No, I did not consent to this

[u/petuniaplant]

I was reading my medical notes when I stumbled across this. I was not informed of the usage of artificial intelligence in my report, nor did I verbally consent to it.

[u/M15tre55W1tch]

I work in ICU. The doctor's in our ED use an ambient AI scribe for documenting patient assessments and findings (it's a regulated tool where the data is stored locally and gets deleted from its memory after 90 days apparently).

They had this auto generated statement at the end of each note stating something like "this note was written using an AI scribe with patient consent".

I noticed that this statement was included on patients who were unconscious in the community, and did not regain consciousness before leaving ED and coming up to ICU.

I sent their manager an email saying it was going to look very bad when a patient's case is reviewed by legal or the Coroner and these doctors notes said an unconscious person gave consent.

If a patient genuinely consents to the use of the tool, that's great. But you can't be using it and claiming that they consented to its use when that's a medical impossibility.

Edit: thank you for the award internet stranger! Very unexpected.

Another edit: multiple awards! Thank you very much!

[u/willbeatyourass → u/M15tre55W1tch]

What came of you speaking up?

[u/M15tre55W1tch → u/willbeatyourass]

They changed the wording to "this note has been generated with the use of an AI scribe".

But for all patients. So I don't know if they no longer ask the awake ones for consent, or if they just aren't recording that they do.

I have followed up again suggesting that they need to have two options - one for the awake patient giving consent, and one for using the tool to generate a note for someone that was not conscious.

I've become friendly with the senior hospital lawyer recently. I'm thinking of asking her to talk to their clinical director about the risk of their statements and proposing legally appropriate language.

I've tried being collegial and helpful. But at the end of the day, it's not my department, and I'm a nurse not a lawyer.

[u/Ok-Bug4328 → u/M15tre55W1tch]

They never asked anyone for consent. 

The doc never read the disclaimer that was being entered on his behalf. 

And docs are already using AI to summarize the AI notes 

[u/M15tre55W1tch → u/M15tre55W1tch]

I will say, since implementing the use of the tool emergency specialists are able to examine 6-11 more people per 8 hour shift - so reducing the burden of admin on them and releasing time to see patients is pretty amazing (it was recently on the news here).

[u/happytrashpanda333 → u/M15tre55W1tch]

How was the quality of that care? How much extra time did each patient get?

Or is this just another "tool" to drain doctors and nurses of every bit of spare time and energy they might have gained by giving them more patients to work with?

Do tell.

[u/pignoodle → u/happytrashpanda333]

When these tools are implemented correctly, they actually humanize interactions (since there's room for more conversation & less screens) and reduce doctor's "pajama time" by double-digit percentages (since less form-filling to catch-up off hours). Outside of just stats, I agree that consent is a very important prerequisite.

[u/Fullertons → u/pignoodle]

It actually blows my mind. People would find this to be a problem. Do you really want your doctor busy writing notes when he could just be having a conversation with you in a machine takes notes?

[u/ChrisTheWeak → u/Fullertons]

It's not that I'd prefer my doctor to spend their time taking notes rather than asking questions and investigating whatever illness I have, it's a concern about whether the quality of the AI notes will be on par with that of the doctor. Is the trade off worth it. That's the question. Also, question of accountability in the event something does go wrong. If the AI writes something that was inappropriate to my chart, if it gets missed, if it affects my quality of care down the line because someone else is now misinformed about my condition. These are risks with both the traditional method as well as the AI, but it is important to identify the comparative risks as well as the error correction in both cases when comparing other stats as well.

[u/polenta23 → u/ChrisTheWeak]

I work in vet med and our doctors use these ai scribe tools. They review and edit the notes but it still saves them an immense amount of time

[u/CapicDaCrate → u/polenta23]

Same. It's really not that bad. It's actually a good use of AI

[u/acnerd5 → u/polenta23]

I' glad they do! I hope that's something the software asks them to do before finalizing things, but that's a huge relief for me personally.

[u/newmainafterstalker → u/ChrisTheWeak]

I used to work for an insurance company’s call centre. We implemented an AI documenting tool (totally just coincidentally before my entire team got laid off… wonder how we got to let like 20 people go?? But okay.) and honestly it made my notes much more thorough. I had to edit them, but you can copy+paste into a note and ctrl+f to fix anything weird like he vs she. The rest you edit the normal way where you delete sentences and rewrite them. I thought it made my notes better and saved me a lot of time.

But you’re right! How many call centre workers are proofreading the notes first? How many doctors are??? If you follow the rules it helps a ton but how many people do? I can only assume you trust the people to proofread the way you’d trust them to write good notes. An unconscious person has no choice but to trust the person caring for them takes good notes, so maybe it is the same? They can’t ask for another doctor, a second opinion, whatever. But a conscious person can say no to AI notes, so idk

[u/Outrageous_Sea_9606 → u/ChrisTheWeak]

The quality of the medical records have increased greatly in my vet clinic since we started using our AI scribe.

It misses /nothing/. We do still read over and edit our records, but it takes 2-3 minutes to do that vs. the 10+ minutes to write up a complicated medical case.

There is only so much space in a brain to store information about the day's patients. If you brought in your pet for a serious medical issue and happened to mention as an aside something minor I.e. your pet is in for profuse vomiting and that's the focus of the appointment, but you also mention he has a small lump on his back that you noticed the other day.

Well, even if we look at the lump while your pet is at the clinic, chances are we're going to forget about that by the end of the day when we're writing our records up. Because we had to focus on storing all the info about the vomiting and the lump was insignificant in comparison. The AI scribe makes sure to note about that small, seemingly insignificant lump, so we have better information about that issue when the lump gets bigger or ulcerates and does cause a problem.

Our scribe also makes note of the emotional medical records for all patients that come to the clinic. This is immensely helpful for giving better patient care with our nervous, anxious, and aggressive pets. It notes what specific triggers are, what works to soothe and calm the pet, and what recommendations we made to manage behaviour. So that way we're not having to guess next year about what worked and what didn't work for that pet. The pets are less stressed, which means owners are less stressed. Pets are more likely to be brought in when they are unwell or have a concern because bringing them in becomes less of an ordeal and more of a routine.

Our AI scribe has been invaluable for allowing us to provide better patient and client care at my vet clinic.

Finally, it's a complete "cover our ass" when unhappy clients make false accusations against us. I had a client falsely accuse me of doing something severe that could have cost me my job and my license. It was just her and I present in the appointment room, so it was her word vs. mine. Thankfully, I had our recorder going which was undeniable proof (because it stores the full audio recording) that I was innocent. I never do appointments anymore without the recorder.

[u/Sushi_Explosions → u/Fullertons]

As a physician, the accuracy of these tools varies wildly. I would rather the documentation that I create doesn’t randomly hallucinate things that will get me sued or lead to someone doing the wrong thing.

