r/privacy • u/OkChips9323 • 8h ago
discussion medical practice recorded my appointments with AI when I expressly denied consent
I joined a new medical practice as a patient. There was no AI form to give or deny consent. Under their consent forms pages, to cover my bases even though there was no mention of AI use, I wrote "I DO NOT CONSENT TO AI RECORDING" and signed and dated.
Imagine my shock when I read my notes, which are extremely long and detail every random word of the appointment, now in my permanent medical file.
At the end of each clinic note, it says this bucket of flaming lies:
"Patient and/or family have been informed of the use of Ambience, an Artificial Intelligence (AI) scribe dictation technology in the documentation of medical records. Patient and/or family was further advised that the AI scribe is not used to make any health care decisions and that AI-scribed notes will be reviewed by the clinician for accuracy. Patient and/or family was able to ask questions and offered the opportunity to opt-out. Patient and/or family voluntarily consents to the use of AI scribe technology for medical documentation and understands that he/she may withdraw this consent at any time."
I WAS NOT INFORMED. I DID NOT CONSENT.
I EXPRESSLY DENIED CONSENT.
AND NOW I HAVE TO BE AFRAID OF GETTING KICKED OUT OF THE MEDICAL PRACTICE, BECAUSE I TOLD THE ADMINISTRATORS THAT THIS IS NOT LEGAL. THEY CAN LEGALLY FIRE ME AS A PATIENT FOR SAYING THEY DID SOMETHING WRONG.
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u/Enthrallogies 8h ago
Let me know how it goes. I also expressly refused to sign the AI waiver at my practice last month. Haven't checked the notes yet to confirm though. Good luck.
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u/OkChips9323 8h ago
Download your records, always. Always read them, too, in case there is an error so you can ask the doctor to add new notes next time to try to patch the error.
What a nightmare, honestly... How are these people thinking no one will notice! And it's in a two-party consent state too, it's literally illegal. But because I said that to an administrator, now I'm worried I'll be discharged from the practice. That isn't right. This shouldn't be legal.
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u/Formerruling1 5h ago
Whether the wiretapping laws matter is an open legal question - in several two/all party states Healthcare providers have successfully argued in court that the use of AI transcription tools do not count as wiretapping /eavesdropping instead arguing that they are simply digital aids to the professional, or fall under "regular course of business" exemptions.
That said, use without that disclaimer is almost certainly a violation of either their internal risk management policies and/or a violation of their licensing terms of use with the vendor. That leverage alone should get them to delete any recordings that might still be saved (unlikely), remove the notes, note your denial of consent and stop using such services.
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u/Lancifer1979 6h ago
They did it to me too, without the patient consents bs. When I called them on it they claimed it was turned off and did it again. I went into the front office and asked for a copy of their certificate of insurance and their malpractice insurance Policy number. They erased those notes and didn’t do it again. I also got assigned to a new doc
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u/OkChips9323 5h ago
holy crap. I’m sorry that happened to you. there should be a class action lawsuit. did they write you new notes, or do you have zero notes from that medical encounter?
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u/_backdr0p 3h ago
Your recourse depends on where this occurred. Check your region privacy officer website. Also most medical associations have a section noting that a patient cannot be retaliated against for disagreeing to a doctor or offices policy if the disagreement is reasonable.
Refusing AI Scribe in an appointment is a reasonable action by you as a patient. Also the Scribe works both ways, there is additional proof for you that you were not verbally told of it's use etc.
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u/OkChips9323 2h ago
I agree. The retaliation csn come if a patient says the words “illegal” or “lawsuit.” to me it seems like discrimination; if a medical practice is doing something illegal, and these AI lack of consent practices seem to border on illegal in certain states that have two party consent rules, that’s not OK and it shouldn’t be allowed. I have a feeling there are going to be a ton of glass action lawsuits about AI usage of medical data without patient knowledge or consent.
Or even if a patient consents, they don’t know what their consent to because the AI companies are offering services for free or a discount so that they can mind every patient data. The doctor doesn’t own the patient’s data, the patient does. But that’s what’s being given away for free. most patients have no clue that that is what they’re consenting to when they say yes to AI in a medical setting, if they ever consent at all.
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u/andthenwombats 8h ago
They can’t legally fire you as a patient for doing that actually. But if you threaten legal action they can because of the conflict of interest
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u/flowerpanda98 8h ago
they can basically kick you out for being too difficult
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u/russellvt 5h ago
They can "drop you" for almost any reason ... conflating it with threatening a lawsuit is idiotic, to say the least.
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u/OkChips9323 8h ago
The effed up thing is, I think they can. If a patient mentions legal action, they can discharge you. Like, you're not a patient anymore. It's awful.
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u/russellvt 5h ago
They can discharge (ie. Refuse service) for ANY reason, provided you're not in a life threatening situation. Stop pushing bad info, already.
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u/interwebzdotnet 5h ago
Why is it F'd up? It's a private business and you are creating extra risk/ liability they are not comfortable with, and as a patient you aren't comfortable with how they run their business. The risk you think you are taking is no different than the risk they think they are taking with a problematic patient who seems litigious.
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u/russellvt 7h ago
You shouldn't be "sharing info" that you obviously don't know/understand, yourself.
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u/bolonomadic 5h ago
Yes, and if you proceeded with legal action, you would likely have to submit your appointment transcript to the court for lots of additional people to read it.
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u/fdbryant3 7h ago edited 2h ago
One, I would consult a lawyer, you may have grounds for a case. Two,so what if they discharge you? Go find another medical practice, it does not sound like they are a good fit for you.
