If I had to select one game changer in urology over the past 12 months, clearly it would be using artificial intelligence (AI) and ChatGPT (for generative pertaining transformer) for managing both clinical and nonclinical aspects of a urological practice. This article discusses 4 potential applications of ChatGPT for urology and how this novel technology can improve the efficiency and productivity a urological practice.

First you must register at https://openai.com. Because of limited space, I will only describe what I entered in the Chat box and a few paragraphs of each response.

1. Enter in the Chat box, “Write a job description for a medical assistant in a urology practice.”

   Forty-five seconds later, the following response was received on my computer:

   Job Title: Medical Assistant (Urology)

   Job Summary: We are seeking a skilled Medical Assistant to join our urology practice. In this role, you will work closely with our team of healthcare professionals to provide exceptional patient care and support. Your primary responsibilities will include assisting with patient intake, performing routine clinical tasks, and maintaining accurate medical records.

   Key Responsibilities:

   • Greet patients and escort them to exam rooms.
   • Take vital signs, review medical history and reason for visit with patient.
   • Assist physician during examinations and procedures.
   • Perform routine clinical tasks such as urine tests, blood draws, and specimen collections.
   • Administer medications as directed by physician.
   • Clean and sterilize medical equipment.
   • Maintain accurate and up-to-date medical records.
   • Coordinate patient referrals and follow-up appointments.
   • Provide patients with education and resources related to their condition.
   • Participate in team meetings and assist with administrative tasks as needed.

2. To request a handout on frequently asked questions (FAQs) for PSA screening, enter in the Chat box, “Provide the FAQs on PSA screening.” Here are the responses from ChatGPT:
   1. What is a PSA test? A PSA test is a blood test that measures the level of prostate-specific antigen (PSA) in the blood. PSA is a protein produced by the prostate gland, and high levels of PSA can indicate the presence of prostate cancer.
   2. When should I get a PSA test? The American Cancer Society recommends that men discuss the benefits and risks of PSA screening with their doctor starting at age 50 for men at average risk of prostate cancer. Men at higher risk, such as African American men or men with a family history of prostate cancer, may want to consider getting screened earlier.
   3. Is a high PSA level always an indication of prostate cancer? No, a high PSA level does not always mean that a man has prostate cancer. Other factors, such as an enlarged prostate or an infection, can also cause PSA levels to rise.
   4. What happens if my PSA level is high? If your PSA level is high, your doctor may recommend further testing, such as a biopsy, to determine whether you have prostate cancer.

Enter in Chat box, “Write a blog on the importance of nutrition in urologic diseases.”

Nutrition is an important part of managing urologic diseases, including conditions that affect the kidneys, bladder, and prostate. Making dietary changes can help to improve your overall health and manage symptoms associated with urologic diseases. Here are some tips on nutrition for urologic diseases:

Kidney Disease:

If you have kidney disease, it’s important to limit your intake of sodium, potassium, and phosphorus. Sodium can increase blood pressure and lead to fluid retention, while potassium and phosphorus can accumulate in the body and cause complications. To limit these minerals, you should:

• Avoid processed and packaged foods, which often contain high amounts of sodium, potassium, and phosphorus.
• Choose fresh fruits and vegetables that are lower in potassium, such as apples, berries, and green beans.
• Limit dairy products, which are high in phosphorus.
• Use herbs and spices to flavor your food instead of salt.

Bladder Disease:

Bladder conditions such as interstitial cystitis (IC) can cause discomfort and pain. Certain foods and drinks can aggravate symptoms and should be avoided, such as:

• Acidic foods and drinks like citrus fruits, tomatoes, and coffee
• Spicy foods like hot peppers and chili powder
• Carbonated drinks and alcohol
• Artificial sweeteners

1. Creating a letter to the insurance company to obtain authorization for multiparametric MRI:

   Enter in the Chat box, “Write a letter to UnitedHealthcare regarding patient John Doe (membership ID XXXXXXXX, Birthdate XX/XX/XXXX) who has an elevated PSA level, 8.3 ng/ml, a free/total PSA ratio of 19% (normal is greater than 25%). I am requesting a multiparametric MRI and a prostate biopsy to complete his evaluation for prostate cancer. Please provide recent references regarding the appropriateness of this procedure. Signed Dr. Neil Baum, with carbon copy (c.c.) to John Doe.”

   The following letter was generated in less than 45 seconds, and another 60 seconds was required for the nurse or the medical assistant to add the patient’s name and identification number.

Dear UnitedHealthcare,

I am writing to request approval for a multiparametric MRI and prostate biopsy for patient <John Doe>, who holds a membership ID of XXXXXXXX and was born on XX/XX/XXXX. Upon examination, Mr. <Doe’s> PSA levels were found to be elevated at 8.3 ng/ml, with a free/total PSA ratio of 19% (normal is greater than 25%). Given these findings, I strongly recommend a multiparametric MRI and prostate biopsy to assess the condition of Mr. Doe’s prostate gland and determine if further treatment is necessary.

I request that you approve this study for Mr. Doe’s benefit and ensure that he receives the care he needs.

I am including recent references that document the appropriateness of mpMRI in the management of men with an elevated PSA level. These are references from peer-reviewed literature on the value of mpMRI in the management of patients with elevated PSA levels. I believe it is essential to remain up to date on the latest advancements and recommendations in the field.

Thank you for your attention to this matter. Please do not hesitate to contact me if you have any questions or require additional information.

Sincerely,

Dr. Neil Baum

c.c. John Doe

(8 current references were included)

Bottom Line: I hope these abbreviated examples demonstrate the useful application of ChatGPT for urological practices. I would be interested in hearing from you if you have discovered additional applications of this exciting technology. If you want the complete responses that I received from ChatGPT, contact me at doctorwhiz@gmail.com.