[u/aTransGirlAndTwoDogs → u/Fullertons]

We have human medical scribes. I worked as one. The question is not "should we give doctors more direct patient time," it's "should we rely on an AI over a human note taker." As always, the problem comes back to artificially restricted medical staffing and profit-driven healthcare structures.

[u/hanging_thief → u/Fullertons]

Well when we know that machine will just make up bullshit to fill in the gaps yes I do have a massive problem

[u/EggsAndRice7171 → u/Fullertons]

In a few years it’ll be cool. I really don’t trust anyone to use AI properly and with the right care at the moment even doctors. It’s so new and so many people are very casual about it. I don’t trust that they’re actually rereading the transcript word for word and making sure it’s not writing anything wrong yet. I think as AI gets better and more training for AI comes along it’ll be easier to feel comfortable

[u/WittyFix6553 → u/EggsAndRice7171]

We’ve had the technology to transcribe speech into text for decades.

[u/Xavus → u/WittyFix6553]

If only that's what they were using instead of leaning in to AI where it isn't helpful because it is the current fad.

I have meetings all day at my job where the company has AI write summaries of what happened in the meeting and what action items are decided on, etc. I would give it maybe 80% accuracy, the other 20% it completely misunderstands context and reaches an incorrect conclusion, or just straight up hallucinate something that never happened.

80% accuracy is not bad for a quick notes summary of a meeting to refresh your memory when you were there, and when you can double check other sources first. But also my work isn't with a person's health on the line. I would not trust a 20% error rate in a complex field like medicine when a person may live or die by the difference if someone overworked with no context has to just believe what the AI thinks happened.

[u/DracoBengali86 → u/WittyFix6553]

That's not what this is though. If it's using ai it's to summarize an interaction. That comes with all the potential issues ai use comes with including hallucinations. If it's just transcribing, then it is less likely to actually be using ai.

[u/moreliketen → u/WittyFix6553]

Did these decades-old technologies have the capacity to hallucinate? I know they weren't error free, but I'm guessing they did not have the capacity to spontaneously generate false information.

[u/regnarok590 → u/WittyFix6553]

And we have known it isnt very accurate for decades. Just because a technology exists doesn't make it good enough for use everywhere.

[u/theshotgunman → u/WittyFix6553]

And for decades it's consistently made mistakes

[u/EggsAndRice7171 → u/WittyFix6553]

Yeah and it’s sucked for decades

[u/Ok_Assistant_6856 → u/Fullertons]

It's capitalizing on the number of patients that can be seen, and then billed. It's not to help quality if care, and we all know this.

If a doctor has too many patients to actually care for them, the hospital should hire more doctors.

This is the constant growth model creeping into medicine. No bueno.

[u/HerbertDibdab → u/Ok_Assistant_6856]

This x100. In the US system the goal of AI usage will 100% be profit motive. In no way will it be implemented with patient care quality in mind. Not talking about doctor or any health care professional motives here, the cash rush comes directly from health insurers, who have basically bought mining rights to the health of the US population.

[u/Wagubagu → u/Fullertons]

I’ve had nothing but incorrect notes since. I was not prescribed a pain medication for my chronic and severe pain because AI diagnosed me during a conversation with a nurse so the prescribing dr had the wrong info.

[u/TheHighDruid → u/Fullertons]

When it comes to medical data it's much more about how it's being processed, and who gets access to it.

Even a hospital that's using an in-house model most likely has a provider that comes in to set it up. Are they using your data to train models for other hospitals? How much of your information is retained in the build that goes to the next hospital. "Anonymised" data can often be de-anonymised, so being able to consent to these systems is pretty important.

[u/Illustrious_Bunch678 → u/Fullertons]

No matter what they say about privacy, I do not trust these data companies. Nor do I trust the government not to pull something and use the notes to weed out "the weak." HIPAA is based on the precedent set by Roe v Wade and that is gone now. Patient privacy is no longer guaranteed.

[u/Ophidiophobic → u/happytrashpanda333]

I work at a healthcare organization and the providers here LOVE the AI scribe. Manual documentation is usually their least favorite part of the job. They still do the important things like decide care plans for the patient, what labs they need, and what prescriptions they should be on, but now they don't have to both explain it to the patient and then document again on the EHR. That means that providers are able to be more present during the visit and also don't have to take extra time to write up their notes after the visit.

[u/JayRayBear99 → u/Ophidiophobic]

I've heard a few people had diagnoses added to their charts because the AI misheard something. Now it's in their permanent chart. Is this not a concern anyone has? Are they reading the notes after to confirm they are correct, or just happy that they have less work?

[u/Hamster12301 → u/JayRayBear99]

Yeah, some of these providers are straight up not looking at what the AI generated AT ALL. It does generate the entire conversation but then it does a synopsis and gives "suggested diagnoses". Basically just does an entire note for you and you can choose to copy and paste the whole thing without looking at all.

I realized for example that my pain doctor was using one of these and not telling me because suddenly the little amount of notes he was doing, became much more different than before and he didn't even bother to remove the "suggested diagnoses" title it gave, lol. So my diagnosis at that visit was "anxiety disorder unspecified" because I had told him I just lost a family member and was in grief. Instead of my usual pain conditions because I have a bunch of problems that cause me chronic pain.

[u/OutsideSame3629 → u/Hamster12301]

OMG I went to my primary care physician a week after my dad died of cancer and it’s still in my file that I have severe depression adjustment disorder

It irritated me because I was like who wouldn’t be sad like why is this medically notable

[u/Delilah_Moon → u/Ophidiophobic]

What is the QC on the notes & review process? I work for “big tech” and have been using AI tools for notes for a while - and they’re often littered with errors.

[u/Delilah_Moon → u/[deleted]]

That’s great that you do it. Unfortunately, considering that providers re already spread thin, forgive me if I don’t have faith that they will be checking notes for accuracy.

These are the same folks who can’t read a chart to know my name before walking in the room…

[u/errrnis → u/Delilah_Moon]

I just said this in another comment. I’m also in tech (working for an AI company) and I’ve seen some wild stuff come out of AI.

[u/RaNdomMSPPro → u/Delilah_Moon]

The ai scribe could be awesome if properly trained and the providers are consistent with how they describe things to the scribe.

[u/porscheblack → u/Delilah_Moon]

These are specifically created for medical, as in they pick up all the correct names of body parts and medical terminology. My wife's a doctor and uses them. She only had access at work and she gets twice as many notes done with them.

As far as QC goes, she's watching what it records as she's saying it. She can manually correct it if it makes an error or there are word prompts she can use. At no point is this just inputting things and never being looked at. I have been really impressed by how well it works because in order to be effective it definitely has to have a 99%+ accuracy rate.

[u/Delilah_Moon → u/porscheblack]

I work in cybersecurity. While the platform language may have been trained on medical terminology- it does not mean it will understand and notate correctly.

I mean to be fair, I’d expect any basic LLM to be able to interpret medical terminology - it’s a basic function of AI.

