AI scribes write the note. Who keeps the conversation for the patient?

This week, ambient scribe company Suki announced a $90 million Series E, with plans to scale and add "agentic workflows." It's one more sign that AI documentation is becoming standard in exam rooms.

I'm glad. Clinicians are buried in documentation, and tools that give them back time and attention matter. But as these tools spread, I keep coming back to one question: who are they for?

The note is written for the chart

A scribe's job is the note. It captures the visit in the format the medical record needs: history, assessment, plan. It's a summary, and that's exactly what it should be.

But the visits where patients most need help remembering are the complex ones. A surgeon points at the MRI and shows where the problem is. They sketch the approach on a whiteboard. They slow down and say, "This is the part I want you to hear."

A text summary can't hold that. It loses the tone, the emphasis, the image on the screen and the drawing. The patient goes home, the family asks what the doctor said, and often nobody is sure.

Recording raises a real consent question

Any technology that records a visit has to earn the patient's trust. The scribe market is learning that now. One health system faces a class action, first reported in January, alleging that patient visits were recorded by an ambient AI tool without proper consent (Medical Daily covered the case in June). These are allegations, not findings, but they're a useful reminder.

Physicians have real concerns about recording, too. They worry about how a recording might be used, who can see it, and whether it changes the conversation. Those concerns deserve straight answers, not reassurance.

My view is that recording works when three things are true:

• It's opt-in and transparent. The patient knows it's happening and agrees to it.
• The provider stays in control. They can pause, resume, delete and re-record, or mark something for internal use only.
• The patient actually benefits. The recording is something the patient and family can watch, not just something processed in the background.

What video keeps that a note can't

When a visit is recorded inside a secure, HIPAA-compliant platform, the patient gets more than a summary. They get the conversation itself.

They can rewatch it at home when the anxiety has worn off. They can share it with a spouse who couldn't take off work, or with the adult child who'll be the caregiver after surgery. A designated decision-maker can hear the surgeon's explanation firsthand instead of through the patient's memory of it.

That doesn't compete with the scribe. The note serves the chart and the video serves the family. Both have a place.

What practice leaders can do this quarter

• Map your hardest conversations. Surgical consults, new diagnoses, discharge plans. These are where a recording adds the most.
• Check what patients actually take home. For each of those visits, ask: is it a printout, a portal summary, or nothing?
• Write your recording policy before patients force the issue. Patients can already record on their own phones. A clear, opt-in, provider-controlled option inside your own platform is better for everyone than a phone hidden in a pocket.
• Keep consent explicit for any recording tool. That includes scribes and video. Make sure what your patient portal says matches what actually happened in the room.

A question for you

For your most complex conversations, what does the patient take home besides a summary?