1. Three different things are sold as an AI scribe
The phrase covers three products with different failure modes, and vendors rarely say which one they are selling. Work out which you are being shown before you compare anything else, because the price per visit and the work left for the provider are not comparable across them.
| What it is | How it works | What it still needs from the provider |
|---|---|---|
| Ambient | Listens to the visit and drafts the note from the conversation | Review and edit — the draft is a first pass, not a note |
| Transcript-to-note | Takes an existing transcript, usually from a video visit, and structures it | The same review, plus a transcript to exist in the first place |
| Dictation | Turns speech into text, with formatting | Everything clinical — the structure and the reasoning are still yours |
Aminova’s scribe is the second kind for video visits and the first for in-person ones, and in both cases it produces a draft SOAP note the provider reviews, edits and signs. Nothing it writes is filed on its own. That is the model to expect from any serious vendor; be suspicious of one that implies otherwise.
2. The twenty-minute test
Ask to drive, and bring a messy visit rather than a clean one. The clinic that tests with its own worst recording learns more in twenty minutes than it will from three polished demos.
| Test | What you are looking for | What failure looks like |
|---|---|---|
| A visit with two numbers in it | Both doses land in the note, attached to the right drug | One number, or the right number on the wrong drug |
| Someone talks over the provider | The note attributes statements correctly | The patient’s guess appears as the plan |
| A patient changes their mind mid-visit | The final decision is what appears | Both versions appear, or the first one does |
| A drug name said once, quietly | It appears, spelled correctly | A phonetic near-miss that reads as a real drug |
| A visit that ends abruptly | A partial draft, clearly marked | A confident, complete-looking note with a hole in it |
| Say something explicitly off the record | It is not in the note | It is |
The fourth row is the one that should worry you most. A transcription error on an ordinary word is obvious; a transcription error that produces a different real medication is not, and it will be signed.
3. What a scribe costs, and the cap that decides the bill
Three pricing models are in use, and they diverge sharply depending on how your clinic actually runs. A high-volume aesthetics practice and a low-volume longevity practice should pick differently.
| Model | Who it suits | Where it hurts |
|---|---|---|
| Per provider, per month | Clinics with steady, full schedules | A part-time or seasonal prescriber costs the same as a full one |
| Per visit | Low volume, or trialling it | Scales with exactly the thing you want to grow |
| Per hour recorded | Long visits that are few | Long intakes get expensive quickly |
Then find the cap. Most per-provider pricing includes a usage allowance and charges beyond it, and the allowance is where a quoted price stops resembling the invoice. Ours is published: one scribe seat is included with every Prescribing plan and extra seats are $49 a month, with 100 scribed hours per seat per month and $0.50 an hour after that. Whatever a vendor’s numbers are, get the allowance, the overage rate and the unit (visits? minutes? hours?) in writing — those three decide the bill, not the headline.
Do the arithmetic on your own volume before the call. A prescriber running six hour-long visits a day works past 100 hours in a month; one running fifteen-minute follow-ups does not come close.
4. The consent almost nobody checks
A scribe listens to a medical conversation, which means recording consent is not a formality and not the vendor’s problem. This is the single most common gap we see, and it is usually discovered after months of recordings exist.
The question to put to any vendor is narrow and revealing: what does your scribe do when it cannot confirm the patient consented? There are only two possible answers, and only one of them is safe.
| Behaviour | What it means in practice |
|---|---|
| Fails closed | No provable consent, no recording. Nothing is captured you cannot account for |
| Fails open | Records anyway and leaves the paperwork to you, including for the visits already recorded |
We learned this one the hard way rather than theoretically. Our recording gate originally reused the same permissive check that governs booking — which is deliberately forgiving, because when you cannot tell whether a form is signed you should still see the patient. Applied to recording, that logic inverts: four separate situations, including a clinic that had simply never uploaded a consent template, produced “go ahead and record”. It was rebuilt in August 2026 to fail closed on every one of them. The booking gate stayed permissive on purpose. Ask your vendor which way theirs points.
Consent requirements themselves vary by state and by what you are recording, which is a separate subject with its own post: what you must have before you record.
5. Where scribes still fail, in every specialty
These failure classes are not specialty-specific and no vendor has eliminated them. A vendor who says otherwise is describing a demo, not a year of use.
| Failure | Why it happens | What catches it |
|---|---|---|
| Numbers | Doses, units and frequencies are short, quiet and easily confused | A provider who reads the numbers before signing, every time |
| Attribution | The model cannot always tell who said what | Checking that the plan is the provider’s, not the patient’s |
| Confident completeness | A partial note does not look partial | Comparing the note length against the visit length |
| Negation | “No chest pain” and “chest pain” are one word apart | Reading the negatives, which is where it bites |
| Silence | Nothing said is nothing written, including the exam you did quietly | Narrating what you do, or adding it afterwards |
The practical consequence is that a scribe changes where the provider’s attention goes, not whether it is needed. The time saved is in composition. The time still required is in verification, and a clinic that budgets for the first without the second will sign bad notes faster than it used to write good ones.
6. Five things to get in writing
Scribes handle the most sensitive data in the building, so the paperwork matters more here than for almost any other tool. None of these are unreasonable asks and every one of them is easier to settle before you sign.
| Ask | Why |
|---|---|
| A signed BAA | You are the covered entity and the scribe handles PHI. This is not optional |
| Whether your data trains their model | Get a written no, or know exactly what you have agreed to |
| How long recordings and transcripts are retained | And whether you can shorten it |
| What happens to the notes if you leave | Notes in your chart are yours; confirm the audio and transcripts too |
| Where the processing happens | If data residency matters to you, it has to be in the contract |
On the first one: there is no such thing as a HIPAA-certified product, and a vendor describing itself that way has told you something about its internal rigour. What exists is a business associate agreement, which we sign with every clinic, and which any scribe vendor should offer without being chased. Which vendors sign a BAA covers the wider stack.
7. Frequently asked questions
What is the best AI medical scribe for a small clinic?
It depends on your visit length and volume rather than a ranking. Low-volume practices usually do better on per-visit pricing; steady full schedules do better per provider. Test with your own messy recording, not the vendor’s sample.
How much does an AI medical scribe cost?
Commonly a per-provider monthly fee with a usage allowance. Aminova publishes one scribe seat as included with every Prescribing plan and extra seats at $49 a month, with 100 scribed hours per seat per month and $0.50 an hour beyond that. Always ask for the allowance and the overage rate, not just the headline.
Does an AI scribe need patient consent?
It is recording a medical conversation, so yes, and the requirements vary by state. The question to ask a vendor is what the scribe does when consent cannot be confirmed: it should refuse to record rather than record and leave the paperwork to you.
Can an AI scribe sign the note?
No. A scribe produces a draft; a clinician reviews, edits and signs it. Any product implying otherwise is describing something you should not buy.
Do AI scribes work for hormone and peptide visits?
They can, but doses and units are exactly where general-purpose scribes slip. Test with a visit containing two different numbers and check both landed on the right drug.