I mean, if she’s watching it as it’s updating - she’s really just dictating. That’s not anything more revolutionary than dictating to Apple notes or Word.

[u/Illustrious_Bunch678 → u/happytrashpanda333]

As a nurse: The second. It's absolutely the second. And as soon as AI makes a mistakes we will be blamed for it. But they're also forcing us to use it. I hate this time line.

[u/Sea_McMeme → u/happytrashpanda333]

Complete transparency that won’t surprise you: they don’t care about quality of care. I’m currently leaving a hospitalist job, because the hospital terminated the contract with my former employer to bring in a cheaper group. And during the entire process not once was quality of care or anything truly patient centered ever mentioned. It’s all about volume and saving money. And since I’m fortunate enough to be able to leave, I did. But it’s just so shitty out there on all sides that actually care about patients.

[u/tinyevilpeanut → u/happytrashpanda333]

Right, people misunderstand this as "the doctor can spend more than five minutes with me now!" whereas what is actually happening is they are just spending five minutes with more people per shift. More patients in same amount of time = more money.

[u/hanging_thief → u/M15tre55W1tch]

I'm not concerned with how patients a doc can see I'm concerned about how accurate their data can be whit ai proving itself extremely unreliable when it comes to technical documentation

[u/known_chomper → u/M15tre55W1tch]

I think you are absolutely right!! Yay, doctors are now “allowed” to bill 6-11 more people per day! This is great, for the hospital.

[u/Otherwise-Ball-5043 → u/M15tre55W1tch]

Is a smaller number of doctors seeing more patients per shift really a good thing in the big picture? I realize emergency departments are overworked as a baseline and to a certain degree everything that lowers the workload is helpful, but everyone seems to be jumping on board with "doctors can use AI to see more patients" as a substitute for "we need more doctors to cover the existing number of patients" really quickly.

[u/gorpie97 → u/M15tre55W1tch]

one for the awake patient giving consent, and one for using the tool to generate a note for someone that was not conscious.

And one for the awake patient not giving consent. (Unless you meant that as a separate thing entirely.)

The pessimist in me says they're just going to stick with the new verbiage and not bother with informing the patient.

[u/NorthernVale → u/M15tre55W1tch]

Bold of you to assume they ever asked for consent to begin with

[u/psychorobotics → u/M15tre55W1tch]

One problem is hallucinations, police in the US was testing AI for reports and in one it wrote that the cop turned into a frog. There was a Disney movie playing in the background of the bodycam and the AI thought the transformation was happening to the cop rather than in the movie.

[u/canwebringthebedup → u/M15tre55W1tch]

I also work in critical care. I would guess that somewhere in the ballpark of 40% of all notes feature something either auto-populated or haphazardly copy-pasted from a previous note that is either completely inaccurate or an outright fabrication. Errors are so ubiquitous that I almost think it would be hard to give them any sort of legal weight at this point unless they're utterly egregious and directly correlated to a sentinel event of some sort. (Obviously in theory all errors have legal weight, but practically speaking these cases always rely on "standards observed in practice.")

[u/int3rstitial → u/canwebringthebedup]

Yup, this. It's infuriating. Medical records used to be a reasonably accurate way of communicating medical information, and now they're just trash.

[u/tickado → u/int3rstitial]

Yeah, harder to copy/paste an error indefinitely when we had to hand write our note. Nowadays one person's simple mistake or sloppy Hx taking when originally documenting can carry forward for the rest of the chart.

[u/Hamster12301 → u/canwebringthebedup]

And this is why getting on Social Security disability is also getting much harder... I got denied in part because they found a "note" from an unrelated doctor I hadn't seen in years and years, who had some medical assistant copy and paste over "patient is functioning well in work and school" (no idea why that was ever even in there in the first place).

I am neither in work nor school nor am I functioning well. I deliberately asked them to remove that, and they never got back to me. And that one line specifically was singled out as part my denial, despite 10+ doctor's letters and literally over 3,000 pages of medical history showing very poor functioning. LOL. It's really fucking great.

[u/tickado → u/Hamster12301]

This supports my response to someone elsewhere in the comments saying 'it's just notes, it's not that deep'.

It absolutely IS that deep. What's legally documented by a health professional in a patient's chart can have real life affecting consequences!!! (and I am a health professional)

[u/itsbecccaa → u/canwebringthebedup]

lol yes. Yesterday I had a seizure in my doctors office and I was looking forward to seeing how it was documented in my notes. It went like this.

“Patient had procedure X. (Detailed notes on procedure) Tolerated well no complications” - obviously copy pasted from previous procedure

Followed by very different hand written “in front of me she has 2 focal seizures back to back we had to give her rescue med….” lol that one was written. Completely contradictory to the “no complications” in the previous paragraph!!

[u/SpeedRacer_Mach6 → u/M15tre55W1tch]

You work in the medical field and you don’t you know what implied consent is for unconscious patients?

/s

[u/299792458mps- → u/M15tre55W1tch]

It’s called implied consent, and it happens all the time in healthcare. All they have to do is say that the AI transcription assists the doctor in providing superior patient care by offloading a menial task like transcription, and a reasonable person would consent to receiving superior care. 

[u/WolfeMD → u/M15tre55W1tch]

not a lawyer but I'm fairly sure its a crime to falsify patient consent on a medical record so yea def push it, its a big issue.

[u/boyuber → u/M15tre55W1tch]

They'll just add it to the consent for treatment and be done with it.

[u/Lettuce_Prey69 → u/M15tre55W1tch]

it's a regulated tool where the data is stored locally and gets deleted from its memory after 90 days apparently

Just because the data is stored locally, doesn't mean the model is running on locally on hardware owned by the hospital. I'd bet they are using a model that's running on remote hardware using a subscription based service, which means that patient data is being sent to a company like OpenAI or Anthropic.

That would absolutely be illegal for them to do.

[u/bleach_tastes_bad → u/M15tre55W1tch]

Why would you need an unconscious person’s consent to write their note using AI? You need a conscious person’s consent because you’re recording their voice, but if they’re unconscious you’re not recording them, why does it matter?

[u/corporateacademia]

My doctor asked me directly if i was okay with it. I said no and its reflected in my chart. You should be able to opt out of that

[u/DangerZoneFinder → u/corporateacademia]

same, and they'd ask every time I visited, could be something new they're trying and just slipped their mind to ask

[u/crunkadocious → u/DangerZoneFinder]

Still a violation then. This shit needs out of medicine.

[u/Emergency_Bench_7515 → u/crunkadocious]

This is literally one of the few good use cases for AI. It's not replacing a human it's just a tool being an aid so the Doctor can actively listen rather than focus on recording what is being said. For some people that can make a big difference.

edit: I've literally never seen a medical scribe, that's cool though. I don't think AI is needed, it just seems like medical roles are understaffed all around.

[u/Undeterminedvariance → u/Emergency_Bench_7515]

Meh. I got home from an appointment last year, logged in and read the visit note. Note said “patient uses cannabis daily to help with pain”.

