ChatG[PT]: Why your AI physical therapist can’t get you 100% better

I know, I know, another article about AI. I’m sure I’m not the only one a little tired of hearing about AI, but the reality is that it’s here and people are using it. I also don’t blame patients for listing their symptoms in an AI tool before coming to physical therapy to help determine what may be going on with their bodies and develop their expectations for treatment. I have done this for various healthcare concerns of my own and AI tools can be quite helpful.

The important thing to remember is that it should be viewed as just that – a tool. In my experiences using it, it asks great questions! It helps develop a really beautiful subjective evaluation based on what information you provide. But we can’t stop there. As clinicians, we start creating a hypothesis from a patient’s subjective evaluation and often have to pivot entirely after an objective evaluation. 

Key Points:

1. AI tools are only capable of diagnosing based on the information that they’re given. If it doesn’t ask you the right questions, it won’t give you the right diagnosis.

2. AI can’t watch all of your movements and can’t feel for tenderness or joint restriction which may be important clues as to why your pain is happening in the first place.

3. AI can’t do manual therapy treatments to help you move better and facilitate healing.

4. If you’re not a “textbook case,” AI will have a hard time determining an appropriate diagnosis and treatment plan.

5. If your AI PT treatment plan didn’t work, you may have now waited a lot longer to go in to see your human PT, which can make the issue a little harder to treat. Chronic issues can take longer to unravel especially when compensatory patterns have had more time to set in.

Read on for a deeper dive into why your human PT is more thorough than your AI PT.

What is a subjective evaluation?

This is the initial phase of the evaluation in which the patient shares their story and explains what they are feeling in their body. It’s a time for the clinician to ask detailed questions about what caused the injury, how it’s changed over time, pain patterns throughout the day, identify things that make it feel better or worse, and determine how the injury is impacting the patient’s life. We also ask other questions about injury history and health status that help us consider what treatments may or may not be appropriate, recovery timelines, and other special considerations. 

AI tools know a lot of the important questions to ask, especially questions specific to the current problem and particularly questions that would identify red flags that may indicate a visit to the emergency room. Some limitations here are that as the patient, it can be hard to explain a problem clearly without a thorough understanding of anatomy or medical terminology and it can be hard to know what details are important to share, especially if it seems unrelated to the injury. For example, ChatGPT may simply ask if you have any underlying medical conditions as a way to help diagnose or treat your pain, but won’t ask all the other questions about injury history, stress, sleep, fueling, menstrual status, etc. that we as clinicians use as important pieces of one’s entire clinical puzzle. AI may be able to tailor a better response if you prompt it with that information, but how do you know what information is important to provide? Good thing your human PT knows!

What is an objective evaluation?

After establishing a clear subjective history, we then expand your clinical picture by taking a look at how you move, your range of motion, how strong you are, and how your joints and muscles feel. Yes, there are AI running gait analysis tools out there that can watch how you move, and I’m sure there are ways that AI can analyze your squat form as well. However, your PT can watch you do those things as well as MANY more movements in a relatively short period of time and gain a great understanding of how your movement patterns are contributing to your pain. It would take quite a while to capture and upload a bunch of videos of yourself doing various exercises such as calf raises and single leg squats for your AI PT to get a decent idea of where your strengths and weaknesses lie. And unfortunately Claude cannot reach through your screen and palpate your calf to assess for pain or increased muscle tone. (I am imagining a little robot arm extending through my laptop screen to poke my calf… creepy! Perhaps it’s a good thing we’re not there yet.) The bottom line is there is a lot more to the evaluation of your condition besides asking the questions in a subjective history. If AI can’t access all the data, it won’t be able to provide the best output.

What about treatment?

This is where your human PT shines and your AI PT falls short. Your AI tool will make guesses and assumptions about you based on common causes of injuries to determine a treatment plan. As Kacy wrote in her blog on fancy gait analysis tools, “[T]he key word here is ‘generic’.” If you want a treatment plan based on your unique needs, you’ll need the help of your human PT at this stage in the game.

Even if the AI diagnosis is correct, when it comes to treatment options, AI is limited. Again, there are no robot arms coming out of the computer screen to perform soft tissue mobilization, dry needling, joint mobilizations, or other manual therapy interventions that can help you feel better and help facilitate recovery. Additionally, it would be time consuming to have ChatGPT watch you perform all the exercises that it suggests as part of your treatment plan to determine if it’s appropriate for you, if you are performing it correctly, and if it’s challenging enough. 

At Precision Performance and Physical Therapy, we want to help you feel your best so you can get back to the things you love and we have the tools and experience to get you there faster than your AI PT. 

Hopefully ChatGPT doesn’t hold this one against me. 

With Love from Your Human PT,

Dr. Perrin Clavijo, PT, DPT

Precision Performance & Physical Therapy in Atlanta and Serenbe