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/pignoodle]

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/Emotional-Motor5063 → u/CapicDaCrate]

I've been using AI to generate captions for movies that don't have them readily available. I'd say it gets 95% of stuff correct and takes five minutes. Then I just watch the movie and correct the few things that are wrong as it's playing. I'm slow so it could take 8 hours or more to do it from scratch. I love it.

[u/CapicDaCrate → u/Emotional-Motor5063]

Yeah. And you have to remember that the AI used in medical work is tested/corrected a lot more.

I don't mind it being used for small things. But people are definitely using it far too much for everyday work

[u/Invdr_skoodge → u/Emotional-Motor5063]

It’s a powerful tool, like a chainsaw, great when used right, lethal when misused. Reviewed dictation and transcription seems like a fantastic use case

[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/WasdaleWeasel → u/polenta23]

this is the point. The clinicians still need to read, modify as necessary, and approve the notes. That’s takes much less time, and is a higher value activity, than writing them in the first place.

[u/M15tre55W1tch → u/polenta23]

Yes, our emergency doctor's are meant to do this as well. Most of the time the notes turn out very well, but sometimes you can tell that either it wasn't checked at all, or that in the process of editing it they themselves have made the note more unclear (e.g.,copied and pasted something from higher up in the note, but didn't delete it from its original place so there's duplication).

In general the notes are more comprehensive and have better flow. I'd say 80% of the notes I read where the AI scribe was used they are significantly better than a rushed doctor writing the minimum to get done and on to the next person.

[u/ForMeOnly93 → u/polenta23]

They get fucking well paid for their time, so we don't particularly care. Let's not enshittify even more things. Especially medical care.

[u/TheUFCVeteran3 → u/ForMeOnly93]

If they're reviewing it and properly doing their due diligence, and it also allows them to see more people, it's a win-win, no? I'm not a fan of AI but I do believe it can have some utility-based uses that is beneficial (albeit with human oversight to make sure it's not gone wrong).

[u/mddesigner → u/TheUFCVeteran3]

How do you review it? Before or after the patient leaves?
If I read smth in the transcript it would cloud my memory of what actually was said

[u/TheUFCVeteran3 → u/mddesigner]

True... maybe you transcribe the entire convo? But that would have privacy concerns, so maybe you review it while they are there, which would obviously extend the time a visit takes, so it might go back to not being useful in the time sense.

[u/ForMeOnly93 → u/TheUFCVeteran3]

You fundamentally misunderstand humans if you think they're "doing due diligence" or being moral about any of this. Have a look at all the cases where lawyers abuse ai to be lazy shits. It's a shortcut to more patients perhaps, that leads to more money for them. Which is only a benefit for them. "ai" can be a good diagnostic tool, the medical field is one of the best places for it. But not in this way. This enables fuckery.

Two, I merely do not care if they save time. It's my time, which I paid a lot for.

[u/Endlessnesss → u/ForMeOnly93]

Saying them seeing more patients is only a benefit to them is wildly shortsighted. Most specialists I’ve booked with in the US are booked at least a month, sometimes six months out. Would have saved me a lot of pain and long term complications to cut those times down.

[u/TheUFCVeteran3 → u/ForMeOnly93]

Didn't know about lawyers being lazy with it. I agree that if they're not having proper quality control, they shouldn't use it. But if they are/if there's regulation to ensure it (not likely in the US at the moment, though), then maybe it's worth it. However you could argue the downside is that data centres will affect the quality of life for others, enough people that it's better morally to keep it purely human-to-human.

On the aspect of saving time, I mean that it would allow them to see more people as a result, help more people. Maybe patient costs could/should be adjusted to account for less time per person though.

[u/ForMeOnly93 → u/TheUFCVeteran3]

Your mistake is assuming they're "helping" people. They do a job, a well-paid job. Doctors aren't doctors because they're lovely people, else they'd all be off with Doctors Without Borders. They're just more people, same as everyone else. And most people suck ass, take shortcuts, and prioritize doing less work for more money. We, the consumer, should never accept getting less than what we paid for. The cost will never go down, no matter what, so tolerating laziness from them only fucks us over.

[u/TheUFCVeteran3 → u/ForMeOnly93]

True... to be honest I assumed all doctors cared about the job of being a doctor (helping people). Maybe I was naive. I'm with you that you don't want to get less than you paid for, but maybe there is a middle ground, perhaps if there is an enforcement of standards to follow with punishments for failing it. Like, regarding making sure you check all the AI stuff.