I certainly didn’t say that. And I don’t need it in my medical record.

[u/Schwifftee → u/Undeterminedvariance]

I told my doctor spontaneous emission and they recorded premature ejaculation, so there's that.

[u/Undeterminedvariance → u/Schwifftee]

This wins. That’s hilarious.

[u/00-Monkey → u/Schwifftee]

I just call it ecstasy.

[u/retardborist → u/00-Monkey]

And when we're holding hands it's like having sex to me

[u/_14justice → u/Schwifftee]

Hehe ... nocturnal emission, perhaps??

[u/super_hoommen → u/Undeterminedvariance]

I mean my doctors office had me down as a white Latina tobacco user (I am none of those things) so I think stuff like this happens regardless of the AI portion lol

[u/SnooMemesjellies1522 → u/Undeterminedvariance]

Could that be why my visit summary said, "she is obese." Those exact words. I am 5'6" and weight 125 lbs. I asked my doctor about it and she took it off my record, but no explanation was offered.

[u/ToTooTwo3 → u/SnooMemesjellies1522]

Because somebody accidentally hit the scribe button while conversing about someone else. Sometimes it even gets stuck on. Happening less as people get used to the tech.

[u/Typical_Goat8035 → u/Undeterminedvariance]

Yeah similarly, my specialist was defending her medication choice, saying "if you were a chain smoker and drank 10 drinks a day, we would be picking a different treatment".

Then at my next checkup my PCP gave me this honesty speech about how being truthful with your doctors gets you the best care. I gave her a confused look and she turned her screen my way and showed me "addressed medication safety concerns due to heavy tobacco and alcohol usage" from that visit....

It taught me to read over my digital chart after each visit. I mean, I'm all for doctors having tools to help them with their busy schedules, I only mind when it leads to these kinds of inaccuracies.

[u/logicbecauseyes → u/Emergency_Bench_7515]

Only a matter of time

https://giphy.com/gifs/3o7TKOJ6KlCTcGJA40

[u/TennisOk4660 → u/Emergency_Bench_7515]

The problem is, the places that are using the AI tool to help with charting/notes. It's getting things WRONG. Just a few weeks ago someone was on here confused AF because the AI put in there notes that they were male, when in fact they were a -female-. There was more to the story as well but, just no AI for hospital settings is just not ready.

[u/2red-dress → u/TennisOk4660]

This seems incredibly dangerous. The inaccuracies say AI is not ready to be relied on the way it apparently is relied on.

[u/samyall → u/TennisOk4660]

That is not an AI failure but a doctor failure for not checking the notes.

[u/mddesigner → u/samyall]

At that point remove the the ai It is much faster to write it myself than to double check the ai -gp

[u/sameoldfred → u/Emergency_Bench_7515]

It's sounds good until you learn that the transcription is outsourced to questionable third party.

[u/mddesigner → u/Emergency_Bench_7515]

As a doctor it isn’t hard to note down things the patient says What is hard is filing it in appropriate way the hospital will accept Like there is a lot of useless padding in hospital paperwork

[u/Watchmaker163 → u/Emergency_Bench_7515]

No it’s not. Dictation software has existed for decades: if this was really about saving time/making sure things were recorded, they could use software specifically for that purpose. “AI” note taking is generative and will not reflect what is said, which means it is useless in a medical scenario.

One of my doctor’s offices started asking if I consented to a similar thing, I said no, and a couple months later they dropped it b/c they were having more problems than ever.

[u/Weast12 → u/Emergency_Bench_7515]

No it's replacing humans I got let go from my scribing job I had for 4 years because of AI. In fact the entire department of scribes we had got let go.

[u/UnderlightIll → u/Emergency_Bench_7515]

If a clinic or hospital is understaffed, that is usually by design. Doctors make them money but medical assistants and nurses do not. It is not a "good case" for AI when YOUR OWN medical information is put into the algorithm for training and data harvesting.

If they are understaffed, hire more.

[u/bs0569 → u/Emergency_Bench_7515]

Not when it’s constantly feeding patients that didn’t consent incorrect information. They can just do their fucking job

[u/ObeseHamsterOrgasms → u/Emergency_Bench_7515]

yes, we use AI for xrays at work. i still look at the clinical view first because it isn’t perfect and doesn’t always get things right (we can manually reject any incorrect findings). but it is especially helpful in showing patients their own xrays, as it color codes things and gives measurements. it is much easier for a lay person to understand what i am trying to show them. i like it a lot just for patient education purposes. and i can just toggle right back to the clinical view for my own diagnostic purposes.

[u/slfan68 → u/Emergency_Bench_7515]

Except it did replace humans. I'd actually argue it was one of the first sectors to be replaced by AI - medical transcription/medical scribe. My mother did that for over 20 years until they eliminated her job in the mid-2010's with speech recognition software that sucked ass at the time.

[u/SweatyCounter2980 → u/Emergency_Bench_7515]

I don't trust it, it's a very thin line between "AI transcribing" to "AI interpreting your data and selling it to medical insurance companies". It also won't help your doctor, hospitals are increasingly designed for profit, so the administration would just increase their patient load now that they don't write notes, so they still won't be able to focus because they have so much more people to see.

[u/DCGuy511 → u/SweatyCounter2980]

Actually it is a huge illegal line.

[u/Linked713 → u/SweatyCounter2980]

Dude that's a grand canyon, not a thin line. Selling your medical data is highly illegal and any doctor would lose their license. I get "ai bad yada yada" but let's not just spew nonsense

[u/Skurfer0 → u/Emergency_Bench_7515]

It will also make a big difference when the AI hallucinates part of the conversation because the 62 year old GP isn't properly trained in how to generate effective prompts and uses the AI for a memory crutch to boot.

[u/EvidenceNo8561 → u/Emergency_Bench_7515]

I agree that it can be useful, but the problem is that no one is checking it afterwards. Did you read the recent Reddit post about the woman who was a mail carrier? She described herself as a “mailwoman” and the AI recorded that she was transgender. Then after that it was a huge pain in the ass to fix it and it was insidiously on multiple charts. Imagine if she hadn’t read the notes and that had sat in her file for years?

[u/moropeanuts → u/Emergency_Bench_7515]

It is replacing the medical scribe. Medical scribing is a huge employment route that many pre-medical students take to learn on the job and get the money they need to survive and apply to medical schools. There is no other job that you can get before medical school that will teach you as much as a medical scribe who is 4 feet way from a doctor at all times for the entirety of their shift. Now future docs will go in without that experience.

[u/BootsDaBadAss → u/moropeanuts]

When are medical scribes used? I have never seen anyone taking notes during appointments or hospital visits, so I'm curious where/when they're actually used if it's so popular for med students.

Edit just to clarify: I'm not doubting anyone, just curious where they end up since it's clearly not in the (very mild) areas I end up at the doctor for.

