How do you handle AI scribe with patients who don’t want to be recorded?

Brief Answer

You can safely use an AI scribe and still fully respect patients who do not want recording by doing three things. First, offer the tool as an option with a clear, neutral script and an easy opt out. Second, have a fallback documentation method ready, for example a short spoken or typed summary into the scribe after the visit without recording the patient. Third, document the preference in the chart and note when the AI scribe was not used. Care should be identical whether or not recording is on.

The Longer Answer

A practical way to think about this is: patient choice, alternative workflows, and documentation.

1. Core principles when a patient declines recording

This frame helps you decide quickly in the moment without debating each case.

2. Step by step workflow when someone says “no recording”

Before the visit

• Use a chart flag or banner to note prior preference so you do not need the same long explanation every time.
• Decide which visits will default to AI and which will default to manual notes if you already know the patient is uncomfortable.

At the start of the visit
A simple, neutral script can be:

“I use a secure tool that helps turn what I say during sessions into my clinical notes so I can focus more on you and less on typing. If you would rather I not use it, that is completely fine and I will take notes the usual way.”

Then pause and let them answer.

If the patient declines

• Acknowledge and normalize
  • “No problem at all, we will keep it off for today.”
• Turn off or pause the scribe immediately.
• Do not revisit unless clinically relevant or the patient later asks.

After the visit
Switch to your fallback method, for example a short summary spoken alone in your office or a quick typed outline that you later expand with AI.

3. Options when you cannot record, but still want AI help

Many clinicians choose one main fallback and use it every time a patient opts out, which keeps cognitive load low.

4. How to talk about privacy and consent in simple language

You can keep the explanation short and repeatable.

• Emphasize purpose
  • “This is to help me finish accurate notes so I can be more present with you.”
• Clarify safety
  • “The tool is built for healthcare and follows privacy rules, and I still review and sign every note.”
• Make the choice explicit
  • “If you prefer not to use it, your visit and your care are the same. I will just document in the usual way.”

If you use written consent forms, you can include a simple clause about use of transcription or AI note tools with an option to decline.

5. What to document when a patient refuses recording

You do not need a long statement. You do want a clear record that the preference was respected.

Examples:

• “Reviewed optional AI assisted documentation. Patient declined recording for this session. Manual note completed.”
• “Patient prefers not to use audio based scribe. This preference will be honored for future visits unless they request a change.”

For risk sensitive contexts, you may also document if you used a non recording workflow, such as post visit dictation that contains only your own summary.