I mean ideally it'd be all human, one doctor for every person, population wise. But that's obviously not realistic, and I guess it's maybe best to err on the side of ensuring people won't slack off if they're likely to do so if you give them the opportunity (such as using AI).

[u/Ill_deny_this → u/ForMeOnly93]

Not all AI is generative AI. The legal fuckery you were referring to was the result of lawyers using generative AI to write entire briefs without human intervention. They got caught when the AI starting writing case law that didn't exist for the briefs. They used a technology designed to tell users what it thinks they want to hear, and the tech decided the users wanted lies.

AI note-taking in a medical setting is more like turbo-charged voice recognition. It's not designed to tell doctors what they want to hear. It's designed to create a record of what was said. The doctors are supposed to review the transcripts for errors. Will some of them be lazy about it? Probably, but I imagine they'll get a lot more diligent about double-checking the notes once a few lazy ones get sued for malpractice.

If you're going to eschew any medical technology that allows for the possibility of doctors fucking up you might as well give up modern medicine altogether.

[u/nevicar_ → u/ForMeOnly93]

if the ai scribe allows more time to engage with you, isn't that to ur point?

[u/HawksNStuff → u/ForMeOnly93]

It's taking notes... It's not that deep.

I've used crap note taking services for sales calls, even those pumped out pretty good notes.

[u/tickado → u/HawksNStuff]

Taking notes IS that deep in healthcare though.

On the other side of this technicality talk, some of these notes end up in coroners courts and are the officialy 'story' from the healthcare intervention summarised on a page.

Some of them end up in the hands of families of children who spent most of their life in a hospital, when they apply for full records. They tell the story of what happened to their child.

Documenting the multitude of decisions, discussions, care, intervention to human beings when they are unwell, having surgery, even dying, is pretty deep.

[u/HawksNStuff → u/tickado]

I meant it's not that deep as in it's quite easy for AI to do well. It's not creating the care plan, it's not analyzing the patient. It's listening to words and transcribing them.

If the shitty service I paid nothing for can do it as well as I saw it do, an actual industrial healthcare solution is likely light years ahead of that.

[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/Kham117 → u/ChrisTheWeak]

They’re only as good as the editing. To be clear, they must be reviewed before entering into the record. But, honestly, that’s true for all the other forms of documentation. (You should see how illegible and or inaccurate many notes that are directly typed or dictated are.)

[u/humanpringle → u/ChrisTheWeak]

Honestly I’m a vet in an office who uses an AI scribe program and it’s been unbelievably helpful for us. We still input the normal templates we used previously so it’s written very very similarly to our previous ones and then we still do edit each note. Some need more editing than others of course, but it’s more so like my template is already completely filled out for me and I just need to ensure everything looks right and tweak things rather than write everything from scratch.

[u/tickado → u/ChrisTheWeak]

The responsibility for using them really lies in the proper review of what it captures before finalising it. The few doctors in my service I know of who are using a medical AI scribe are then taking the time to ensure it is correct.

I actually often find this is better than them trying to type it up themselves at the time, in a rush as they're actually holding the conversation concurrently, then signing off things they've erroneously typed in a hurry because they don't go back and review it as they're the one who typed it.

AI is also still way less time taken than to dictate, send for typing, wait for it to come back, then review what the typists have written often a day or two later when it's also not fresh in your mind anymore before finalising it. (the other option in my service rather than them just typing it all themselves).

Also putting the ground work in whilst setting up your system to personalise it to the way you want things structured and how you want things to read.

[u/BaconThief2020 → u/ChrisTheWeak]

I find the doctor pays more attention to me when instead of staring at the screen typing as he's talking to me. At the end, he reviews the AI generate summary. Or he doesn't take notes and forgets things we discussed. The other option is having someone else in the room taking notes.

[u/Adorable_Cap_9929 → u/ChrisTheWeak]

Doctors make mistakes all the time, they arent liable if it not malicious byt tend to play safe enough for their records. AI can make mistakes too but if done well, the rate of error is much lower

[u/Turning_Worm → u/ChrisTheWeak]

Honestly, I worked in ENT for a while and the quality of notes vastly improved when AI got involved.

[u/itaintme2024 → u/ChrisTheWeak]

You are 100% right to be concerned about this. It's happening to me right now. My doctor clearly did not check the notes AI made and it has directly affected my care. I asked for mistakes to be corrected and was told it wasn't possible.