[u/Crazhand → u/BootsDaBadAss]

Current medical student, I was one for Orthopedics. Many incoming students are doing the medical assistant/EMT route now since scribing is falling out of favor. Scribing is really nice though because you’re actually apart of the encounters and actually get to see what being a physician is like.

[u/Artistic_Chicken_557 → u/crunkadocious]

How dare doctors write notes based off your real time input!

Surely them sitting down 5 hours after your visit to write notes on the appointment is much better for you. Im sure they won't forget anything you said!

[u/AtlanticPortal → u/corporateacademia]

It should be an opt in thing like it happened to you. Not an opt out.

[u/Hefty-Reaction-3028 → u/AtlanticPortal]

As long as you get asked, it's the same

[u/CustomerLittle9891 → u/corporateacademia]

FYI you didn't opt out of the scribe. You opted out of being recorded, but your doctor probably uses it after you're done.

[u/slippinthrudreamland → u/CustomerLittle9891]

from what i understand, if they weren't recorded, the scribe wasn't used. the "ai scribes" are specifically llms trained on medical data that work in conjunction with speech recognition programs. because the input it processes is spoken language, without a recording, nothing is done. i don't use these ai scribes in my line of work, though, so take my word with a grain of salt.

[u/CustomerLittle9891 → u/slippinthrudreamland]

The scribes will transcribe a one-sided dictation incredibly well. I can conversationally tell my scribe the HPI and plan in about 1 to 2 minutes, what would take 5 to 10 to type manually.

If a patient declined the scribe in the room I dictate my notes after. Less efficient that way, but still way faster than the old way.

[u/FDFI → u/corporateacademia]

Why would you opt out of a tool that helps the physician do their job better?

[u/lava172 → u/FDFI]

AI scary

[u/gmcarve → u/corporateacademia]

Why no to this and not other things, like computer use, telephone or fax ?

Must patients be asked to sign off on every piece of software used in the healthcare chain?

I don’t want to.

Use the tools that help you do your job best doc.

Focus more on me, less on the tablet. Sounds great.

[u/aminervia]

They often don't say "AI" -- maybe instead they asked if you were ok if they used a tool to transcribe the appointment?

I've always been asked, it's one of the first things out of their mouth

[u/Primary-Holiday-5586]

Ok, report it to the dr or the office. I've always been asked. Maybe they did and you missed it, or maybe they forgot. Ask them.

[u/MasticatingSheep → u/Primary-Holiday-5586]

Yeah. My doctor asks in a way that sounds like she's just recording the conversation. I don't really care either way, as I've even let her bring students in.

I kind of wonder if their doctor asked about recording and OP didn't put together that this note and that recording as the same thing.

[u/Dotcaprachiappa → u/MasticatingSheep]

They are in no way the same thing. You can't blame OP for considering "recording" and "feeding to ai" as two separate things that should warrant two separate disclaimers.

[u/ClassicNebula1081 → u/Dotcaprachiappa]

Legally consent is needed to record. Consent is not needed to use ai.

[u/Little_Mechanic9462 → u/ClassicNebula1081]

Sure but the situation here is that it it stated patient agreed to use AI for tramscribing and summarizing. Aomething the patient clearly did not do. Perhaps patient agreed to have it have it transcribed and summaried - but noy by "AI" they state ir like they clarified it would be AI.

[u/Fermently_Crafted → u/MasticatingSheep]

Recording something and putting that recording through an LLM are two completely different things

[u/TFTHighRoller → u/MasticatingSheep]

I may consent to recording and a student sitting in but i generally do not consent to my deeply personal data to be blindly used in AI stuff.

[u/ConLawHero → u/TFTHighRoller]

It's all HIPAA protected. It's no different than the doctor manually writing notes except it is going to be more accurate and the doctor will pay more attention to you during the visit instead of trying to write some of the notes while talking with you.

[u/gamerdoc32 → u/ConLawHero]

As a doctor I can confirm this. Since using an AI scribe my notes are way better and I’m able to focus on the patient more (I work in primary care). Also this has been a game changer for my surgical colleagues who have to see an ungodly amount of patients in clinic. Their notes are now beautiful and everyone on the treatment team can follow along.

I see a wide variety of patients and I consent by asking “I have a software on my phone that will listen and type up our visit are you okay if I use it?” I and every doctor I know reviews it prior to submission because it is a legal document and we want it to be accurate.

[u/ConLawHero → u/gamerdoc32]

I'm a lawyer and I remember a case I was working on and I had to review handwritten doctor's notes, granted this was like 10 years ago, and I wanted to murder the doctor because they were rambling and completely incomprehensible. What I would have given for AI transcribed notes.

I also remember when my wife was in residency and was learning how to do notes and she would spend literally 5 to 6 hours writing all of the notes. I can't imagine what residency looks like now with AI. That was such a large part of why she was at the hospital for so long.

[u/Yamatocanyon → u/TFTHighRoller]

It's really just about not having to spend most of the visit with the Dr typing away at the computer. I told my Dr hell yeah go for it, and visits feel a lot more personal because he just pays attention to me for most of the visit instead of clacking away at the keyboard for the whole thing. 

[u/adamfps → u/Primary-Holiday-5586]

That doesn’t sound like an interesting Reddit post though

[u/Primary-Holiday-5586 → u/adamfps]

Oops, sorry 😞

[u/sparkyblaster → u/Primary-Holiday-5586]

Maybe the AI should have picked up that it wasn't asked? 

[u/Mo_Steins_Ghost → u/Primary-Holiday-5586]

There's forms he signed at some point that probably include that language. Usually at check in. If he didn't read them before signing, he probably should have... I'm not saying that they don't ramrod you through signing documents, but if you sign something before reading it, that pretty much cuts off any legal recourse unless you were forced to sign under duress.

A lot of doctor's offices in the US especially now do a thing where they have an electronic signing pad, they verbally tell you what you are signing (in far too short a description) and/or flash it on a screen and usually patients hurry through signing it without reading or asking to read what they are signing.

I like to make offices wait as I read through when they pull this shit.

[u/DeterminedQuokka → u/Primary-Holiday-5586]

I would wonder about this also. It’s possible they asked without saying ai. A lot of times they just say they are transcribing it. Not they are using ai to transcribe it.

It could also be in one of many many forms people sign.

[u/KayakerMel]

My PCP has been using an AI tool to help with documentation (that's writing up the notes) for around a year now. He takes out his phone at the start, asks for my verbal consent to use the AI tool, and even hits pause whenever we discuss something we might not want recorded (like complaining about insurance companies).

[u/Redxmirage → u/KayakerMel]

These AI notes have been around since 2018 (earliest I saw it at least, don’t know when the first one was). Radiology has been using it around that time too for AI assessment to help catch misses. It’s more popular now but people acting like AI haven’t been in hospitals for near a decade now

[u/colorblind-and → u/Redxmirage]

So much existing technology has gotten the AI label slapped onto by both the tech companies and the general public and it frustrates me to no end.

