Last week I had a routine doctor’s visit.  Routine…but there was something new.  “We’re updating our paperwork,” I was told, and was handed a clipboard with a stack of papers.

Much of it was genuinely confirming things, which they do annually – still at the same address, no new allergies, no new symptoms, etc.  There was also some HIPAA notices they’re required to give annually, and, sadly, a survey they conduct annually asking if patients are exposed to a variety of negative environmental issues driven by poverty or crime.

But there was one new form I’d never seen before.  “Our office utilizes an automatic transcribing service to ensure accurate and timely notes are saved for your visit.  This helps us improve…”

I couldn’t decline that fast enough.

The AI is In

These AI transcription tools are becoming common at my medical offices.  They place a microphone in the room and it records everything said between you and your physician.  Then this transcript is whisked off to some AI service, which creates a summary that is placed in your file.

In theory, this means the office has a near-perfect log of everything discussed, every treatment option reviewed, every symptom mentioned, etc.

In reality, there are a lot of problems.

Why I Declined

The obvious issue is privacy.  Knowing how the tech works, I’m aware that there isn’t a datacenter in my physician’s office to handle all of the AI work.  They’re using a SaaS AI product like ChatGPT.  I expect that what I discuss between my doctor and I remains between my doctor and I.  With AI transcription, the entire conversation goes to ChatGPT, Grok, or whoever.  Very likely, it goes to some third-party SaaS service specializing in this niche, which in turn uses ChatGPT under the covers, so it’s going to at least two places.  I have no assurance that the transcripts are not deleted, or anonymized for “training purposes” properly.

The second concern is accuracy.  I think we’ve all had issues with AI making mistakes.  Heck, ChatGPT even says “ChatGPT can make mistakes. Check important info.” at the bottom of every chat.  Well, this is important info…who is checking it?  I guarantee a clinician is not patiently listening to each transcript and checking that the summarization is accurate.  And I am given no option to review it.  What if it hears “heartache” as “heart attack”?

And finally, if I know I’m being recorded, I’m a little more hesitant to say things.  Is this info being fed to my insurer?  Today if you apply for life insurance, your prescription history is checked by the insurer.  Will visit transcripts be the next thing that can be reported on?  And does the recording make my physician more hesitant?  Is he going to be guarded in everything he says because he’s terrified of being sued for malpractice?

Maybe someday when doctors are androids, this will be routine.  But I think there’s still good reason to check “Decline” on that form.

raindog308

raindog308 is a longtime community LETizen, technical writer, and self-described techno polymath. With deep roots in the *nix world, he has a passion for systems both modern and vintage, ranging from Unix, Perl, Python, and Golang to shell scripting and mainframe-era operating systems like MVS. He’s equally comfortable with relational database systems, having spent years working with Oracle, PostgreSQL, and MySQL.

As an avid user of LowEndBox providers, raindog308 runs an empire of LEBs, from tiny boxes for VPNs, to mid-sized instances for application hosting, and heavyweight servers for data storage and complex databases. He brings both technical rigor and real-world experience to every piece he writes.

Beyond the command line, raindog308 has a life-long love of German Shepherd Dogs, high-quality knives, target shooting, theology, tabletop RPGs, playing guitar, and hiking in deep, quiet forests.

His goal with every article is to help users, from beginners to seasoned sysadmins, get more value, performance, and enjoyment out of their infrastructure.

You can find him daily in the forums at LowEndTalk under the handle @raindog308.