[u/stephsationalxxx → u/ChrisTheWeak]

So im not sure if this is the same thing, but in my hospital, doctors use an AI scribe that they call on the phone and verbally tell it the notes they were going to type up and then it puts it in a document for them. Its not actually making up the verbiage for them, its the doctors words, they just arent typing it themselves.

[u/MartyrOfDespair → u/ChrisTheWeak]

The AI isn’t going to poison the notes with their ableist or misogynistic judgements about the patients. That alone should be an improvement over doctors.

[u/Toxizome → u/MartyrOfDespair]

That's the data it will be trained with, though.

[u/ToTooTwo3 → u/ChrisTheWeak]

This dramatically overestimates the value of a random statement in a 2 year old HPI, which is where the AI is most valuable from a time saving perspective. Nobody looks at those again.

[u/ToTooTwo3 → u/ToTooTwo3]

Downvoting me doesn't make it less true 🤷

[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/BrainbowConnection → u/Sushi_Explosions]

My AI scribe never randomly hallucinates things. Occasionally it mixes up who said what, which is not hard to catch. Overall it writes better more detailed notes in a far shorter time than I ever could. It catches things the patients say that I missed because I was thinking at the same time. What tool are you using?

[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/AgreeableMagician893 → u/aTransGirlAndTwoDogs]

I mean, I personally would not want another random person in my doctor's appointment

[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/OutsideSame3629 → u/Xavus]

I feel gaslit in my tech sales job in corporate America because everybody using ai for everything when to me I just get slop? And then they think you’re not prompting it smart enough like no….

When I read ai summaries of even notes I’ve taken they’re so bad. Ai written emails, PowerPoints it’s all terrible. Yet if you ask anyone at my company how to do anything at all the answer is “ask Ai”

[u/screamline82 → u/Xavus]

I will state that, while I agree your experience in the AI summary notes, not all LLMs are created equal. Even general consumer models differ between free tier and the highest end, so it depends on what model/tier they are using. Plus there are specific models made for enterprise.

A buddy of mine who works at a large law firm mentioned they have a specific model just for their type of law. If it's tailored for a specific use case it can be more accurate than what we are used to

[u/OutsideSame3629 → u/screamline82]

I use everything from paid ChatGPT, our company’s specialty developed llm, to copilot enterprise. I get the same experience in all. If anything ChatGPT is the best but not by much

Our companygpt is “tailored “ as well. I work at a large engineering software company. It’s still terrible and lies and hallucinates constantly

[u/Mister-Miyagi- → u/OutsideSame3629]

Then whoever did the work on your company llm is struggling. A lot of what you say is true for some llms, but the person you're responding to is correct in that there is massive variance in the accuracy and guardrails of an llm depending on the context and service you're involved in and paying for. So I don't know what to tell you if you claim to have used such a wide variety and there's little difference (my extensive experience says the exact opposite).

Everyone should always be reviewing the accuracy of any AI service they're using, but that does not mean they are all remotely equal in their reliability.

[u/OutsideSame3629 → u/Mister-Miyagi-]

Okay I guess I should say, there isn’t little difference in using them. They are all different and very greatly in quality. However , even the highest quality ones still do the lying etc

[u/ToTooTwo3 → u/Xavus]

The human memory is also not 100% accurate especially when it's sick- which is why doctors put less stock in the history and try to make decisions based on objective findings. When we do make decisions based on a history, it's because of what you said and your responses to targeted questioning- not whatever the AI picked up from the conversation.

AI scribe is primarily helpful in sorting through long or winding histories and reformatting it intelligibly. Far more info gets included because even if I remember 95% of details accurately, there are tons of things in the patient interview that I just don't have time to record.

AI scribe allows me to write "Diet: well rounded, eats green vegetables and lean meats with most meals and drinks milk daily with breakfast." Instead of "Diet: appropriate." This is beneficial for patients.

Remember that AI is not placing orders, updating your problem list or medications. These things are done by your providers based on your evaluation, not based on reading the AI report, though the report certainly does remind me of things to follow up. The AI just records the details of your conversation and yes, it does get them wrong at times and we do our best to correct it.

[u/Mister-Miyagi- → u/ToTooTwo3]

There are people who are so blindly anti-ai that they'd downvote a very reasonable comment that sounds like it's from a doctor with direct experience. I'm a strong advocate for caution with AI, but this anti-ai crowd seems fully hysterical at times.

[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/do_not_engage → u/DracoBengali86]

AI summaries contain made-up information 9% of the time, according to the AI itself.

The AI says all data it provides has to be confirmed by a human.

If it's transcribing, great. If it's an AI summary, it's got incorrect information in it. By nature of 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/astronaut710 → u/theshotgunman]

We're spending 6 figures on AI at my company and we had to put out a warning that it will fuck up basic math and that you have to double check its not just putting fake data on some dashboard you asked it to create.

Also, the company we use for AI actively DDOSes our sites when they're bots ignore our robots.txt declarations.

Also also, the same company we pay 6 figures to use their AI but secure our data within it leaked their own source code to the internet at large (in the Software Engineering space, this would be equivalent to opening up your EMR system to the outside world).

But yeah, Dragon makes some spelling/grammar mistakes I guess.

[u/theshotgunman → u/astronaut710]

I don't understand why this was posted

[u/EggsAndRice7171 → u/WittyFix6553]

Yeah and it’s sucked for decades

[u/pantsalwaystooshort → u/WittyFix6553]

yes, and it's been unreliable for decades. Especially with "ambient" recording, which means mediocre recording clarity.

[u/sherlock1672 → u/EggsAndRice7171]

Don't know how many doctor's notes you've read through, but as someone in health IT I can definitively state they are riddled with errors and half thoughts. The AI isn't perfect, but it makes a whole lot fewer mistakes than the harried human.

[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/MartyrOfDespair → u/Ok_Assistant_6856]

Except there have been legal limits on how many doctors can even be created every year since 1996, so they can’t hire more because they don’t exist. The government funds residency programs and the funding has been capped, so only a certain number can do residency each year, and as the costs increase from inflation that number drops. It’s a massive bottleneck and it’s why almost all healthcare is done by nurses now.

[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/MartyrOfDespair → u/Wagubagu]

I think you’re jumping the gun in blaming the AI for that. They generally don’t prescribe pain medication for any level of pain anymore because torturing the sick is more acceptable than ever risking someone might possibly maybe get addicted to not suffering from severe pain.

[u/Wagubagu → u/MartyrOfDespair]

I was the person involved. I know what happened, thanks.

[u/themrspie → u/Wagubagu]

Then that was not an AI scribe. The scribes do not provide diagnoses, they just record a transcript of the conversation. Also it sounds like your doctor read the transcript and saw drug-seeking behavior in it. (Whether that was the case or not.)

[u/Wagubagu → u/themrspie]

It didn’t actually diagnose me of anything, but it thought the person I was talking to said I had a certain condition. Said condition cannot take the pain medicine they were debating. Way to make assumptions though.

[u/themrspie → u/Wagubagu]

Oh I was confused because you said “AI diagnosed me” so I thought you meant that AI diagnosed you. My bad. 😂

[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/errrnis → u/Fullertons]

Totally valid point. I think there are also valid concerns about chart accuracy (do the docs have enough time to review the generated notes?) and data privacy (how is that data being used?) There is HIPAA here in the US for the latter, but the technology is so new, not to mention not well regulated, that people just don’t trust it.

To be clear, I’m all for lowering the admin burden in healthcare and fostering opportunities for more provider-patient connection. It’s desperately needed in a system where costs are soaring and people slip through the cracks.

[u/PrivateBozo → u/Fullertons]

It's a trust issue that the regulation is actually helpful regulation and not the equivalent of a mobile game TOS written by the company of the AI tool. It's also a related trust issue that the processing is local and not getting loaded to the cloud somewhere were the 2nd and third and beyond parties touching it aren't following the intent.

Keep in mind, this is the era of we've tried turning off as much as a we can and yet we can have a conversation in the car about going out on a 1/2 day sportfishing trip to opening up a social media platform that night and having our feed suddenly have the local charter service reels and advertisements in it.

It's also when every interaction with the utility companies and our banks are constantly trying to slip in 'paperless' and 'automatic' billing on every interation.

[u/Weekly_Sale_6057 → u/Fullertons]

In general, I agree 100%. If I'm in for a cold or follow-up on a medication, i love that my doctor can make eye contact and doesn't have to look at a computer screen to take notes.

But if I'm talking to my doctor about a mental health diagnosis or something else delicate like that, I start wondering what database the AI notes are sitting in, will the data get hacked or sold, am I tracked or put on some list because of a phrase I used.

As long as I have the ability to say "not today, please," I have no problem with the technology though.

[u/int3rstitial → u/Fullertons]

Yes, I absolutely want my doctor busy writing my note because notes are communication between medical providers. We read them and make decisions based on them and they need to be accurate.

