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Main Authors: Barone, Mariano, Di Serio, Francesco, Moio, Roberto, Postiglione, Marco, Riccio, Giuseppe, Romano, Antonio, Moscato, Vincenzo
Format: Preprint
Published: 2026
Subjects:
Online Access:https://arxiv.org/abs/2604.20791
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author Barone, Mariano
Di Serio, Francesco
Moio, Roberto
Postiglione, Marco
Riccio, Giuseppe
Romano, Antonio
Moscato, Vincenzo
author_facet Barone, Mariano
Di Serio, Francesco
Moio, Roberto
Postiglione, Marco
Riccio, Giuseppe
Romano, Antonio
Moscato, Vincenzo
contents Large Language Models (LLMs) are increasingly deployed in healthcare, yet their communicative alignment with clinical standards remains insufficiently quantified. We conduct a multidimensional evaluation of general-purpose and domain-specialized LLMs across structured medical explanations and real-world physician-patient interactions, analyzing semantic fidelity, readability, and affective resonance. Baseline models amplify affective polarity relative to physicians (Very Negative: 43.14-45.10% vs. 37.25%) and, in larger architectures such as GPT-5 and Claude, produce substantially higher linguistic complexity (FKGL up to 16.91-17.60 vs. 11.47-12.50 in physician-authored responses). Empathy-oriented prompting reduces extreme negativity and lowers grade-level complexity (up to -6.87 FKGL points for GPT-5) but does not significantly increase semantic fidelity. Collaborative rewriting yields the strongest overall alignment. Rephrase configurations achieve the highest semantic similarity to physician answers (up to mean = 0.93) while consistently improving readability and reducing affective extremity. Dual stakeholder evaluation shows that no model surpasses physicians on epistemic criteria, whereas patients consistently prefer rewritten variants for clarity and emotional tone. These findings suggest that LLMs function most effectively as collaborative communication enhancers rather than replacements for clinical expertise.
format Preprint
id arxiv_https___arxiv_org_abs_2604_20791
institution arXiv
publishDate 2026
record_format arxiv
spellingShingle Can "AI" Be a Doctor? A Study of Empathy, Readability, and Alignment in Clinical LLMs
Barone, Mariano
Di Serio, Francesco
Moio, Roberto
Postiglione, Marco
Riccio, Giuseppe
Romano, Antonio
Moscato, Vincenzo
Computation and Language
Artificial Intelligence
Large Language Models (LLMs) are increasingly deployed in healthcare, yet their communicative alignment with clinical standards remains insufficiently quantified. We conduct a multidimensional evaluation of general-purpose and domain-specialized LLMs across structured medical explanations and real-world physician-patient interactions, analyzing semantic fidelity, readability, and affective resonance. Baseline models amplify affective polarity relative to physicians (Very Negative: 43.14-45.10% vs. 37.25%) and, in larger architectures such as GPT-5 and Claude, produce substantially higher linguistic complexity (FKGL up to 16.91-17.60 vs. 11.47-12.50 in physician-authored responses). Empathy-oriented prompting reduces extreme negativity and lowers grade-level complexity (up to -6.87 FKGL points for GPT-5) but does not significantly increase semantic fidelity. Collaborative rewriting yields the strongest overall alignment. Rephrase configurations achieve the highest semantic similarity to physician answers (up to mean = 0.93) while consistently improving readability and reducing affective extremity. Dual stakeholder evaluation shows that no model surpasses physicians on epistemic criteria, whereas patients consistently prefer rewritten variants for clarity and emotional tone. These findings suggest that LLMs function most effectively as collaborative communication enhancers rather than replacements for clinical expertise.
title Can "AI" Be a Doctor? A Study of Empathy, Readability, and Alignment in Clinical LLMs
topic Computation and Language
Artificial Intelligence
url https://arxiv.org/abs/2604.20791