By Dr. Kenneth Zweig

As a primary care physician, I face a daily conundrum – do I look my patients in the eye and listen intently to their concerns, or do I focus on diligently documenting their stories in my computer to ensure no details are missed? Prioritizing direct engagement helps me retain key information and makes patients feel heard, a cornerstone of the doctor-patient relationship. However, it often comes at the cost of hours of additional documentation later, affecting my work-life balance and limiting the number of patients I can see.

Healthcare providers all over the country face this dilemma every day. With Elon Musk and the Department of Government Efficiency (DOGE) now examining Medicare's payment systems to address what he calls "where the big money fraud is happening," the timing is perfect for discussing a solution that could transform healthcare delivery.
Improper payments in Medicare, which include both fraudulent payments and billing errors, have been estimated to cost the government $60 billion annually. Other analyses suggest that the broader costs of fraud and abuse across the healthcare system could be significantly higher. Meanwhile, physician burnout rates are reaching crisis levels, with electronic health records consistently cited as a primary cause. I propose a surprisingly straightforward solution: government-provided AI scribes that could transform healthcare delivery while saving enormous sums of money.

How AI scribes would work
Currently, many physicians use medical scribes to help with charting. These are typically young adults who have an interest in entering the medical field, so start by acting as a scribe to get experience in medicine. Medical scribes can be very helpful to medical providers by allowing them to focus on medical decision-making, rather than the more menial task of data entry. However, medical scribes require fairly extensive training, and typically only stay 1-2 years with a practice before moving on with their education. Also, medical scribes can be quite expensive, which makes them feasible only for the highest-paid specialties, such as orthopedics or neurosurgery.

Recently, AI scribes, which are virtual cloud-based assistants, have been developed as an alternative to human scribes. These are programs that listen to an interaction between a medical provider and a patient, then create a chart note based on the interaction. This technology is quite impressive, as it can filter out superfluous banter and only retain pertinent medical information, written in a coherent, concise manner. While AI scribes can also be expensive, they require virtually no training, and do not call out sick or leave to find better jobs.

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