With the remarkable performance of large language models (LLMs) in medicine, particularly their ability to support clinical decision-making in medical dialogues, a key limitation remains: the static reasoning patterns derived from human expert experience are often inadequate for the dynamic and diverse nature of real-world multi-turn conversations. While recent large reasoning models (such as R1) enable deeper and more complex thought processes to address such challenges, they also introduce significant redundancy. Meanwhile, recent studies on reusing atomic thoughts demonstrate a practical pathway toward dynamic and precise reasoning in general domains. In this paper, we investigate the role of atomic thought-based experience in medical dialogue tasks. First, we collect human expert clinical experience. Then, we propose a novel distillation framework that extracts atomic thoughts from teacher models and reuses them to guide reasoning and generate responses. Based on this framework, we construct training data from ReMeDi and fine-tune student models, which demonstrate enhanced performance in both static and interactive medical dialogue scenarios. Furthermore, we examine the impact of experience across various models, datasets, and scenarios. Crucially, transferring this experience empowers weaker models to generate high-quality reasoning data, matching the annotation capabilities of stronger LLMs while significantly reducing costs. The code is available in this repository https://github.com/VioletAmethystLunar/Atomic-Thoughts-Medical-Dialogue.

Artificial intelligence doctor assistants (AIDAs) help streamline clinical decision-making and reduce physician workload. While existing systems primarily utilize Large Language Models (LLMs) or retrieval-augmented generation (RAG), these methods typically retrieve static facts—whether as text passages or structured graphs—lacking the explicit logical pathways essential for multi-step reasoning. In this paper, we propose the AIDA-SEAT framework to provide reliable clinical decision-making support. First, we design the state-evaluation-action tree (SEAT), which covers diagnosis, treatment, and examination. To develop this tree, we refine and transform SEAT collected from medical documents and doctors. Then, we propose an adaptive method to select optimal trees tailored to the current patients’ state. Finally, we leverage LLMs to perform state assessment, evaluation, and action execution based on the tree, thereby generating reliable responses. To evaluate the effectiveness of our method, we conducted extensive experiments on a self-built dataset. Our method achieves 1.01% higher than current state-of-the-art (SOTA) baselines across five departments, including common RAG-based methods. Furthermore, analysis of 200 consultation records during deployment on an online hospital revealed that system-assisted responses are 24.16 seconds faster on average than manual ones, improving efficiency by 26.85%.