An Invisible "Primary Doctor"? ── The First Steps of AI Chatbots Transforming Medical Consultations, and Their Pros and Cons

1. Why "Medical Consultation × AI Chatbot" Now?

1-1. "Consultation Entry Points" Changed by the Pandemic

• Since the pandemic, the global trend has shifted from "going straight to the hospital" to "first doing an online self-check."

• Issues such as long waiting times, shortage of medical staff, and infection risks have become apparent.

• In this context,chatbots that provide advice on the necessity of medical visits and departments based on input symptomshave rapidly spread.coherentsolutions.com+1
  
  

In Japan, COVID-19 consultation bots by municipalities and private "symptom checkers" have already appeared, but overseas,

• emergency department triage

• daily health management for chronic disease patients

• insurance company inquiry desks

• simple mental health consultations

chatbots are entering various medical entry points.

1-2. Patient Needs: Fast, Easy, and Anonymous

Recent surveys and discussions highlight the following reasons why patients use AI chatbots:bloodcancerunited.org+1

• Available 24/7, even at night and on holidays

• Discuss embarrassing symptoms (sexual, mental, excretory, etc.)without showing your face and anonymously

• Translate medical jargon intoyour own words

• When unsure whether to see a doctor or wait, use as asecond opinion

Especially among younger generations, there is less resistance to "search first" or "chatbot first," and there is a suggestion that the position of the **"first consultation partner"** for medical information is shifting from search engines and social media to AI chatbots.pursuit.unimelb.edu.au+1

2. What Types of Medical AI Chatbots Are There?

Medical-related chatbots can be broadly categorized into the following types:JMIR+1

2-1. Symptom Checker and Triage

• Example: "Symptom Checker" like Ada Health

• Users select or input items like "cough," "fever," "chest pain."

• AI asks additional questions and suggests possible diseases and "urgency" and "recommended actions (wait, see a doctor, emergency, etc.)."

• In some emergency departments,there are attempts to use AI for online pre-visit questionnaires and triage.PubMed+1

2-2. Chronic Disease Support Bots

• For patients with diabetes, hypertension, heart disease, cancer, etc.
  
  

• By inputting daily blood sugar, blood pressure, weight, medication status, etc.,

  • "Your blood sugar is high today, so reduce carbohydrates at dinner."

  • "Your weight has been increasing recently, so let's review your exercise time."
    and other lifestyle advice are automatically returned.
    
    

• It is expected to fill the "gap" between doctor visits as a supporter.Yale School of Public Health+1

2-3. Mental Health and Counseling

• Bots for consulting on stress, anxiety, insomnia, depression, etc.

• Based on methods like cognitive behavioral therapy (CBT), it guides self-care in a conversational format.

• However,many serious risks have been reported in the mental health field, and experts have expressed strong concerns (discussed later).Stanford HAI+2The Guardian+2

2-4. "Health Consultation" Use of General Chatbots

• Cases where users ask health and medical questions to general-purpose large language models like ChatGPT

• Not specifically designed medical bots, but general-purpose AI being used as an "all-purpose medical consultation desk."

• Both accuracy and safetyvary greatly depending on the design, which is a problem.American Psychological Association+1

3. Benefits of AI Chatbots for Patients

3-1. A "Virtual Reception" Available 24/7 with No Waiting Time

• There are many situations where you want to ask something immediately, like a fever in the middle of the night or a child's injury on a holiday, but it's hard to call a hospital.

• With AI chatbots, you can get preliminary advice in minutes.

• Recent research has reported cases where AI showedhigh concordance with doctors and high sensitivity in preventing missed diagnoses of severe patients for emergency triage purposes.PubMed+1

However, this is at the level of being **"not perfect but promising as an auxiliary tool,"** and it has not been concluded as a "replacement for doctors."

3-2. Encouraging Medical Visits

• For patients wondering, "Is it okay to see a doctor for this level of symptoms?" messages from chatbots like

  • "Please visit the emergency department immediately."

  • "Consider visiting within a few hours."
    can help connect seriously ill people to medical care quickly.SpringerLink+1
    
    

• Conversely, in cases where it is reasonable to wait, it may reduce unnecessary emergency visits.

3-3. Lowering Language Barriers

• With multilingual chatbots,

  • foreign patients can consult on local medical systems and how to convey symptoms.

  • Explain difficult medical terms in everyday language.

• In Japan, as the number of inbound tourists and foreign residents increases, a new flow of **"first consult AI in your native language to organize content → interpreter app + doctor"** is becoming more realistic.JMIR+1

3-4. Benefits for Healthcare Providers

• By having AI handle some of the routine interactions likeinterviews, preliminary explanations, and lifestyle guidance, doctors and nurses can focus on more complex cases.

• By assisting with medical record keeping and document creation, AI can also helpreduce the burden of paperwork, as reported.IntuitionLabs+1

However, careful balance is required to ensure that "efficiency" does not compromise patient safety or the quality of human communication.

4. Unmissable Risks: Misinformation, Bias, and Mental Health

While there are significant benefits, serious risks of AI chatbots have also been pointed out.

4-1. Incorrect Medical Information and "Plausible Lies"

• Many chatbotslearn from vast amounts of text on the internet, which includes outdated and incorrect information. ##HTML_TAG_521