Learn

Your doctor wants to record the visit with AI. Here is what to ask before you say yes.

Your clinic will tell you the tool is HIPAA compliant. That doesn't actually mean much. Four questions to ask before you agree, and what to do if you would rather not.

Joel Folgner

Joel Folgner

— 10 min read
Share
A doctor in navy scrubs sits with a notepad and pen while a patient in a hospital gown, her hand resting on her chest, describes her symptoms.
Photo: Ahmed via Unsplash

You may have visited a doctor's or therapist's office recently and been asked if you consent to an AI note taker. Many are not sure if they should allow AI to listen in on their personal conversations with a provider. Despite the hesitation, this technology is in place today.

That tool being used is an ambient AI scribe. It listens to the whole conversation, turns it into a transcript, and drafts your visit note into your chart for the doctor to review and sign. This allows the doctor to focus on you instead of a screen. Abridge, Microsoft's DAX Copilot, and Nabla are the ones you are most likely to be sitting in front of, and they are already common. At UC San Francisco, 70% of physicians were using an AI scribe in daily practice as of 2026.

Anyone who has attended a workplace meeting featuring an automated notetaker has already encountered this kind of technology. Most of us have seen those tiny bots popping into our online meetings. However, the doctor's exam room is a completely different environment, and the reality might surprise you.

A smartphone lies face up on a wooden desk with an open laptop blurred behind it.
Photo: Bruno Nascimento via Unsplash

HIPAA compliance

You have probably been told the tool is HIPAA compliant, or you will be when you sign. That phrase is not as impressive as it sounds.

No federal agency certifies anything as HIPAA compliant. HHS says so on its own guidance page. It and its Office for Civil Rights "do not certify any persons or products as 'HIPAA compliant.'" A vendor can be careful, audited, and contractually on the hook, but there is no certification to be obtained.

HIPAA also does not require your provider to ask your permission before the recorder runs. Writing the note is part of treating you, and 45 CFR 164.506 lets a provider use your information for treatment without a separate signature from you. So the compliance promise is true, and it is also beside the point. It describes how your information gets handled once it exists. It says nothing about whether it should have been recorded to begin with.

The rule that gives you a say is not a federal one. It is your state's law on recording a private conversation, and it changes state by state.

Where you live decides

Unlike some states, California requires everyone in a private conversation to agree before it can be recorded.

In late 2025, a patient named Jose Saucedo sued Sharp HealthCare in San Diego Superior Court. The complaint alleges Sharp recorded exam room conversations through Abridge starting in April 2025, that more than 100,000 patients may have been recorded. The complaint also alleges that the system inserted statements into charts saying patients "were advised" and "consented" when they say they were not and did not. In April 2026, three patients sued Sutter Health and two MemorialCare entities in federal court in Northern California under the California Invasion of Privacy Act, the state's medical confidentiality law, and the federal Wiretap Act.

As of August 5, 2026, no court has made a ruling. Abridge is not a defendant in either case. Sutter said it is reviewing the matter and takes patient privacy seriously. Sharp said it cannot comment on pending litigation.

An older woman sits in a clinic chair holding the back of her neck while a doctor with a stethoscope listens beside her.
Photo: Curated Lifestyle via Unsplash

Oregon is a good example of why the details matter, because Oregon is weaker than most people assume. State law (ORS 165.540) makes it illegal to record an in-person conversation "if not all participants in the conversation are specifically informed that their conversation is being obtained." The law says informed. It does not say they agreed. In an Oregon exam room, the law requires that you be told. If you are told and you keep talking, that statute has done its job.

Texas went a different direction and wrote the disclosure into medical practice law. Senate Bill 1188 took effect in September 2025. It covers a practitioner using AI for diagnosis or treatment, requires that practitioner to tell you, and requires them to review what the AI produced. House Bill 149 followed in January 2026 and reaches wider, covering any health care service where you interact with an AI system, with the notice due no later than the day you are seen and written to be read rather than buried. The attorney general enforces House Bill 149. Senate Bill 1188 runs through civil penalties and the licensing boards. Neither one lets a patient sue.

The tools appear to work

While the courts battle over privacy law, there are benefits to these AI assistants.

A doctor sits at a desk with his head bowed and hands clasped against his forehead, a keyboard and paperwork in front of him.
Photo: Getty Images via Unsplash

In October 2025, JAMA Network Open published a study of 263 clinicians across six health systems who used an ambient scribe for 30 days. Burnout went from 51.9% to 38.8%. That is a quality-improvement study rather than a controlled trial. The people who answered the follow-up survey are the ones who stuck with it. But the results are encouraging, even if not settled.

There have been other studies. UCLA ran a randomized trial of 238 physicians across 14 specialties, published in NEJM AI, comparing Nabla and DAX Copilot against no scribe at all. Nabla users cut about 41 seconds off each note, 9.5% better than the control group. DAX users showed a change too small to call real. Both scribe groups did report less exhaustion at the end of the workday and a lighter mental load than the doctors working without one. A doctor who is not typing and taking notes is a doctor who is listening more closely. Which is a hard metric to measure.

