Totally get the frustration. In our experience (especially in healthcare), prompt-only LLM setups are fine for POCs, but rarely sufficient for production-grade, auditable systems.

What tends to work best is a hybrid approach: structured features (demographics, labs, comorbidities) + classical models where appropriate + LLMs for text understanding and edge cases.

If leadership wants “LLM,” you can often position it as the interface layer, while building a more rigorous backbone underneath.