same two management options. Treat now, with surgery or radiation, accepting the risks of urinary incontinence and changes to sexual function. Or monitor closely with regular tests and biopsies, treating only if it grows.
AI can present both options alongside those statistics. What a doctor brings is knowledge of the person sitting across from them.
Marcus has no other significant health conditions. His doctor knows this, and knows Marcus well enough to know that uncertainty sits badly with him. Both management paths are genuinely reasonable, but Marcus cannot live with waiting. He chooses treatment.
Tomás has advanced heart failure, something his doctor has been managing alongside him for years. She knows that his heart condition poses a more immediate threat to his health than this slow-growing tumor does. She knows, too, that he watched a friend go through radiation and come out diminished. She recommends active surveillance. For Tomás, it is the right answer and a relief.
Judging risk and uncertainty
To decide how to manage a patient’s condition, a doctor first considers evidence from the medical literature and then applies the available management options to the patient’s particular circumstances. This requires honest communication, shared decision-making, jointly navigating risk and acknowledging uncertainty.
AI does not know what you have been through or what risk trade-offs you are willing to accept. It cannot acknowledge uncertainty the way a good doctor can, returning to it with you as your circumstances change.
The father of the feverish toddler probably got a useful answer: AI has seen enough feverish toddlers in the medical literature to make a reasonable call. But knowing what to do next, including when to stop watching and start worrying, is a conversation best had with your doctor.
This article is republished from The Conversation under a Creative Commons Attribution-NoDerivatives 4.0 International License.