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u/KarmaPharmacy 7h ago
For a lot of rural areas, sometimes there are no choices, if there’s medical care at all.
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u/OkChips9323 5h ago
Finding medical care at all is a total crisis for a lot of people. Choice and "go somewhere else" aren't options.
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u/Long-Librarian-997 3h ago
Yah sure its that easy. My country has lots of people with no family doctors. My area is hard to get a doctor I only got one cause my parents asked theirs.
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u/interwebzdotnet 6h ago
Well, are we assuming that you can just make random edits to a contract and the other party is obligated to abide by it?
Reminds me of the people posting on Facebook that they don't have the right to use their pictures or information.
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u/Shoddy-Childhood-511 6h ago edited 5h ago
Afaik you can kinda do this, because contracts should be a negotiation, but afaik you need to highlight the changes for them somehow, since you obviously should not be tricking them.
If someone does this to your employer, then you should never sign the contract yourself, but instead send it to the company lawyer and they would always draft a modified version. Also, you could just dump them as a client if their money is not worth your lawyer's time.
I'd expect it's worthless if he did not highlight the changes for them somehow. I'd assume the secretary to whom you return the signup forum would not have signing authority, so this requires some escalation early on.
Otoh..
Anything medical or HR should be extremely careful about their AI uses, likely certainly they should be reported to, and approved by, the practices' insurance.
Internet suggests AI medical laws are largely anti-discrimination focused in the US now, not necessarily useful for OP, but they'll likely become stricter eventually.
Also, there is a malpractice risk if they trust AI judgements without closely double checking them, or somehow miss-use the AI, like by leaving shit in its context window.
This maybe a gift to the practice, in that they rethink some risky business practices.
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u/interwebzdotnet 5h ago
Sure,then in that case,this person was expecting whoever owns the practice to run the contract by their lawyer before seeing the patient?
Like I said, it's a pretty ignorant move by OP to do this and expect some instant result. Just pick a different doctor and talk to them about AI more than 5 minutes before the appointment.
No different than the folks who thought a comment on Facebook amended the ToS. If you don't like what a business does,talk to them or find another option.
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u/Long-Librarian-997 3h ago
Someone I know was a transcriber they all got let go cause they all the clients moved to AI. So i imagine this is going to be a bigger issue then most realize.
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u/EarthAgain 4h ago
You didn’t read OPs message correctly.
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u/interwebzdotnet 4h ago
No, I did. And my point stands. Writing your disagreement onto a contract about a businesses terms 5 minutes before you partake in their services, without even talking to anyone about it...then expecting them to abide by your own written edits to their contract without the obvious time required to review it by them and their attorney is not something a serious adult would do... and then to honestly expect they would just go along because you wrote it down? C'mon man, any grown adult knows better.
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u/ContemplatingFolly 3h ago
"There was no AI form given to approve or deny consent." Business shared with a third party: AI.
Obviously OP has limited options here, but you are being perverse about it.
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u/interwebzdotnet 3h ago
Yeah, really limited options....like speaking directly to all of the actual humans who are right in front of your face? 🙄
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u/_Bia 8h ago
What does fire you as a patient even mean? I'm not a lawyer, but this sounds like something you can sue for in small claims court for damages. Leave and find a different doctor.
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u/PianistNo8873 7h ago
If the office staff or doctor has an issue with your attitude or behavior, failure to show for appointments amongst other things, they do not have to continue the relationship with you and they will fire you. You cannot sue a doctors office for firing you. It’s just like a store refusing to serve you, it’s their option who they want to work with. It sucks because it is so difficult to find good practices that are accepting new patients and when you do it takes weeks if not months to get the initial appointment.
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u/interwebzdotnet 6h ago
Yeah,and hand writing edits to a contract doesn't mean the other party is instantly required to abide by it either. Lots of ignorance in this thread.
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u/Toyhawk88 7h ago
It’s probably not going to make a difference—it’s hard to find a practice that doesn’t use AI and a bunch of third party apps. Stay healthy is what I recommend.
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u/OkChips9323 5h ago
that's a bit ableist. disability and poor health are not choices for many people.
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u/Long-Librarian-997 3h ago
Yep what is the alternative, all practices are using AI now. I knew a couple transcribers and they all lost their jobs one for courts and one for medical.
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u/NoFuel1197 2h ago
Reading the posts here has the same vibe as reading about Japanese soldier who kept on fighting decades after the war had ended.
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u/Express-Cartoonist39 6h ago
Did you sign it and clearly state on the form you DONT consent? I do... I mark it out with big ass marker huge x and state i dont consent.. Its awful now..we need to push back more people
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u/jadekitten 6h ago
They ask me each time. When I read the after visit summary, it’s clear and comprehensive.
I will say on occasion I would hear a family member doing dictation, not intentionally, it was a small house.
It was always extremely detailed. I think when that is your profession, you likely get very good at it. I’m not saying there isn’t AI involved but there could be another explanation.
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u/WolflingWolfling 5h ago
Have you read the OP?
'At the end of each clinic note, it says this bucket of flaming lies:
"Patient and/or family have been informed of the use of Ambience, an Artificial Intelligence (AI) scribe dictation technology in the documentation of medical records. Patient and/or family was further advised that the AI scribe is not used to make any health care decisions and that AI-scribed notes will be reviewed by the clinician for accuracy. Patient and/or family was able to ask questions and offered the opportunity to opt-out. Patient and/or family voluntarily consents to the use of AI scribe technology for medical documentation and understands that he/she may withdraw this consent at any time."'
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