In this particular case there could be AI integration into the software now and if there's not voice to text software has always had similar privacy concerns to AI's.

I'd hope that something specifically developed for the medical field so long ago was made to be Hippa compliant.

[u/Flight_Harbinger → u/colorblind-and]

So much existing technology has gotten the AI label slapped onto by both the tech companies and the general public and it frustrates me to no end.

Yep I've been feeling the same. I sell photography / videography equipment and a lot of manufacturers have been slapping "AI" on features that are indistinguishable from expectedly more advanced recognition algorithms. These are pieces of software that are more efficient, but not distinguishable from previous iterations in capability. Good luck explaining the difference to people anti-AI in its current state or super pro-AI in its current state.

[u/PinsToTheHeart → u/Flight_Harbinger]

Similar to how all convection ovens now have an "Air fryer" mode despite that being what it was the whole time lol

[u/ingodwetryst → u/Flight_Harbinger]

People don't realise how long 'machine learning' has been part of cameras either

[u/Obvious-Slip4728 → u/colorblind-and]

What do you mean? Voice to text software has always used AI and it has always been called AI. A lot of existing technology is being called AI, because it is AI. 

There have not been lots of privacy concerns as the AI model to run the voice recognition software can be run locally. 

Privacy concerns mostly involve a specific subset of AI, called generative AI, especially when LLM are used that are so powerful that they cannot be run locally, raising concerns about data sharing and privacy. 

[u/WhyNWhenYouCanNPlus1 → u/colorblind-and]

machine learning has been around for decades in specialized settings

[u/SapphicGarnet]

This reminds me of something that really pissed me off recently. So my GP does use an AI tool and told me, and I've seen plenty of news and posts like this of healthcare doing so.

Recently I was referred to a therapist by GP. After our session, she sent a letter to me and the GP detailing what issues I had and the next steps (this is normal for my condition, happened before).

So at the beginning of the session, she said "do you mind if I use a program that records and takes notes". Eh, I thought this is the new norm, if it makes it easier for you. During the session I said things like "I don't experience X but Y happens" or "it's not A but it really is B" where those are similar but VERY distinct in severity. In the letter, it says "SapphicGarnet experience X and has A." What??!!

So I shoot off an email to correct things. Thinking I'm being polite, I say "oh I think your AI notetaking tool misinterpreted things I said" rather than "you're not doing your damn job properly." She replied saying that AI was not used but she'd send a new letter with my corrections.

Then in the new letter she sent me to make sure i agreed there was "SapphicGarnet thought AI was listening to her in our appointment". It sounds like I'm bloody paranoid!

[u/Jay_Nova1 → u/SapphicGarnet]

Straight to the lobotomy wing

[u/moreliketen → u/SapphicGarnet]

Sounds like something someone who has experienced x and has a would say.

[u/etcpt]

HIPAA gives you the right to review and correct your medical record (assuming you're in the US). Send a note to your provider indicating that you did not consent and your medical record is incorrect. You may have to do a particular form with them. They have 60 days to respond to the request.

[u/ArtisticDragonKing]

I have a coworker in a vet clinic that asks patients if she can "audio record notes for the pet" and gives a brief explanation why. However, she fails to mention the audio recording directly inputs into an AI log that gives suggestions for her next steps. I strongly dislike her methods.

It may have been something like that?

[u/BumblebeeOfCarnage → u/ArtisticDragonKing]

More likely it’s just a transcribing software. Still needs patient consent though. I’d say the bigger concern is the recording and not the AI in this situation

[u/Odd-Scientist-2529 → u/[deleted]]

That’s not how it works. It doesn’t make any recommendations. It’s purely a scribe, and will summarize the conversation. 

The doctor would have to say out loud in the exam room.  “I recommend Fluticasone nasal spray” or “I recommend budesonide nasal spray” for it to construct the “plan” section of the note. 

If this is what is happening to him, its 100% user error. 

The only way it could happen is that he is rambling about possible treatment options out loud and isn’t clearly stating just the one he wants. 

The AI scribe does not generate recommendations. It simply lists the ones that were verbalized in the visit. 

To add evidence to this point: any medication or diagnostic test has to be manually typed in for it to appear in the note under the “Plan” section as an action item. Otherwise it would be in narrative form. 

So this is user error. 

[u/Harpunzel → u/Odd-Scientist-2529]

I believe some AI scribes including Heidi are now summarising clinical resources relevant to the presentation, with a clear link which recommendation comes from which resource. I haven't used Heidi since before that update, but some of my colleagues have and find it reliable. It only takes from locally relevant clinical guidelines rather than the whole internet.

[u/CustomerLittle9891 → u/ArtisticDragonKing]

Right now there isn't a active software that does that for human medicine.

Epic is about to roll out something that does, and a AI agent could easily transfer the scribes note into OpenEvidence or something, but not a direct "here are the recommendations" type program.

[u/Decent_Elderberry115 → u/ArtisticDragonKing]

For human healthcare it is scribe software that records the visit and turns it into a note. There should be a printed consent that gives the patient info about how the recording is used. I have coworkers who use AI. I do not because it writes shit notes full of errors.

[u/Fortestingporpoises]

Providers are definitely supposed to ask you directly for your permission. My wife provides therapy on one of the apps and asks her clients permission directly before using the AI notes.

[u/Nawoitsol]

My primary care physician is at the age where I discuss his potential retirement at every appointment. The last time we met he said the AI note taking has added at least a couple more years to his career. He had grown to hate the documentation part of his job. So I’m ok with AI notes. It’s really just the background for the appointment. Orders get put in directly.

[u/Bloodmind]

There’s a very good chance it was buried somewhere on some intake form that you signed at some point. Tell them you want to opt out if you don’t want it.

[u/Jealous_Marketing_84 → u/Bloodmind]

“verbal consent”

[u/ueegul → u/Bloodmind]

OP suggests it was verbal consent, not written consent.

[u/jeanpaulmars → u/Bloodmind]

My sister is a speech therapist (runs her own practice), and there too, patients/clients have to sign consent forms allowing her to consult with other doctors and/or the school (in the case of children).

She also uses speech-to-text and automatic summaries per treatment session.

Consent at her practice is essentially "take it or leave it": you agree and you can be treated, or you don't agree and she simply won't take you on as a patient.

[u/telebasher]

Folks, OP seems to be mildly infuriated over the inaccuracy of the notes, not that AI was used.

[u/petuniaplant → u/telebasher]

Indeed. I am upset that the notes reflect something incorrect, that being I “verbally consented.”

[u/mvmstudent → u/petuniaplant]

I work In healthcare and a lot of time doctors created templates with the consent verbiage already built in. Meaning he may not have used it but forgot to delete the consent part from his notes. Annoying for sure.

