Large Language Models in Medical Chatbots: Opportunities, Challenges, and the Need to Address AI Risks
Bibliographic record
Abstract
Large language models (LLMs) are transforming the capabilities of medical chatbots by enabling more context-aware, human-like interactions. This review presents a comprehensive analysis of their applications, technical foundations, benefits, challenges, and future directions in healthcare. LLMs are increasingly used in patient-facing roles, such as symptom checking, health information delivery, and mental health support, as well as in clinician-facing applications, including documentation, decision support, and education. However, as a study from 2024 warns, there is a need to manage “extreme AI risks amid rapid progress”. We examine transformer-based architectures, fine-tuning strategies, and evaluation benchmarks specific to medical domains to identify their potential to transfer and mitigate AI risks when using LLMs in medical chatbots. While LLMs offer advantages in scalability, personalization, and 24/7 accessibility, their deployment in healthcare also raises critical concerns. These include hallucinations (the generation of factually incorrect or misleading content by an AI model), algorithmic biases, privacy risks, and a lack of regulatory clarity. Ethical and legal challenges, such as accountability, explainability, and liability, remain unresolved. Importantly, this review integrates broader insights on AI safety, drawing attention to the systemic risks associated with rapid LLM deployment. As highlighted in recent policy research, including work on managing extreme AI risks, there is an urgent need for governance frameworks that extend beyond technical reliability to include societal oversight and long-term alignment. We advocate for responsible innovation and sustained collaboration among clinicians, developers, ethicists, and regulators to ensure that LLM-powered medical chatbots are deployed safely, equitably, and transparently within healthcare systems.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.024 | 0.066 |
| Meta-epidemiology (narrow) | 0.001 | 0.001 |
| Meta-epidemiology (broad) | 0.001 | 0.002 |
| Bibliometrics | 0.002 | 0.001 |
| Science and technology studies | 0.001 | 0.005 |
| Scholarly communication | 0.008 | 0.016 |
| Open science | 0.004 | 0.006 |
| Research integrity | 0.003 | 0.005 |
| Insufficient payload (model declined to judge) | 0.007 | 0.004 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".