Not All ChatGPT Is the Same ChatGPT: A Clinician’s Field Test
I asked ChatGPT three clinical questions at three price points. The difference between the tiers is not a marketing claim. It is a clinical one. Here is the evidence.
A colleague asked me last week whether ChatGPT was worth paying for. She was using the free version and getting answers she described as decent. I told her the question was wrong. The question is not whether free ChatGPT is decent. The question is whether decent is good enough when you are managing a 29-week preeclamptic patient at 2 a.m.
I decided to find out.
I took two real clinical scenarios and asked them across tiers of ChatGPT:
OpenAI’s public pricing page lists the current plan categories: Free, Go, Plus, Pro, Business, and Enterprise. Current U.S. list prices, in short:
Free: $0/month.
Go: about $8/month, availability and price vary by country.
Plus: $20/month.
Pro: $200/month.
Business: $25/user/month billed annually, or $30/user/month billed monthly, minimum 2 users. OpenAI’s business pricing page lists the annual plan and notes the monthly billing price.
Enterprise: custom pricing, contact sales.
Prompt: “What is the management of a preeclamptic patient at 29 weeks””
Free-tier style answer:
At 29 weeks, preeclampsia is managed with close maternal and fetal monitoring. The patient may need hospital admission, blood pressure control, lab testing, fetal surveillance, corticosteroids for fetal lung maturity, and magnesium sulfate if severe features are present. Delivery is considered if the mother or fetus becomes unstable.
Prompt: “How should I counsel a patient with prior preterm birth at 27 weeks now a cervix of 15 mm at 18 weeks?”
I would assume this means a singleton pregnancy, an asymptomatic patient, a prior spontaneous preterm birth at 27 weeks, and a transvaginal cervical length of 15 mm at 18 weeks. If the prior 27-week birth was medically indicated, PPROM, twins, fetal anomaly, or infection-related, counseling would change.
Free-tier style answer:
This patient is at high risk for another preterm birth. She should be referred to maternal-fetal medicine. Management may include cervical cerclage, vaginal progesterone, repeat cervical length monitoring, and counseling about warning signs such as contractions, bleeding, leaking fluid, or pelvic pressure. She should be followed closely.
Below is for paid subscribers only. Find the answers based on the tiers. The rest of this post is for paid subscribers.