The reasons to hesitate

Start with accuracy, because the draft the AI writes is not always right.

The best measurement available is a 2025 study in npj Digital Medicine that had clinicians annotate 12,999 sentences of AI-written documentation built from real primary care conversations. The AI invented content in 1.47% of sentences and left something out in 3.45%. Of the invented content, 44% was rated major. Omissions were the more common problem. The AI is summarizing, and summarizing means deciding what to drop.

The doctor is supposed to catch that before signing, and most do. A University of California, Irvine analysis of 23,760 notes containing AI-drafted sections found 84.4% were edited before sign-off, which also means about one in six were signed with no changes at all. Robert Wachter, who chairs the department of medicine at UC San Francisco, raised the enforcement problem with Medical Economics, which reported that there is no technical mechanism to ensure a physician has actually read the note before signing it. Who answers for it when the machine gets something wrong is still being worked out everywhere else too.

The recording is a different thing from the note. A note is a summary, and a person decided what belonged in it. The audio is everything that was said out loud. The aside you did not think was part of the visit. The relative who spoke up from the chair in the corner. The thing your doctor heard and chose not to write down. The American Bar Association's health law section tells providers to assume AI-generated documentation may be scrutinized in malpractice claims, privacy actions, or regulatory investigations.

How long the audio is retained is set by the health system, not by your doctor. Kaiser Permanente told CalMatters in June 2026 that recordings are stored no longer than 14 days. A patient FAQ from a California pediatric group using Abridge says audio and transcripts are automatically deleted after 30 days, and that the practice does not give patients a copy of either one.

And systems that follow every rule still get breached. Using the federal breach portal, HIPAA Journal counted 772 large healthcare breaches in 2025 affecting about 138.5 million people. The running total since 2009 passed a billion people this spring. That is the environment your recording would be sitting in, and it is why those breach letters keep arriving from providers you barely remember.

Most of us are already uneasy about it. A KFF poll of 1,343 adults taken in late February and early March 2026 found 77% were concerned about the privacy of personal medical information given to AI tools. Among people who had already handed over that kind of information, 65% were still concerned.

When the visit is a sensitive one

A sports physical and a therapy session are not the same decision.

CalMatters reported in June 2026 that Kaiser mental health clinicians raised concerns about recording therapy sessions, including how the consent was being framed to patients and pressure on staff to use the tool. If you are talking about mental health, substance use, reproductive care, immigration history, or anything with legal weight, a stored recording carries more weight than a note on a sore back would.

A young woman lies on a couch talking with her hands raised while a therapist takes notes on a pad in the foreground.
Photo: Vitaly Gariev via Unsplash

Three specifics, because the extra protections people assume are there mostly are not.

Therapy notes. The HIPAA rule that shields a therapist's private psychotherapy notes (45 CFR 164.508) only covers notes kept separately from your chart. The scribe drafts the regular progress note, so that shield does not reach it.

Reproductive care. The 2024 federal rule that added protection for reproductive health information was struck down nationwide in June 2025 in Purl v. HHS. The appeal was later dropped, so that protection is gone rather than paused.

Substance use. These records do keep an extra layer of federal protection, under 42 CFR Part 2. That one still holds.

None of this is a reason to skip care, but if you are uneasy about AI recordings, you are not out of line.

What to ask, and how to say no

You do not need to know any of the law to have this conversation with your provider. There are four questions you can ask, at check-in or at the start of the visit, to help decide.

  1. Is this visit being recorded by an AI tool?
  2. What happens to the audio, and how long is it kept?
  3. Does the company use it for anything besides my note?
  4. Can we turn it off, or pause it, if I ask?

On the third question, the answers differ by company and it should be in writing. Abridge's public privacy policy will not answer it for you. That policy covers its website and its business contacts, and it says outright that it does not apply to what a hospital and its clinicians record and store in the service. That part is governed by the contract between the vendor and the health system, and you never see it. Nabla says audio is never stored, only processed in chunks and discarded, with transcripts and notes kept 14 days by default and backups expiring a week after that. Those are company statements, not audited findings, but they are the company's own words and you can hold them to it.

To decline, say it plainly: "I'd prefer you not record this visit with the AI scribe. Please document it the usual way today." A California pediatric group's patient page says the same thing, that a clinician can simply document the visit the traditional way instead. You can ask that your decline go in the chart. You can also ask for a pause partway through, which doctors report doing.

If the note about you comes back wrong, HIPAA gives you the right to request a correction (45 CFR 164.526), and the provider generally has 60 days to answer. If you think a recording happened without you being told, the federal complaint route is the OCR portal at ocrportal.hhs.gov, and it has to be filed within 180 days of discovery.

This is a personal decision, and it should be. The technology is helping the professional taking care of you, but it is also making a recording of your voice that lives somewhere you cannot control. Ask these four questions before you consent, because the answers could change yours.

Sources

Read more

[ Free every Tuesday, plus the Cache ]
Tech news without having to be tech savvy. Subscribe ×