[u/1000LivesBeforeIDie]

You know what annoys the crap out of me is everyone suddenly getting excited about an “ai option” when they could have just been charting in Google Docs and using the microphone.

[u/homes_and_haunts]

Might depend on the state, but my providers (including vet!) have signs in the exam rooms saying that they use an AI scribe, and if you don’t object you’re consenting by default.

[u/caffeinebump]

I had my annual today and they asked me to read and sign their updated consent to care and there was a paragraph in it that said I was consenting to the use of AI.

[u/HyruleSmash855 → u/caffeinebump]

Same. I don’t remember AI coming up for a recent doctor visit over the phone, but when I looked at the output from the appointment, there was a clause about the patient consenting to AI being used for the transcription or something. The actual doctors note seem to have typos, so it did not look like an LLM output so I’m wondering if this post could have that clause being pasted into the notes by default or something.

[u/grodon909 → u/HyruleSmash855]

I am a doctor, and use AI for my notes. I made my note template such that it includes a disclaimer about the use of AI on the bottom, even if I don't end up using it or forget to turn it on. I also mix and match--I usually write my assessment myself because the AI don't do it the way I like, but I will throw in the plan it generates with some edits. It doesn't know how to prioritize information, so my subjective will be a series of phrases and sentences in an as close to logical order as I can get, while the AI subjective will include things like their complaints that have nothing to do with my specialty or tangents about something else. 

[u/mcharytoniuk]

The general goal of that is so that the doctor can spend more time with you instead noting down the entire visit through the keyboard manually... So that's actually a good use of AI.

[u/MaxSupernova → u/mcharytoniuk]

I’m actually kind of happy with it because it means the doctor says *everything* out loud.

He gives more details and specifically narrates every single part of my checkup. I’ve learned more about things they’re looking for and the condition of my body since they started using the AI transcriber.

[u/CustomerLittle9891 → u/MaxSupernova]

One thing I noticed when I started using mine is how much more conversational my visits became. I was no longer asking questions in ways I could easily document in the moment so I would only have to stay 1 hour late instead of 2.

If a patient wants to go on a longer tangent about their symptoms, I don't have to redirect the conversation back to easily documented bits

It's been really nice not shaping all of my visits around the need to document everything in a short amount of time.

[u/sparkyblaster → u/MaxSupernova]

I'll give you that. Every time I go to the dentist it seems there is another issue they want to tackle that they never mentioned to me. I had no idea a filling was failing. 

[u/Defense-of-Sanity → u/MaxSupernova]

Thank you for pointing this out. A very wonderful byproduct, imo!

[u/ZiggoCiP → u/mcharytoniuk]

Most of it isn't even AI; it's dictation! Which has been a thing, voice-to-text, since the got dang 70s-80s!! People think it only happened in the 2000s because of phones, but it's been a thing, especially in medicine, for basically a half century, and it's only gotten better as time has gone on.

As for diagnostics, it's still unreliable, but simple voice-to-text has been a thing for a very long time. Speech-to-text isn't AI; it's just programs that transcribe speech.

[u/etcpt → u/mcharytoniuk]

If and only if the provider then reviews the note for accuracy and completeness. See the person who posted on r/mildlyinfuriating a few months ago about their provider mischaracterizing them as MTF trans which appears to have been because the AI heard "mailwoman" (i.e., postal carrier) and interpreted "biological male identifying as a woman".

[u/WeeklyBanEvasion → u/mcharytoniuk]

Also visit notes have become much more detailed and useful after the implementation of these AI transcribing services. 

[u/Plumblossonspice]

You have limited time and a lot to do. An AI transcriber helps you log everything.

I’d prefer this to the days when hospitals etc kept hand-written scribbles in big folders that they carried from place to place - I’ve had my rheumatologist go ‘where is your file?’ And go running around looking for it. He’d picked up a stack and left my file in another room. Just imagine the risks. Plus, when they leave things out of the notation they made. Ever had a pharmacist ring the doctor’s office because they can’t read the handwriting? I have.

Transcribing makes sure everything is taken down and electronic systems mean that nothing is getting lost, things are easily shared between doctors and departments and fewer mistakes are made.

[u/GreenEggsSteamedHams → u/Plumblossonspice]

But this doesn't fit the "AI IS BAD FOR EVERYTHING ALL THE TIME" narrative!!

[u/FireproofCottage]

They should be asking at the start of the visit. One of my doctors was in the military and they used something similar so he always asks. My GP forgets every single time; I only know she's doing it because, like OP, I read the notes. They're walking a fine line. How this is supposed to work is AI transcribes the visit, but the human health care worker is supposed to read the note before signing it.

I did medical transcription for a while right when this was being implemented. Some of the errors I found AI making were horrific, especially right versus left and when patients would describe a symptom and AI would inexplicably put "no" in front of the phrase. Good doctors catch those. Lazy doctors just sign, and the havoc perpetuates itself.

If you agree to your doctor using AI transcription of notes, look them right in the eye and say "I expect you to be reading the notes to confirm they're correct before they're signed off." Then that statement and the reply become a permanent part of your medical record should they ever be needed. Sometimes busy professionals need reminding that automation can't replace humans entirely.

[u/Fishwithadeagle]

For those wondering, if you say no, you're getting less face to face time. Having the ability to use DAX for charting my subjectives has allowed me to use significantly more time towards direct patient care rather than charting.

[u/bad_actor]

A Cone Health branch I visited in North Carolina relied on their AI summary to determine what happened during my physical. The AI said we had discussed a separate condition (we didn't) and I got billed for an additional visit. I fought it both in person and online and still couldn't beat the false charges. I was never asked about AI and absolutely would have declined.

So anyway I'm looking for a new doctor.

[u/That-Mix7702]

Remember, AI is not an expert in anything.

[u/Single_Principle_972]

That is exactly it, in a nutshell. Your physician is able to truly listen to you, while AI also listens. AI then summarizes the conversation - creates the doctor note - which the doc then modifies if necessary, and accepts it into your chart, and then the audio conversation is deleted. Your doctor is quite likely to not remember to, or not take the time to, document every bit of what you discussed, so AI is going to be a more accurate reflection of your office visit.

Source: I supported the ED module of the largest electronic medical record software company for many years. Also, I was a bedside nurse for many, many years before that… and if only I was smart enough to create AI I would have been a billionaire decades ago! Because I remarked to colleagues on several occasions that if only there was someone listening to my conversations and assessments of my patients, and then transcribing them for me into the chart, my charting would be a thousand times better! I often was running my tail off for 12 hours, with no opportunity to document - all that pesky saving of lives stuff is the priority - and then sitting down to chart. Trying to look back on 12 hours of patient care for sure meant I was forgetting to write down a lot of little things!

[u/girlikecupcake → u/[deleted]]

Did you file a complaint to get your record corrected?

[u/vonRecklinghausen]

I'm a physician. This technology is being used widely in our health system. It's so trash. Please report this to the clinic or hospital- they should have a Patient Liaison. Patient feedback is the ONLY thing that changes hospital culture. Please complain!!

