August 28, 2025
AI Scribes 101: A Psychiatrist's Quick Start Guide
Written by
William Sauvé, MD
Last week, a colleague told me she finally made it to her daughter's soccer game. First time all season. Her secret? She'd started using an AI scribe.
Many psychiatrists and NPs report spending nearly 2 hours daily on documentation outside of clinical sessions. It's the part of our job that steals evenings, strains relationships, and drives burnout.
Meanwhile, 78% of your colleagues are already testing or using AI scribes to reclaim that time, according to a recent poll in our Psychiatry Collective community.
This guide cuts through the hype.
In the next 10 minutes, you'll learn what AI scribes actually do, how they differ from dictation, and how to address the ethical and practical concerns unique to psychiatric practice.
What Is an AI Scribe?
An AI scribe is software that listens to your patient sessions and automatically creates structured clinical notes. Think of it as an intelligent assistant that not only transcribes but organizes information into the format you need.
Unlike simple transcription, here's what happens: Your patient says "I've been really anxious and can't sleep." You respond with "Let's increase your sertraline to 100mg."
The AI doesn't just type these statements; it knows to put the patient's complaint in the Subjective section and your medication change in the Plan.
The output is a formatted note in your preferred style: SOAP, BIRP, DAP, or others. No more staying late to finish documentation.
AI Scribes vs. Dictation: The Real Difference
Many of us already use dictation, so what's different about AI scribes? Let's clarify what we're comparing:
Dictation Software (like Dragon Medical) converts your speech to text in real-time. You speak into a microphone—usually after the visit—saying things like "Patient presents with major depressive disorder comma recurrent comma severe period." The software types exactly what you say, but you're still responsible for organizing it into a proper note.
Dictation Services employ human transcriptionists who take your recorded dictation and transform it into polished notes. You might start by saying "This is a follow-up visit" or "Use my standard template," then talk through your observations. The service cleans up your speech, removes filler words, and delivers a formatted note hours or days later.
AI Scribes represent something entirely different. They listen to the actual conversation between you and your patient, then automatically organize that dialogue into a structured clinical note.
Here's how they compare in practice:
The biggest difference: You stay fully present with patients instead of mental note-taking or rushing to dictate before you forget details.
Addressing the Elephant in the Room: Ethics & Privacy
AI listening to appointments raises valid concerns. Here's how to think through the key issues:
Patient Privacy: Beyond HIPAA Checkboxes
Yes, reputable AI scribes are HIPAA-compliant. But that's the minimum. Here's what actually happens to your data.
Most AI scribes follow this pattern:
- Audio streams to their secure servers (usually AWS or Google Cloud)
- AI processes the conversation into a note
- Audio is deleted (typically within 24-48 hours)
- The generated note is retained for 30-90 days for you to access
- Everything is encrypted both in transit and at rest
Critical questions to ask vendors:
"Do you sign Business Associate Agreements (BAAs)?"A BAA is legally required—it makes the vendor responsible for protecting patient data just like you are. No BAA = walk away immediately.
"How long do you retain recordings?"Best practice: Audio deleted within 24-48 hours after processing. Red flag: Any vendor keeping recordings longer than 7 days.
"Can I delete all patient data if we part ways?"You need the right to request complete data deletion. Some vendors charge "data export fees"—know this upfront.
"Where are your servers located?"Many mental health practices prefer U.S.-based servers for regulatory clarity and compliance with HIPAA standards.
Put this in perspective: Your EHR already contains far more sensitive data (SSN, addresses, full medical history) than an AI scribe that only processes session content. But unlike your EHR, which needs long-term storage, AI scribes can and should delete recordings shortly after use.
Your Professional Responsibility
AI scribes don't replace your clinical judgment. You remain 100% responsible for:
- Reviewing every note before signing
- Ensuring accuracy of clinical information
- Deciding what belongs in the permanent record
- Maintaining appropriate boundaries
Document your review process. A simple line like "AI-assisted documentation reviewed and edited by provider" covers your bases.
The Recording Question
Some states require two-party consent for recordings. Even where not legally required, transparency builds trust. Many vendors claim to delete audio recordings shortly after transcription, with some retaining audio for brief periods (such as 24-48 hours) for troubleshooting.
How to Talk to Patients About AI Scribes
The conversation doesn't need to be complicated.
Try this 15-Second Explanation: "I'm using a documentation tool that helps me focus on our conversation instead of typing notes. It securely processes our session and creates a summary for your medical record. The recording is deleted shortly after. Are you comfortable with that?"
Handling Concerns:
- "Where does the recording go?" → "It's processed securely, just like when we do teletherapy, then deleted within a day or two."
- "Will anyone else hear this?" → "No, it's automated software, not a person, and it's bound by the same privacy laws as your other medical records."
- "I don't want to be recorded." → "No problem, I'll take notes the traditional way."
In practice, few patients decline to have their sessions documented using AI scribes, although occasional reluctance is reported. Most are relieved you can focus on them instead of a computer screen.
Special Considerations
Consider turning off the scribe for:
- Patients with paranoia about technology/surveillance
- Discussions of illegal activities
- When patients specifically request it
- During sensitive moments (you can pause/restart)
Extra communication for:
- Adolescent patients (explain to both teen and parents)
- First sessions (include in general consent discussion)
- Group therapy (get everyone's consent)
Smart Questions to Ask During Demos
With dozens of AI scribes competing for your attention, the demo requests can quickly become overwhelming. Every vendor promises the same thing—they'll fix your documentation problem overnight.
Skip the feature lists and marketing speak. Focus on what actually matters.
The Non-Negotiables:
- "Do you sign BAAs and have documented HIPAA compliance?"
- "Can I edit the note before finalizing?"
- "Can I pause recording during sensitive moments?"
The Workflow Questions:
- "How does this get into my EHR?" (One-click? Copy-paste? Browser plugin?)
- "Can I use my existing templates or does this replace them?"
- "How long until I see the completed note?"
The Psychiatry-Specific Questions:
- "Show me how you handle 'Spravato’ or 'clozapine'" (tests medication accuracy)
- "Do you include Mental Status Exam sections?"
- "Can I switch between narrative and structured formats?"
he Reality Checks:
- "Do you offer a free trial?"
- “What's the true monthly cost after any intro period?"
- "What support do you provide during implementation?"
Getting Started with a Free Trial: Your First Week
Ready to try an Ai Scribe? Here's your roadmap:
Day 1-2: Foundation
- Pick ONE tool with a free trial
- Test audio quality in your office
- Run 2-3 mock sessions with yourself
Day 3-5: Pilot
- Start with straightforward med checks
- Review every note carefully
- Note what works and what needs adjustment
Day 6-7: Evaluate
- Calculate actual time saved
- Assess note quality
- Decide whether to continue or try another tool
Success looks like: spending less time on notes while maintaining (or improving) quality. If a tool doesn't deliver both, move on.
Where This Leaves You
AI scribes aren't perfect. They'll occasionally mishear medications or attribute statements to the wrong person. But for many psychiatrists, the trade-off is worth it: more time with patients and fewer late nights charting.
As psychiatrists in our community have shared, even with the editing required, saving time is the norm.
Ready to join the conversation? The Psychiatry Collective hosts regular discussions about AI scribes and other practice tools. Join our community to learn from colleagues who've been where you are now.
Remember: The goal isn't to find the perfect AI scribe. It's to find one that's better than drowning in documentation.
Connect with forward-thinking peers, advance your practice, and attend expert events. Join the Psychiatry Collective today.
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