# Ask Patients with Patience: Enabling LLMs for Human-Centric Medical Dialogue with Grounded Reasoning

arXiv: https://arxiv.org/abs/2502.07143 · HTML: https://mlsanity.com/paper/2502.07143/

## Key facts

- Cited by 19 papers in the map (data through 14 Oct 2026).
- Placed in Clinical and biomedical applications, one of 17 directions in LLM reasoning.
- Builds on 14 of its 39 references that are in the map.
- First posted on arXiv 11 Feb 2025.

## Placed in

- LLM reasoning / [Clinical and biomedical applications](https://mlsanity.com/lr/clinical-and-biomedical-applications/)

## Builds on (most cited first, 14 of 14)

- [Language Models are Few-Shot Learners](https://mlsanity.com/paper/2005.14165/) (2020)
- [GPT-4 Technical Report](https://mlsanity.com/paper/2303.08774/) (2023)
- [Hallucination is Inevitable: An Innate Limitation of Large Language Models](https://mlsanity.com/paper/2401.11817/) (2024)
- [Can Generalist Foundation Models Outcompete Special-Purpose Tuning? Case Study in Medicine](https://mlsanity.com/paper/2311.16452/) (2023)
- [Capabilities of Gemini Models in Medicine](https://mlsanity.com/paper/2404.18416/) (2024)
- [AgentClinic: a multimodal agent benchmark to evaluate AI in simulated clinical environments](https://mlsanity.com/paper/2405.07960/) (2024)
- [HuatuoGPT, towards Taming Language Model to Be a Doctor](https://mlsanity.com/paper/2305.15075/) (2023)
- [HuaTuo: Tuning LLaMA Model with Chinese Medical Knowledge](https://mlsanity.com/paper/2304.06975/) (2023)
- [DoctorGLM: Fine-tuning your Chinese Doctor is not a Herculean Task](https://mlsanity.com/paper/2304.01097/) (2023)
- [DISC-MedLLM: Bridging General Large Language Models and Real-World Medical Consultation](https://mlsanity.com/paper/2308.14346/) (2023)
- [BianQue: Balancing the Questioning and Suggestion Ability of Health LLMs with Multi-turn Health Conversations Polished by ChatGPT](https://mlsanity.com/paper/2310.15896/) (2023)
- [MedFuzz: Exploring the Robustness of Large Language Models in Medical Question Answering](https://mlsanity.com/paper/2406.06573/) (2024)
- [BiMediX: Bilingual Medical Mixture of Experts LLM](https://mlsanity.com/paper/2402.13253/) (2024)
- [KNSE: A Knowledge-aware Natural Language Inference Framework for Dialogue Symptom Status Recognition](https://mlsanity.com/paper/2305.16833/) (2023)

## Built on by (most cited first, 19 of 19)

- [Multi-Agent-as-Judge: Aligning LLM-Agent-Based Automated Evaluation with Multi-Dimensional Human Evaluation](https://mlsanity.com/paper/2507.21028/) (2025)
- [3MDBench: Medical Multimodal Multi-agent Dialogue Benchmark](https://mlsanity.com/paper/2504.13861/) (2025)
- [ProMed: Shapley Information Gain Guided Reinforcement Learning for Proactive Medical LLMs](https://mlsanity.com/paper/2508.13514/) (2025)
- [InfiMed-ORBIT: Aligning LLMs on Open-Ended Complex Tasks via Rubric-Based Incremental Training](https://mlsanity.com/paper/2510.15859/) (2025)
- [Medical Reasoning in the Era of LLMs: A Systematic Review of Enhancement Techniques and Applications](https://mlsanity.com/paper/2508.00669/) (2025)
- [CaRT: Teaching LLM Agents to Know When They Know Enough](https://mlsanity.com/paper/2510.08517/) (2025)
- [Reasoning Is Not All You Need: Examining LLMs for Multi-Turn Mental Health Conversations](https://mlsanity.com/paper/2505.20201/) (2025)
- [Evo-MedAgent: Beyond One-Shot Diagnosis with Agents That Remember, Reflect, and Improve](https://mlsanity.com/paper/2604.14475/) (2026)
- [MedOpenClaw and MedFlowBench: Auditing Medical Agents in Full-Study Workflows](https://mlsanity.com/paper/2603.24649/) (2026)
- [Strong Reasoning Isn't Enough: Evaluating Evidence Elicitation in Interactive Diagnosis](https://mlsanity.com/paper/2601.19773/) (2026)
- [AI Standardized Patient Improves Human Conversations in Advanced Cancer Care](https://mlsanity.com/paper/2505.02694/) (2025)
- [Active Evidence-Seeking and Diagnostic Reasoning in Large Language Models for Clinical Decision Support](https://mlsanity.com/paper/2605.22047/) (2026)
- [DDX-TRACE: A Benchmark for Medical Diagnostic Trajectories in VLMs](https://mlsanity.com/paper/2605.23629/) (2026)
- [GraphMed-LT: Patient-Specific Graph Memory with Latent Clinical Thought Refinement for Multi-Turn Medical Conversations](https://mlsanity.com/paper/2510.03536/) (2025)
- [ChatHealthAI: Aligning Electronic Health Record Representations with Large Language Models for Grounded Clinical Reasoning](https://mlsanity.com/paper/2606.02802/) (2026)
- [Reinforcement Learning for Evidence-Seeking Diagnostic Reasoning with Large Language Models](https://mlsanity.com/paper/2607.02983/) (2026)
- [ELICITED: EHR-grounded Longitudinal Interactive Conversations for Information-seeking Triage Evaluation and Decision-making](https://mlsanity.com/paper/2608.09024/) (2026)
- [Ask or Answer: A Decision Framework for Multi-Turn Health Misinformation Intervention](https://mlsanity.com/paper/2608.21721/) (2026)
- [MedRoundsQA: A Persona and Difficulty Aware Evaluation for Multi-Turn Medical Consultations](https://mlsanity.com/paper/2609.12851/) (2026)

## Abstract (arXiv)

The severe shortage of medical doctors limits access to timely and reliable healthcare, leaving millions underserved. Large language models (LLMs) offer a potential solution but struggle in real-world clinical interactions. Many LLMs are not grounded in authoritative medical guidelines and fail to transparently manage diagnostic uncertainty. Their language is often rigid and mechanical, lacking the human-like qualities essential for patient trust. To address these challenges, we propose Ask Patients with Patience (APP), a multi-turn LLM-based medical assistant designed for grounded reasoning, transparent diagnoses, and human-centric interaction. APP enhances communication by eliciting user symptoms through empathetic dialogue, significantly improving accessibility and user engagement. It also incorporates Bayesian active learning to support transparent and adaptive diagnoses. The framework is built on verified medical guidelines, ensuring clinically grounded and evidence-based reasoning. To evaluate its performance, we develop a new benchmark that simulates realistic medical conversations using patient agents driven by profiles extracted from real-world consultation cases. We compare APP against SOTA one-shot and multi-turn LLM baselines. The results show that APP improves diagnostic accuracy, reduces uncertainty, and enhances user experience. By integrating medical expertise with transparent, human-like interaction, APP bridges the gap between AI-driven medical assistance and real-world clinical practice.