Doctors talk about patient-centered care all the time. Then their own professional organization, the AMA, comes out and effectively says: we win, patients lose. I have worked in healthcare for a very long time, and I am tired of hearing about patients being at the center of everything while the system quietly does the opposite.
Here is the backstory. A patient went to her health system for a visit that was documented with an ambient AI scribe, one of those tools that records the encounter and drafts a note for the electronic health record. Afterward she asked for a copy of that recording. The case went all the way to court, and the court sided with the physicians, the health system, and the AMA. The ruling, in effect, was that you get access to the curated version. Whatever the physician and the health system chose to put in the record, you can see. The raw recording of the conversation you sat through, in the room, about your own body? That you cannot have.
That leaves patients with two problems stacked on top of each other.
One rule for me, another for thee
First, the doctor gets to record. Ambient scribes help the health system document faster and work more efficiently, and physicians are allowed to run them during your visit. Second, those same physicians routinely tell patients they may not record the conversation themselves. Many Neatly Health users have told us exactly this: their doctor was clearly capturing the encounter while denying them the right to do the same. It’s a double standard we need to be talking about.
I want to be precise about something, because the AMA's argument leans on it. A recording of a conversation between a doctor and a patient is not the same thing as a physician using dictation to build their own note. Dictation is a doctor narrating their impressions. A recording is the actual exchange, the questions you asked, the answers you got, the instructions you are now supposed to follow. Treating the two as equivalent is how you end up with a ruling this lopsided.
The power gap was already wide
The balance of knowledge and power between a doctor and a patient is skewed before anyone turns on a microphone. You have fifteen minutes, no medical training, and a dense conversation to absorb while you are anxious about your health. The physician has the expertise, the vocabulary, and now an AI tool doing the remembering for them.
Then the same institution tells you that you cannot record it yourself, and that you cannot have their recording either. So how, exactly, is this supposed to work? You are expected to walk out and accurately act on a conversation you were structurally set up to only half retain, with no way to check what was actually said.
Technology should be closing that gap. Instead the AMA's position on AI scribes widens it. The message underneath is hard to miss: these tools are great, they work well, we will deploy them for our doctors, and we would prefer patients not have access to the same capability.
This is a choice, not a law of nature
None of this is inevitable. The industry is genuinely excited about advances that make clinical work easier, and a lot of that excitement is earned. But every conversation about efficiency seems to be about the system's efficiency. What about the patient? Who is building the tools that help the person on the other side of the desk understand what just happened to them?
At Neatly, that is the entire reason we exist. We think a patient has every right to an accurate record of their own care, and to walk into the next appointment knowing exactly what was said in the last one. A curated summary written by the other party is not the same as knowing what happened.
So to my healthcare friends, I mean this as a real question and not a rhetorical one: what is your take? When a court rules that patients cannot access a recording of their own appointment, and calls that a win, does that sit right with you?
Whatever happened to the Hippocratic oath?
The court decision referenced here is Raphael v. Mantei, a 2026 Washington state trial court ruling holding that ambient clinical recordings are used for "administrative purposes" and are not part of the medical record patients have a right to access.
