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As I pull into clinic, my intention is always the same: be fully present with each patient. By the time I'm two patients in, the reality is always different.
We've all read the mindfulness quotes about the virtues of being "in the moment," but somewhere after the first couple visits of the day we face a decision -- to shift our attention away from patients and toward the computer screen with the aspiration to stay on top of notes, or hope that a combination of shorthand notes and our brains will do the trick for writing complete notes later on. Neither option is optimal. One leads to distracted doctoring, and the other to increased cognitive burden in trying to keep all the details straight.
When I was full-time, I used to choose the latter, driving home with a stack of papers full of chicken scratch for my evening charting. My hope was that a quickly scrawled "Tall guy in the Mets hat" would trigger perfect memories of that patient's story, with enough detail to document medical decision-making and avoid prior authorization denial for a cardiac MRI order I'd already written. But, the reality is that it never worked well enough, and the feeling of not being able to perform at my best got to me.
As clinicians, we are the original patient advocates. Listening and empathy are at the heart of our profession. We don't want to have our backs turned to our patients in their most vulnerable moments. We don't want to break eye contact to glance at our screens. We want the time, space, and presence of mind to forge a connection with our patients and provide the best care possible.
Our patients want the same. They want to see a doctor they can trust. They want empathetic counsel and a human conversation. For them, the experience is everything, and too few are getting our best. Generative artificial intelligence (AI), however, is starting to give physicians the ability to provide it. It's putting an end to distracted doctoring.
While generative AI recently has gotten a lot of hype for being able to generate content in the style of Shakespeare, the right application in healthcare, fully integrated into our workflows and existing tools, has the potential to transform the way modern medicine is practiced.
Applied properly, generative AI can create a whole clinical progress note, just from summarizing the conversations we have with our patients. Beyond clinical notes, generative AI can also help clinicians meet billing and regulatory requirements, or help patients stay on top of their health via informative patient instructions. It's already happening. Now, I no longer need to dictate notes afterwards in the unnatural style of "next header, next line, period," while referencing a paper full of my chicken scratch notes. Instead, I can capture my conversation with a patient and get technology out of the way of our connection. By the end of the visit, I can swivel my chair and have a draft SOAP (subjective, objective, assessment and plan) note complete with all the details of the visit.
So much in healthcare needs to be transformed before we arrive at an efficient system that works for all. Generative AI won't solve most of those problems that remain upstream of any new technology -- it won't anytime soon make quality care affordable and accessible for everyone. It won't change the incentive and payment structure.
But it can help us make healthcare feel human again, and that's meaningful progress. Generative AI is putting an end to distracted doctoring by assisting and in some cases automating administrative tasks that separate us from our patients and strip us of our agency. It's enabling doctors to practice medicine the way it should be practiced by removing all of the technology in our workflows that prohibit us from being present.
So, while generative AI won't by itself shift revenue models or align incentives, it can help healthcare feel more human by helping us all feel more present and less distracted, building a bridge between the most important people in healthcare: clinicians and their patients.
Shiv Rao, MD, is a cardiologist and physician executive.
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