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We are in the relief phase of ambient scribing. The efficiency gains are real and the risks are not yet visible in our outcome data — partly because we haven’t looked, and partly because the timescales are too short. The absence of evidence is not evidence of absence.
Shocking and outrageous.
and was saying a lot of technical stuff out loud
The quality article I linked to in another comment, from an early adopter turned critic of 'ai scribing', suggests you're right that they're not saying that for your benefit, they're saying it for the scribe, to structure the note to their liking. This is an example of how the encounter/interaction with the patient changes as a result of using this software
consent
That's an important word, because as the main-linked article says, and my experience corroborates: medical offices seldom explain what exactly patients are 'consenting' to with 'AI scribing' well enough for people to be informed enough to thus be able to truly consent.
I come from a research background and when my family doctor casually asked me if I was fine with him using AI for note-writing upon entering the examination room and sitting down, I was internally like, "ughh, no consent form, explanation, etc.?" But I was there for something sensitive and wanted to 'go along to get along.' So, I casually agreed. A few minutes later, I noticed he wasn't typing, so I said, "I notice you're not typing, is my voice being recorded?"
Needless to say, I soon after wrote the office saying I did not consent to the use of that in my care henceforth.
https://benngooch.substack.com/p/i-was-an-enthusiastic-early-adopter
This is not a small thing. The clinical note in general practice is not merely a medicolegal record. It is, as research in the Journal of General Internal Medicine has articulated, a form of narrative medicine — a clinician-authored story that reflects how the physician understood the patient’s situation at that moment in time. The act of writing it is itself a cognitive process: it forces synthesis, prioritisation, and reflection. It is, in a real sense, how we think.
When an AI records everything rather than what we chose to record, this feedback loop breaks. The note stops being a reflection of clinical reasoning and becomes a verbatim archive. And as a PMC piece on note bloat explicitly warns, this risks obscuring the most medically important information under a volume of equally-weighted detail.
The problem is not just that notes become longer. It is that they become less curated, less authored, less ours. And the clinical memory they are supposed to scaffold — the ability to pick up a case six weeks later and immediately reorient — degrades with them.
Why you should refuse to let your doctor record you
At a recent appointment, Emily’s physical therapist (who knows some about her research) said, “Before we get started, there’s something I want to ask you about.” The something was an automatic “scribing” system their office is trialling for two weeks and deciding whether to purchase. These systems take in a (presumably audio-only) recording of the patient encounter and then output a draft patient note for the chart.
So what’s the big deal with “AI” charting? Here are nine reasons why we recommend refusing to consent to the use of scribing tools in healthcare settings: