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Can you say no to your doctor using an AI scribe?

Health & Wellness

Can you say no to your doctor using an AI scribe?

1757555103926.png Can you say no to your doctor using an AI scribe?
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Doctors’ offices were once private. But increasingly, artificial intelligence (AI) scribes (also known as digital scribes) are listening in.


These tools can record and transcribe the conversation between doctor and patient, and draft structured clinical notes. Some also produce referral letters and admin outputs, and even update medical records – but only after clinician review and approval.


Some estimates suggest about one in four Australian GPs are already using an AI scribe. Major hospitals, including children’s hospitals, are also trialling them.





The pitch is simple: less typing for doctors, more eye contact with the patient. But what about patients’ privacy?


Until recently, the AI scribe market has been largely unregulated. But last month the Therapeutic Goods Administration (TGA) – Australia’s medical device regulator – decided some scribes meet the legal definition of a medical device.


Here’s what this will change, and what patients should know – and ask – about AI scribes in the consult room.





What’s changing


Until now, many AI scribe vendors, from Microsoft to rising Australian startups such as Heidi and Lyrebird – and over 120 other providers – have marketed their tools as “productivity” software.


This means they have avoided the scrutiny of medical devices, which the TGA regulates.


Now, the TGA has found some AI scribes meet the definition of a medical device, especially if they go beyond transcription to suggest diagnoses or treatments.


Medical devices must be registered with the TGA, shown to be safe and do what they claim, and any safety problems or malfunctions must be reported.


The TGA has begun compliance reviews, with penalties for unregistered AI scribes.


This follows similar developments overseas. In June 2025, the United Kingdom health authorities announced tools that transcribe and summarise will be treated as medical devices.


Although still evolving, there are signs the United States will move in a similar direction, and the European Union may too.


In Australia, the TGA has only just begun reviewing AI scribes, so patients can’t assume they’ve been tested to the same standard as other medical products.





What patients should know about AI scribes


They can help – but they are not perfect.


Doctors report spending less time on keyboards, and some patients report better conversations.


But tools built on large language models can “hallucinate” – add details never said. One 2024 case study recorded casual remarks about a patient’s hands, feet and mouth as a diagnosis of hand, foot and mouth disease. The potential for errors means clinicians still need to review the note before it enters your record.


Performance varies.


Accuracy dips with accents, background noise and jargon. In a health system as multicultural as Australia’s, errors across accents and languages are a safety issue.


The Royal Australian College of General Practitioners warns poorly designed tools can shift hidden work back to clinicians, who then spend extra time correcting notes. Research has found products’ time-saving claims are often overstated once review and correction time is included, underlining the need for devices to be evaluated independently.


Privacy matters.


Health data is already a target for hackers and scammers, as the 2022 Medibank breach showed. In recent research with colleagues, we found unsecured third-party applications and lax data protection are among the leading causes of health data breaches.


Clinicians need a clear “pause” option and should avoid use in sensitive consults (for example, discussions about family violence, substance use or legal matters).


Companies must be explicit about where the audio and data are stored, who can access it, and how long it is kept. In practice, policies vary: some store recordings on overseas cloud servers while others keep transcripts short-term and onshore.


A lack of transparency means it’s often unclear whether data can be traced back to individual patients or reused to train AI.


Consent is not a tick box.


Clinicians should tell you when recording is on and explain risks and benefits. You should be able to say no without jeopardising care. One recent case in Australia saw a patient have to cancel a A$1,300 appointment, after they declined a scribe and the clinic refused to proceed.


For Aboriginal and Torres Strait Islander patients, consent should reflect community norms and data sovereignty, especially if notes are used to train AI.





Five practical questions to ask your doctor


Is this tool approved? Is it the clinic’s standard practice to use this tool, and does it require TGA registration for this use?


Who can access my data? Where is the audio stored, for how long, and is it used to train the system?


Can we pause or opt out? Is there a clear pause button and a non-AI alternative for sensitive topics?


Do you review the note before it goes into my record? Is the output always treated as a draft until you sign off?


What happens if the AI gets it wrong? Is there an audit trail linking the note back to the original audio so errors can be traced and fixed quickly?





Safer care, not just faster notes


Right now, the burden of ensuring AI scribes are used safely rests disproportionately on individual doctors and patients. The TGA’s decision to classify some scribes as medical devices is a positive move, but it is only a first step.


We also need:


the TGA, professional bodies and researchers to work together on clear standards for consent, data retention and training


independent evaluations of how these tools perform in real consults


risk-based rules and stronger enforcement, adapted to AI software rather than traditional devices.


Strong rules also weed out flimsy products: if a tool cannot show it is safe and secure, it should not be in the consult room.


This article is republished from The Conversation under a Creative Commons license. Read the original article.

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when I try to get an appointment from my doctor (very rare) the time and date I'm given at the counter is often changed by 'HOT DOCS'" to a time and date totally useless to me. They also tried to fob me off to a nurse. I have made it perfectly clear I will have nothing to do with hot docs and if I need a nurse I WILL DO IT MYSELF. I told my doctor that I was probably training as a nurse before his nurse's parents were even born.
 
Doctors - GPs - usually allow 10-15 minutes per patient for a normal consultation. The first 5 of which is greeting and getting the patient into the consultation room and seated. When you're old and slow and doddery like me, and the consultation room is at the end of a long corridor or further, that's at least 5 minutes gone.
Leaving 10 minutes to
- hear why the patient is seeking the doctor's help
- asking questions to clarify the description - sometimes this also proves the doctor did not listen properly the first instance!
- make a diagnosis
- explain the diagnosis to the patient (some doctors are not very good at that. They use Proper Medical Jargon, which is gobbledegook to the average citizen. This black duck has pulled them up occasionally - I ask them to speak English. Or, once, when the doctor told me proudly I had 'diffuse, subacute spongiform dermatitis, I remarked that was a good description - now exactly what caused it and what is the rationale for the therapy proposed. He never did explain any of it, but then, I had a very, very low opinion of that gentleman.
(Translated:'widespread, chronic or long standing skin disease involving oedema - fluid accumulation of the actual skin cells themselves.*
* oedema (or, if you're a Yankee, edema) refers to any fluid accumulation. It is usually between the cells.

- write any prescriptions and/or referrals required.
Not much time to do all that, is it? No wonder doctors are always running late and are genuinely overworked and under stress.
 
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Doctors - GPs - usually allow 10-15 minutes per patient for a normal consultation. The first 5 of which is greeting and getting the patient into the consultation room and seated. When you're old and slow and doddery like me, and the consultation room is at the end of a long corridor or further, that's at least 5 minutes gone.
Leaving 10 minutes to
- hear why the patient is seeking the doctor's help
- asking questions to clarify the description - sometimes this also proves the doctor did not listen properly the first instance!
- make a diagnosis
- explain the diagnosis to the patient (some doctors are not very good at that. They use Proper Medical Jargon, which is gobbledegook to the average citizen. This black duck has pulled them up occasionally - I ask them to speak English. Or, once, when the doctor told me proudly I had 'diffuse, subacute spongiform dermatitis, I remarked that was a good description - now exactly what caused it and what is the rationale for the therapy proposed. He never did explain any of it, but then, I had a very, very low opinion of that gentleman.
(Translated:'widespread, chronic or long standing skin disease involving oedema - fluid accumulation of the actual skin cells themselves.*
* oedema (or, if you're a Yankee, edema) refers to any fluid accumulation. It is usually between the cells.

- write any prescriptions and/or referrals required.
Not much time to do all that, is it? No wonder doctors are always running late and are genuinely overworked and under stress.
 
when I try to get an appointment from my doctor (very rare) the time and date I'm given at the counter is often changed by 'HOT DOCS'" to a time and date totally useless to me. They also tried to fob me off to a nurse. I have made it perfectly clear I will have nothing to do with hot docs and if I need a nurse I WILL DO IT MYSELF. I told my doctor that I was probably training as a nurse before his nurse's parents were even born.
Goodonya.
Though sometimes I think nurses have a better idea of what's wrong with the patient than some doctors do! I have been seen by some seriously unconvincing doctors in my time.
 
Not long ago I tried another doctor. Palastinian this time (normal doc from Burma). I took my medical reports with me. She rudely asked who the woman with me was and when I said "my carer" the woman never said another word to me. We were actually tossed out after 5 minutes being told I had too many problems to deal with. That idea was formed on the basis of over 60 years of my medical reports. Carer was told "take her back where she came from".
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Not long ago I tried another doctor. Palastinian this time (normal doc from Burma). I took my medical reports with me. She rudely asked who the woman with me was and when I said "my carer" the woman never said another word to me. We were actually tossed out after 5 minutes being told I had too many problems to deal with. That idea was formed on the basis of over 60 years of my medical reports. Carer was told "take her back where she came from".
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I think the Palestinian "doctor" should be taken back to where she came from! How the hell did she get registration to practice in Australia?
 
I am not sure if I can trust AI to take notes. I have a wonderful young doctor who will call to see how I am going if he has not seen me for a couple of months. This is rare these days. So many horror stories. He has said if I need to see him at any time and there are no appointments he will squeeze me in and not to worry. (I do have some serious health issues). He always takes time to be thorough. I have been seeing him for about 8 years and he gladly liaises with my two specialists who are both very good as well. I consider myself very lucky. Only thing is they charge but it is worth it for the quality of care.
 
I have recently been to a heart specialist once every 12 month visit . Bring $500 with you I get $ 195 back from Medicare I have a pacemaker and my previous heart specialist left and went to another state so then this chap took his place .My health was pretty good for my age . Have level 3 home care package . Could still manage to shower myself and keep my place clean and tidy . Had cleaner for 1 and half hours per 2 weeks and take me shopping once a week. This new heart specialist must have a vendetta against the previous one because he has changed every tablet the previous r prescribed for me . Some tablets upset me and my GP changed it back to the previous one that caused no side effects ,much to his dislike. End of June I went to see him and he stopped another tablet and this was going to be much better for me FORCSIGAR is the name of the tablet . The first day I wasn’t well the 2day I was worse it really hit me . All that was printed on the box was take as directed . I was taking it at night so I rang the chemist and he said did I have type 1 or type 2 diabetes . No have never had that in my life but it was for heart problems to remove fluid from lungs and kidneys . He stopped the 6 am fluid tablet in the morning . I have never been so sick in my life it would take the whole page to list my problems . I am sure this tablet contains traces of death cap mushrooms . When I went to my GP she told me to throw them up on the fan so I wouldn’t take them by mistake as I was keeping them as evidence . 10 days was all I took the tablet for WHEN I finally got another app. With him in 3 months and told him the side effects and what my GP had said he got very abusive and told my carer and I to get out now . So I said “ Don’t think I am paying you and we walked out . I have seen another heart specialist since then and he said the tablet is probably out of my body but they can’t get rid of the side effects , you can report him you know to APRA . Well if anyone has ever had the same experience I would like to know .
 

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