The computer interrupted while Pamela was still speaking. I had accompanied her – my dear friend – to a recent doctor’s appointment. She is in her 70s, lives alone while navigating multiple chronic health issues, and has been getting short of breath climbing the front stairs to her apartment. In the exam room, she spoke slowly and self-consciously, the way people often do when they are trying to describe their bodies and anxieties to strangers. Midway through her description of how she had been feeling, the doctor clicked his mouse and a block of text began to bloom across the computer monitor.
The clinic had adopted an artificial-intelligence scribe, and it was transcribing and summarizing the conversation in real time. It was also highlighting keywords, suggesting diagnostic possibilities and providing billing codes. The doctor, apparently satisfied that his computer had captured an adequate description of Pamela’s chief complaint and symptoms, turned away from us and began reviewing the text on the screen as Pamela kept speaking.
When the appointment was over, as a physician myself and anthropologist interested in the evolving culture of medicine, I asked if I could glance at the AI-generated note. The summary was surprisingly fluid and accurate. But it did not capture the catch in Pamela’s voice when she mentioned the stairs, the flicker of fear when she implied that she now avoided them and avoided going out, the unspoken connection to Pamela’s traumatic relation to her own mother’s death that the doctor never elicited.
Scenes like this are becoming increasingly common. Physicians, for generations, have resisted new technologies that threatened their authority or unsettled established practice. But artificial intelligence is breaking that tradition by sweeping into clinical practice faster than almost any tool before it. Two-thirds of American physicians – a 78% jump from the year prior – and 86% of health systems used artificial intelligence as part of their practice in 2024. “AI will be as common in healthcare as the stethoscope,” predicts Dr Robert Pearl, the former CEO of Permanente Medical Group, one of the largest physician groups in the country. As my colleague Craig Spencer has observed: “Soon, not using AI to help determine diagnoses or treatments could be seen as malpractice.”
Policymakers and aligned business interests promise AI will solve physician burnout, lower healthcare costs and expand access. Entrepreneurs tout it as the great equalizer, bringing high-quality care to people excluded from existing systems. Hospital and physician leaders such as Dr Eric Topol have hailed AI as the means by which humanity will finally be restored to clinical practice; according to this widely embraced argument, it will liberate doctors from documentation drudgery and allow them to finally turn away from their computer…
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