AI scribes in general practice: support, silence and the shape of care

AI scribes promise multiple benefits for general practitioners and their patients, but we may risk losing valuable human connection in the process, writes Dr Elizabeth Deveny.

AI scribes are entering general practice settings across Australia. These tools transcribe conversations and draft notes. The promise: less admin, better records and more patient focus.

In a system under pressure, these benefits are not trivial. None of this is about blame: GPs are under immense pressure already.

But what do we all lose when the machine starts to write the notes?

Health care is deeply human. The consultation is more than a transaction or information exchange. It’s relational, contextual and shaped by silence as much as by speech. The introduction of AI into that space is not neutral. It changes not only what gets recorded, but what gets said.

We don’t yet have population-level data on the use of AI scribes in general practice in Australia. Formal research will follow, but early signals like these deserve attention now. Clinicians and consumers report mixed experiences.

I’ve heard many people say that something shifts in the room when their doctor starts using an AI scribe. They can’t always name what’s changed. Some feel less seen. Others miss the way their GP paused to jot things down. That pause helped the doctor think, and gave patients a moment to reflect, breathe and decide what to say.

That small moment of slowness mattered.

And then it’s gone.

The doctor’s still facing you, but something in the room has changed.

Speeding up consultations isn’t always helpful, especially, for example, for people with auditory processing issues or who come from culturally and linguistically diverse backgrounds. A faster clinical conversation may make it harder to participate. One woman told me she left a consultation in tears. She couldn’t keep up and didn’t want to interrupt the GP or the machine. Technology might help one person and accidentally shut someone else out.

A friend recently said this: “My GP seems to forget more of what we talked about than I do, since he started using that bot to write his notes.” She felt less remembered, less heard — enough to consider changing doctors.

This isn’t science, but the patterns are there, echoed in many conversations. Maybe I’m wrong. Maybe these are just teething issues, and we’ll all adapt. But something’s shifting, and I don’t think we can afford to ignore it. The presence of an AI scribe changes the feel of the room. It changes who clinicians speak to, what they notice, and what people are willing to say. If you’re early in your career, these shifts may not be obvious yet, but they shape trust over time.

Some clinicians have told me that reviewing the notes they personally wrote after a consultation often brings a fresh insight. A moment of clarity that helps them piece something together. The act of re-reading their own words, shaped by their memory and attention at the time, can bring nuance to clinical reasoning. I wonder whether AI-generated notes will offer the same depth. When the words aren’t your own and the emotional context is stripped away, does something vital get lost?

All of us in leadership roles — whether consumers, clinicians, system builders or policy makers — need to ask what the AI is learning. What counts as success? Who defines it? This is also a governance question. If we’re training machines on imperfect data, we may be encoding blind spots.

There are also concerns around training and consent. Where power imbalances exist, the rushed “This okay with you?” at the start of a consultation may not constitute meaningful consent. Consumers often say they didn’t have a real choice.

And what if a consumer does mind? What happens then? Consumers don’t want to be punished if they object to an AI scribe being used during their consultation. Some object because no one explains how the technology works or where the data goes. Others simply don’t want their conversations recorded. This is all reasonable. Health professionals need to remember that while they may believe AI scribes are the future, not all consumers are convinced.

We need to shape the use of AI scribes with care. That means co-designing standards with everyone affected, especially consumers. It means making space to pause, reflect and catch what might be missed.

And real consent, not just a rushed line at the start. Without this, we risk undermining trust — the very foundation of good care.

The potential benefits aren’t only for clinicians. We need to ask: what might a consumer experience as a gain? Are their needs being captured and acted on more clearly?

Peer-reviewed studies could help us understand how AI scribes affect not just clinician burnout and system efficiency, but also consumer safety and continuity of care. I’m not anti-technology. If this is progress, I’d say it’s time to get a second opinion — and ask what might quietly go missing.

Silence isn’t empty. It can hold hesitation, even courage. A human can be trained to notice this. A machine can only transcribe.

Even the best transcription is still a translation. And what gets lost in translation, especially in care, can be everything that matters.

Dr Elizabeth Deveny is currently the CEO of Consumers Health Forum of Australia, the national independent peak body for health consumers. Her recent roles include CEO of South Eastern Melbourne PHN, CEO of Bayside Medical Local and Chair of Southern Metropolitan Partnership. 

The statements or opinions expressed in this article reflect the views of the authors and do not necessarily represent the official policy of the AMA, the MJA or InSight+ unless so stated. 

Subscribe to the free InSight+ weekly newsletter here. It is available to all readers, not just registered medical practitioners. 

If you would like to submit an article for consideration, send a Word version to mjainsight-editor@ampco.com.au.