The doctor-patient relationship is built on trust. Every day, patients share information they would never reveal to their employers, friends, or even family. They discuss their fears, medical issues, financial struggles, mental health concerns, and very personal experiences. Because we believe those conversations are private. Confidentiality is not just a legal requirement in healthcare. It is the foundation on which patients can speak up and doctors can provide effective treatment.
That foundation is currently being tested by a new generation of artificial intelligence tools.
Healthcare organizations across the country are rapidly adopting ambient AI scribes, including:
Abridge, Suki, and similar platforms. These systems listen to conversations between doctors and patients, convert audio to text, identify clinically relevant information, and automatically generate medical documentation. The technology is expected to reduce physician burnout, increase efficiency, and allow doctors to focus on their patients rather than their computer screens. Given the administrative burden that physicians face today, the appeal is clear.
Many physicians who have used these systems report spending less time documenting visits and more engagement with patients. Healthcare executives believe there is an opportunity to increase productivity and alleviate one of the most common causes of physician dissatisfaction. Investors see great potential in the rapidly growing market. In many ways, ambient AI appears to be one of the most promising applications of artificial intelligence in healthcare.
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However, the rapid adoption of these systems has raised important questions that many patients may not have considered. That’s what happens when artificial intelligence systems are constantly listening in the doctor’s office.
The issue moved into legal reality. A recent lawsuit involving a healthcare organization using an ambient AI documentation system alleges that patient conversations were recorded without proper disclosure or meaningful consent. Lawsuits involving Abridge and its technology-enabled health systems have garnered national attention because they touch on sensitive issues that affect all patients. Ultimately, courts will decide whether these claims are valid, but the case highlights broader concerns that extend far beyond any single company or medical institution.
The real question is not whether AI can create better clinical notes. The real question is whether patients fully understand that a third party is participating in what has historically been one of society’s most private conversations.
The rapid expansion of ambient AI is not limited to a single vendor. Companies like Suki have established partnerships with some of the nation’s largest healthcare organizations, including Optum and other major healthcare systems, to deploy AI-powered documentation tools at scale.
For generations, patients knew who was present during their appointment. They could see a doctor, nurse, medical assistant, or student observing the encounter. I could see everyone in the room. Ambient AI changes that dynamic. This technology may be represented by a smartphone on your desk, a microphone connected to your computer, or software running silently in the background. Patients may not fully understand that every word spoken during a conversation is captured, processed, analyzed, and translated into structured medical documentation.
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Healthcare organizations often emphasize that these systems operate within a HIPAA-compliant framework and that the vendors have agreements governing the use of patient information. Although these safeguards are important, compliance alone does not resolve the associated ethical issues. Patients are not just concerned about whether the process is legally permissible; They want to know what is happening to their information, who has access to it, how it is being used, and whether they have meaningful choices regarding this issue.
There is an important difference between disclosure and understanding. Patients may sign multiple forms during a visit without reading all the pages. They may allow privacy policies with complex legal language. You may be briefed on how AI tools are being used to assist with documentation. None of these behaviors necessarily mean that the patient fully understands what is happening.
Meaningful informed consent requires more than a signature.
Consider a patient discussing depression, substance abuse, domestic violence, infertility, sexual health, or a recent cancer diagnosis. These are some of the most sensitive conversations that occur anywhere in society. Some patients may not have concerns about AI-assisted documentation.
The healthcare industry often views ambient AI as just another technology tool, but the comparison is incomplete. Electronic medical records store information that clinicians enter into the system. Ambient AI scribes actively listen to conversations, extract information, generate summaries, and create documents. This distinction is important because this technology is involved at the beginning of the information gathering process rather than at the end.
The emergence of ambient AI also raises important questions about the future of medical documentation. Traditionally, physicians have been responsible for gathering information, interpreting it, and documenting it in their own words. AI scribes change that workflow by creating the first draft of medical records. Doctors will still be responsible for reviewing and approving the final document, but the initial explanation will increasingly be provided by machines.
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The challenge facing healthcare leaders is that technology is advancing faster than the public understands. Patients are generally aware of the existence of artificial intelligence. We may use AI-powered search engines, virtual assistants, or consumer applications. What many people don’t realize is that artificial intelligence is becoming deeply integrated into everyday medical practice. As adoption accelerates, transparency becomes increasingly important.
Ironically, ambient AI was introduced to strengthen the doctor-patient relationship. These systems were supposed to allow physicians to focus more on their patients by reducing the burden of documentation. In many cases, you may be able to accomplish just that. Physicians who spend less time typing may be able to spend more time listening. Patients have a better experience because doctors are more engaged during their visits.
While the lawsuits currently making headlines may ultimately be resolved in court, the larger debate is just beginning. Healthcare organizations, policy makers, technology companies, and physicians must work together to establish clear standards for disclosure, consent, data governance, and accountability. Just as patients have a right to know who else is in the exam room, they have a right to understand when artificial intelligence is participating in their care.
There is no doubt that artificial intelligence will play an important role in the future of healthcare. The question is not whether these technologies should exist. The question is whether their adoption will be guided by the same principles that have governed medicine for centuries: respecting patient autonomy, protecting privacy, and maintaining trust.
The exam room has always been a place where patients can speak up because they know who is listening. As ambient AI becomes increasingly common, healthcare leaders must ensure that patients continue to have the same confidence. Otherwise, the industry risks solving one problem while creating another.
