People!
Interacting with real people, facing a person trying to get help for something that they don't want to experience is vastly different than reading about a symptom or group of symptoms in a book.
Right. All doctors are 100% happy to help you, listen intently, and are never condescending! /s
That just sounds like instruct tuning on user data with extra steps. They must've collected hundreds of millions of conversation examples of people asking for medical related things by now.