[u/oortuno]

I was a medical assistant at one point and the Doctor would enter the room and immediately say, "Hi, I'm doctor _____, and I want to ask, if it's ok with you, if I could use this new software we're using that records our conversation and transcribes it into notes for me later. Nobody else will have access to the software's recording."

Bascially, you need to have the option to opt out, or at least be made aware that you are being recorded. If these two things are not provided to you, then I think you have grounds to sue. Of course, they will probably argue that you did consent to it at some point by signing something.

[u/iesharael]

My doctor always asks if I’m ok with the visit being transcribed. I always say yes because I am forgetful and want to be able to go back and find the answer to whatever weird questions I asked. Honestly it’s one of the AI uses I’m more ok with

[u/suppamoopy]

They've been using Dragon Speaking Easy since the early 90's and it worked fine. I don't understand the need to switch.

[u/shelaughs08]

The consent form patients sign at my job before every single visit has it in there. They very rarely get read.

[u/LadySuhree]

This should be illegal.

[u/hymnic]

I usually haaaate AI, but thjs isn't generative* AI, it's a scribe. It doesn't store the audio from the conversations (too bulky), it doesn't use conversations to 'train' because scribe models are sold already trained, and any storage of transcriptions has to be done at the same level of security as all other medical documents. *It "generates" text, but the text is a (hopefully very accurate) record of what you and the doctor said, with no paraphrasing.

[u/CareInteresting7283]

All scribes across the nation are getting laid off due to AI

[u/BuckityBuck]

Are you sure? You read everything you signed, in detail? If so, ask the office for proof of your consent.

In general, you can tell. When a doctor pulls their cell phone out, it's because they're getting a transcript.

[u/deliciouscurryboy69]

I am a doc and I use AI scribes everyday. Tbh, its been one of thr biggest game changers for me because instead of wasting time documenting i can actually sit and focus on what patients are telling me. It also literally saves me about 1 full hour in a 12 hour shift, and now I can spend that time talking to people, educating them, reassuring them, etc. We need to make sure people's data is secure but lets also not miss a chance to actually use tech to restore the humanity in practicing medicine.

[u/TheDollarstoreDoctor]

What a good time to not be in health information management anymore, my blood pressure is spiking looking at this and the comments

[u/CustomerLittle9891 → u/TheDollarstoreDoctor]

How confidently wrong so many people are about the job, how it works and what these kinds of programs mean to providers is unreal.

It genuinely does make me wonder if we're just seeing the most susceptible to anti-AI propaganda just repeat buzzwords.

[u/sir_moleo]

My after visit notes for almost every doctor I have has a bunch of things they "discussed" with me that never happened. They write these notes like they spent 20 minutes going over everything in detail when they spent 5 minutes in the room and booked it to their next patient lol.

Edit: A few examples from a recent dermatology appointment. This doctor is probably the worst offender for this kind of stuff. He spends like 3 minutes talking to me and then he's gone lol. There's no way he could possibly ask me all this stuff on top of the actual issues unless he was also an auctioneer.

• He has not had any blisters drainage bleeding fevers chills rigors or ulcers.
• He denies any headaches or dizziness abdominal complaints instability weight loss and he is not depressed or suicidal and really no other side effects.
• He denies any other suspicious pigmented lesions or palpable lymphadenopathy no infections and no purulent drainage or bleeding from any lesions.
• The diagnosis regarding the psoriasis was reviewed with the patient we did also discuss gentle skin care bathing moisturizing avoiding aggravating factors. We discussed treatment options risks benefits and side effects at length
• I did stress the importance for the use of sunscreens with an SPF of at least 30-45 wide brim hats and protective clothing and we did also discuss what to watch for for any changes in lesions and nevi.

[u/Hyperfocus_Queen]

As a patient with chronic illness, I found that doctors are playing fast and loose with consent these days. Notes include things that are incorrect or never happened, the forced use of AI with false consent, and so much more.

As a therapist, IMO, you cannot ask a patient in the moment for their consent for something like that (i.e. The doctor walks in and says “by the way is it OK if I use AI to document this appointment?”), you have to give patient an opportunity to think about your request and decline it without feeling pressured. To me, it’s similar to asking if a student doctor can participate, or if they share your case study in an academic environment. When it comes to documentation and private information, it just doesn’t feel right to me to ask a patient a question like that on the spot, and there’s times when I’ve even said yes when I didn’t actually mean yes because I felt like I wasn’t given any other options. It is not okay.

[u/TheTVDB]

AI in healthcare is a good thing. Diagnostic models have a higher rate of success than doctors. They shouldn't be the only tool they're using, but combined with the doctor's training and other tools, they're have been shown to improve patient care. These aren't LLMs we're talking about.

[u/GryphonCough]

I had this last time I went to the doctor and checked my notes online. I sent my doctor a message and she said that we had previously discussed it (we had not) and that it’s there just to help her transcribe notes.  

This is all a fucking horrible idea. I’m so tired. 

[u/orangecanela]

This happened to me recently - it was a different doctor (my regular PCP was not available) and I noticed the exact thing in the notes. He never asked for consent, so I was also irritated.

I'm not necessarily opposed to the use of AI to help my doctors take notes, but it was the fact that I never gave consent that was upsetting.

[u/FourFront]

The amount of shit people make up in their heads about what AI is, and isn't being used for is a derangement syndrome in itself.

[u/krt941 → u/FourFront]

Medical offices have been using AI transcribers since before the current AI crazy even started, haven’t they?

[u/goonsquadgoose → u/FourFront]

It’s seriously sad how ignorant so many people are. The medical field is exactly where you want to use AI. Triaging and diagnosing is literally following specific steps based on specific conditions, something computers are much better at than humans are. Not to mention general AI has been used over a decade in that field and people didn’t say anything until they saw it generating art.

[u/CustomerLittle9891 → u/goonsquadgoose]

It's genuinely a moral panic. That's why there's so little critical thinking about it.

[u/Jewronski]

This is machine learning getting lumped into the AI discourse. This is the same tech thats been on your phones for over a decade at this point, with a fancier wrapper, and a controlled output into a text file.

There may be some light actual chat gpt-age going on, but largely auto-scribe tech is one of the few good use cases for AI, and is a real time saver for doctors (who over the years have had a larger and larger paperwork burden foisted upon them)

[u/Maximum-Category-845]

Honestly there is probably a statement somewhere in all the consent forms everyone signs during intake that no one reads.

[u/StarlightInDarkness]

For many clinics/hospitals, it’s now part of the consents patients sign to be treated i.e. all those forms with registration.

[u/DizzyCommercial7705]

Look what I found in the notes from my last doctor's appointment:

"I informed the patient or Legally Authorized Representative about the use of ambient technology to assist in the creation of this note. The patient or Legally Authorized Representative provided their consent for the use of this technology."

No sir, she DID NOT!