Why do people turn to chatbots when seeking medical advice? Is it due to cost, out-of-hours access or simply wanting to feel heard? Christian, Tomás and Grace discuss why patients and clinicians are increasingly using Large Language Models (LLMs) in medical contexts and what that means for the American healthcare system.

The doctors examine how certain attributes of LLMs such as sycophancy and engagement incentives can amplify anxiety, delusions or unrealistic expectations. The lack of accountability by big tech can also undermine trust for patients and healthcare practitioners alike. They raise concerns about training data quality (medical journals mixed with sources like Reddit) and the need for citations, transparency and regulation comparable to healthcare quality oversight. They also ask ChatGPT what it thinks about guardrails and risk controls!

This conversation is spurred on by two New York Times articles (What OpenAI Did When ChatGPT Users Lost Touch With Reality; Empathetic, Available, Cheap: When A.I. Offers What Doctors Don’t).

If you or someone you know needs help, in the US, you can call or text the National Suicide Prevention Lifeline on 988, chat on 988lifeline.org, or text HOME to 741741 to connect with a crisis counselor. If you’re listening in another part of the world, international helplines can be found at befrienders.org.

The episode was recorded remotely in November 2025. Presented by Christian, Tomás and Grace. Music by Nylonia. Produced by Ilia Rogatchevski.

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In this episode of Doctor Friends, emergency physicians Rosny, Christian, Tomás and Grace are joined by Dr. Taylor Nichols, MD – an addiction medicine specialist. The discussion covers substance use disorders and the concept of harm reduction. Taylor shares insights into the impact of drug use on medical practice, his experiences in emergency medicine and the importance of approaching substance use with empathy and evidence-based practices. The doctors also unpack some of the stigma around harm reduction and propose policy-level solutions like overdose prevention sites and medically-assisted treatment.

This episode was recorded remotely in January 2026. Presented by Rosny, Christian, Tomás, and Grace. Music by Nylonia. Produced by Ilia Rogatchevski.

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Follow Taylor on TikTok @tnicholsmd and make sure to check out his podcast Recovery Reform, which is available on your favourite podcast app and YouTube.

Substance abuse and mental health services administration SAMHSA’s National Helpline is a free, confidential, 24/7, 365-day-a-year treatment referral and information service (in English and Spanish) for individuals and families facing mental and/or substance use disorders.

Safespot Hotline: 1-800-662-HELP (4357)

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In this festive season finale, emergency physicians Grace, Christian, Tomás, and Rosny review the highs and lows of 2025 and share their “hot cakes” for the coming year.

The doctors reflect on personal milestones alongside how the wider challenges of American healthcare impact their work. The episode also features their producer Ilia for a new segment, Asking for a Friend, answering listener questions about their close friendships and unique experiences of working in the emergency department during the holidays. Lastly, they predict trends for 2026, including the positive use of AI in medicine and the critical role that immigrants play in providing healthcare.

This episode was recorded remotely in December 2025. Presented by Grace, Christian, Tomás and Rosny. Music by Nylonia. Produced by Ilia Rogatchevski.

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