Reverse Physician-AI Relationship: Full-process Clinical Diagnosis Driven by a Large Language Model

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Main Authors: Xu, Shicheng, Huang, Xin, Wei, Zihao, Pang, Liang, Shen, Huawei, Cheng, Xueqi
Format: Preprint
Published: 2025
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author Xu, Shicheng
Huang, Xin
Wei, Zihao
Pang, Liang
Shen, Huawei
Cheng, Xueqi
author_facet Xu, Shicheng
Huang, Xin
Wei, Zihao
Pang, Liang
Shen, Huawei
Cheng, Xueqi
contents Full-process clinical diagnosis in the real world encompasses the entire diagnostic workflow that begins with only an ambiguous chief complaint. While artificial intelligence (AI), particularly large language models (LLMs), is transforming clinical diagnosis, its role remains largely as an assistant to physicians. This AI-assisted working pattern makes AI can only answer specific medical questions at certain parts within the diagnostic process, but lack the ability to drive the entire diagnostic process starting from an ambiguous complaint, which still relies heavily on human physicians. This gap limits AI's ability to fully reduce physicians' workload and enhance diagnostic efficiency. To address this, we propose a paradigm shift that reverses the relationship between physicians and AI: repositioning AI as the primary director, with physicians serving as its assistants. So we present DxDirector-7B, an LLM endowed with advanced deep thinking capabilities, enabling it to drive the full-process diagnosis with minimal physician involvement. Furthermore, DxDirector-7B establishes a robust accountability framework for misdiagnoses, delineating responsibility between AI and human physicians. In evaluations across rare, complex, and real-world cases under full-process diagnosis setting, DxDirector-7B not only achieves significant superior diagnostic accuracy but also substantially reduces physician workload than state-of-the-art medical LLMs as well as general-purpose LLMs. Fine-grained analyses across multiple clinical departments and tasks validate its efficacy, with expert evaluations indicating its potential to serve as a viable substitute for medical specialists. These findings mark a new era where AI, traditionally a physicians' assistant, now drives the entire diagnostic process to drastically reduce physicians' workload, indicating an efficient and accurate diagnostic solution.
format Preprint
id arxiv_https___arxiv_org_abs_2508_10492
institution arXiv
publishDate 2025
record_format arxiv
spellingShingle Reverse Physician-AI Relationship: Full-process Clinical Diagnosis Driven by a Large Language Model
Xu, Shicheng
Huang, Xin
Wei, Zihao
Pang, Liang
Shen, Huawei
Cheng, Xueqi
Artificial Intelligence
Computational Engineering, Finance, and Science
Computation and Language
Full-process clinical diagnosis in the real world encompasses the entire diagnostic workflow that begins with only an ambiguous chief complaint. While artificial intelligence (AI), particularly large language models (LLMs), is transforming clinical diagnosis, its role remains largely as an assistant to physicians. This AI-assisted working pattern makes AI can only answer specific medical questions at certain parts within the diagnostic process, but lack the ability to drive the entire diagnostic process starting from an ambiguous complaint, which still relies heavily on human physicians. This gap limits AI's ability to fully reduce physicians' workload and enhance diagnostic efficiency. To address this, we propose a paradigm shift that reverses the relationship between physicians and AI: repositioning AI as the primary director, with physicians serving as its assistants. So we present DxDirector-7B, an LLM endowed with advanced deep thinking capabilities, enabling it to drive the full-process diagnosis with minimal physician involvement. Furthermore, DxDirector-7B establishes a robust accountability framework for misdiagnoses, delineating responsibility between AI and human physicians. In evaluations across rare, complex, and real-world cases under full-process diagnosis setting, DxDirector-7B not only achieves significant superior diagnostic accuracy but also substantially reduces physician workload than state-of-the-art medical LLMs as well as general-purpose LLMs. Fine-grained analyses across multiple clinical departments and tasks validate its efficacy, with expert evaluations indicating its potential to serve as a viable substitute for medical specialists. These findings mark a new era where AI, traditionally a physicians' assistant, now drives the entire diagnostic process to drastically reduce physicians' workload, indicating an efficient and accurate diagnostic solution.
title Reverse Physician-AI Relationship: Full-process Clinical Diagnosis Driven by a Large Language Model
topic Artificial Intelligence
Computational Engineering, Finance, and Science
Computation and Language
url https://arxiv.org/abs/2508.10492