Re: How generative AI affects patient agency


Agreement: 
I Agree
Body: 

Dear Editor

Excellent piece with coverage of the full range of potential benefits and risks. It fails to address the need to get a second opinion from an independent source. I was diagnosed and treated for a time as having COPD. I was referred to a pulmonary specialist on the basis of a history of exposure very early in life to a chain smoking grandfather. I finally sought and received a referral to the Mayo Clinic in Rochester, Minnesota, where a team of experts decided that I didn’t have COPD. Rather, I was wolfing my food causing particles to enter my esophagus and lungs to produce COPD-mimicking symptoms. They assigned a trainer to teach me to properly chew food before swallowing and to drink water or other liquid to ensure safe passage of food into the GI tract. Last, one must understand that a referral to a specialist typically results in a diagnosis by the specialist of continuing treatment by said specialist—at least in the USA, where neoliberalism incentivizes health care organizations to add diagnoses and treatments in pursuit of profits.

No competing Interests: 
Yes
The following competing Interests: 
Electronic Publication Date: 
Tuesday, November 25, 2025 – 16:15
AI use: 
No, I have not used AI
Highwire Comment Subject: 
Workflow State: 
Released
Full Title: 

Re: How generative AI affects patient agency

Highwire Comment Response to: 
Check this box if you would like your letter to appear anonymously:: 
Last Name: 
Noble
First name and middle initial: 
John H Jr
Address: 
Georgetown, Texas, USA
Occupation: 
Emeritus Professor u
Affiliation: 
SUNY/Buffalo
BMJ: Additional Article Info: 
Rapid response



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