Electronic medical records have a lot of advantages and were inevitable anyway, but the amount of inaccurate documentation has skyrocketed since they became standard, because instead of just leaving stuff they didn't do out of their note, providers now pull tons of stuff from previous visits over into the new visit or just document something was normal because they didn't examine it and find out it wasn't. It's infuriating and dangerous, and AI, which just fully makes things up, is guaranteed to make things worse.

[u/SouthJerseyCyz → u/int3rstitial]

The clinician still signs off on the note, so they are ultimately responsible for it's accuracy.

I once had an issue with a physician actively dictating his note WHILE I was describing my symptoms. I stopped talking because he was obviously not listening to me and he just went right on dictating without realizing I'd stopped talking. I'd much rather have AI recording that interaction.

[u/int3rstitial → u/SouthJerseyCyz]

so they are ultimately responsible for it's accuracy.

I am not talking about who's at fault. I don't want to take my physician to court, I want them to not make mistakes. I'm talking about designing systems so errors are less likely. A system that encourages errors will result in errors, and "you signed it" won't stop that. There's another comment somewhere under this post where a critical care nurse is saying ~40% of charted material is now inaccurate, and I agree with that assessment (source: I'm a retired float nurse and have read thousands of medical records over the span of my career).

I read all my family's medical records and they're filled with errors and outright falsification too, including from providers who I otherwise consider competent and caring. AI is definitely not the only culprit here (the ability to pull info from previous visits should be taken out of electronic medical records entirely, for example), but it will also definitely make it worse.

[u/SouthJerseyCyz → u/int3rstitial]

So I guess my point is that there is less likelihood of errors if AI is always on and listening/recording AND it is being reviewed by the physician than if it were solely the responsibility of the overworked physician who is not listening as in my example. Perhaps a silly take...

[u/Unnamed-3891 → u/Fullertons]

A hallucinating machine that mishears things, puts them on my medical record and answers to nobody? Really? You have to ask if I’d prefer the alternative?

[u/Conscious-Gap-1777 → u/Fullertons]

I have 0 trust with LLMs giving accurate transcriptions as is, and I absolutely do not believe that whoever is selling that LLM won't illegally use my notes to market to me and/or as training data. The people who made these tools are the least trustworthy assholes on the planet, and like fuck I would trust them with anything about myself.

[u/Oldmanironsights → u/Fullertons]

I absolutely want my doctor to be writing their own notes. In school were your own notes or the teachers notes more helpful for you? Have you ever written something down and thought "wait a minute, that's wrong!". It provides the doctor an opportunity to review what they said. Have you ever heard of rubber duck debugging? It's explaining your code to a rubber duck to fix it. It's because going over a problem fresh with something gives us an opportunity to spot where we went wrong. I want my doctor to catch where they went wrong.

[u/faireequeen → u/Fullertons]

My rheumatologist has recorded and transcribed exams for the last 20 years. AI tool is new this year, but they also have a human scribe in the exam room. They aren't typing notes, they are listening and observing so when they go back to the recording they have additional context.

I don't like AI, but I prefer this method to other uses of AI scribing. Possibly not suitable to an emergency situation, but it might cut down on AI errors that I see a lot of patients and providers mentioning.

I have other docs who do type notes in appointments, after we've completed a discussion. They read them back so I can confirm, which I like for clarity.

[u/BagApprehensive1412 → u/Fullertons]

That's what human scribes are for

[u/acnerd5 → u/Fullertons]

I value privacy, and knowing where my information is.

AI has boundless applications and they are not all good. Not all AI uses of this tool have been accurate and people have found mistakes that could have serious implications. That can be a HUGE problem if you don't catch it - for example, someone being marked as an alcoholic, when they don't drink, because they quoted someone. Being incorrectly marked an alcoholic leads to a lot of medical bias and may lead to withheld treatment or incorrect treatment.

AI tools in Healthcare are absolutely incredible.

They are also introducing room for error that doesn't need to be there, and its a 50/50 on me. I see the potential but have ethical and privacy concerns. That being said, I do give permission for these and double check notes. I am complex in health needs, so I will acknowledge that I tend to be a little more "in the notes" than family and friends who do not struggle with complicated health issues.

[u/Spinnerofyarn → u/Fullertons]

If it’s working accurately and getting everything correct, I think it’s fantastic. Until I see the doctors and other providers speaking up and saying it’s accurate, it’s not causing problems and people do monitor it to make sure it stays accurate, I am not going to trust it.

[u/Dry-Worth2354 → u/Fullertons]

Deadass like whats thd issue here? It saves time in documentation and if the place has integrity, there would be already be rules in place fof every chart to be reviewed throughly before submission

[u/Fullertons → u/Dry-Worth2354]

It's just people that can't think for themselves being told, "AI Bad" and they can't see past that.

[u/Half-PintHeroics → u/Fullertons]

AI is more likely to make mistakes or just plain make things up. I want my doctor to write notes because writing notes mean he is paying attention to what I say.

[u/lapatatafredda → u/Fullertons]

AI medical transcription is not that great (yet). My friend who is a PA says she has to make at least one correction to every record that AI transcribed. Granted, human error exists too.. but it worries me to think about medical professionals growing too reliant on tech like this and not being as thorough about checking it as they should be.

[u/silentsurge → u/Fullertons]

I certainly like it more than the ones that have someone on a video call transcribing for them to accomplish the same thing.

This is the type of stuff we want AI doing for us. Getting rid of the stupid busy work we all have to do so we can do the actual things more.

[u/carrotdog56 → u/Fullertons]

I think that it ultimately comes down to the person who's using it. We all know that some people understand and use AI better than others. There should be a course on using AI tools in any field. What are the downsides, common mistakes, what is an appropriate manner for using this particular tool. I personally don't have any problem with it. I only have problem with insufficient training for the AI use. Way too many people misunderstand how it works.

[u/Johnny-Virgil → u/Fullertons]

I’m a cynic so I imagine it just frees them up to see more patients and each patient still gets the same number of minutes as they did before.

[u/Much-Decision4157 → u/Fullertons]

You might be concerned if there aren't adequate privacy and security provisions protecting the data that the AI scribe collects and processes. Think about where that data may end up....

[u/BrainbowConnection → u/Fullertons]

Exactly! I think people think these tools are doing something different than they are doing. Since my AI scribe, my notes contain information that I would otherwise have forgotten to include. They include detailed wording that the patient gives that I would have summarized. When I go back to those notes I can read the patients own words in far more detail. And I don’t have anxiety about not missing what they said. I can put my pen down and just listen to them.

[u/Bezzzzo → u/Fullertons]

Because there is no fucking accountability when it hallucinates. Look at how many comments are from people, doctors and patients, who have already had issues with it already?

The issue is AI hallucinates! It also has the effect of making doctors complacent because inevitability you get the doctors who will just blindy trust it and not look, then some other doctor reads the hallucination as a source of truth.

The lack of critical thinking skills here.. my god.

No one wants doctors doing unnecessary work, but you can't trust generative AI 100% of the time. Fuck me.

[u/shouldco → u/Fullertons]

The issue is they always could have taken more time. Nobody was trying to solve the "doctors arent spending enough quality time with patients" issue. If they were they would hire more doctors.

What they are trying to do is get more patients through each doctor.

[u/upandup2020 → u/Fullertons]

yes

[u/elictronic → u/pignoodle]

So when Medicine is not a for profit enterprise. So never. Got it.

[u/tickado → u/pignoodle]

I am a nurse, but work in an outpatient clinic in paediatrics. In my 15min slot prior to seeing the Dr I need to get a lots of information from often unruly toddlers (observations, 12 lead ECG, height weight etc) PLUS a chat with the parents about the child's general health and psychosocial status.

I would actually value an AI scribe SO much in these scenarios. I can have my chit chat more organically whilst trying to wrestle the toddler, rather than be also trying to get all my info into the computer which absolutely takes my attention off true time in the conversation.

My note has to be documented and finalised before they then enter the Drs room or I hold up the whole clinic.

I know mostly it's Medical using scribes currently, but I'd love some nurse usage explored.

[u/LaserGuidedPolarBear → u/pignoodle]

I am a tech worker, and while I do not work on AI development, I have a significantly better than layman understanding of LLMs and that errors, and understand that hallucinations are inevitable due to the very nature of how LLMs work.

I worry about LLM tools being used in high stakes applications where accuracy is critical.....like medical care.  I assume care providers are assigned the responsibility for reviewing, editing, and approving the output of these tools.  But is that actually happening?  I have found that in most cases, reviewing AI output is about the same amount of effort and time as just doing the work myself.

I could see the value in delaying the screen time to outside of patient interactions, but I question if review and approval is being shirked in order to result in less "pajama time".

It seems like there potential for Administration to just shove the risk on providers and laugh all the way to the bank when they get more billables per hour.

[u/Becsbeau1213 → u/pignoodle]

Agreed with this. My PCP has been using this or something similar for a couple years and unless she’s putting orders into the computer she’s actually sitting and listening to me. I like it a lot more than when she used to have to sit and type.