The Art of Talking to Humans, Not Computers: Rediscovering Patient-Centered Care in the Age of AI
by Joshua Tamayo-Sarver, MD, PhD, FACEP, FAMIA
For years, my interaction with healthcare technology revolved around typing into electronic medical records and clicking through endless drop-down menus — essentially, “talking to the computer.” It was “efficient”, or so I thought, until I experienced the difference with using an ambient AI documentation solution we built for our physicians.
This technology, which listens to my patient conversations and generates my medical notes, initially filled me with discomfort. I realized I had become so accustomed to dictating information to a machine that I’d stopped fully engaging with my patients.
The AI solution forced me to re-learn the art of conversation — to listen actively, ask clarifying questions, and explain results with empathy and detail, not for the computer, but for the human being in front of me.
The results have been astounding. Not only has my documentation become more efficient and accurate, but my patient relationships have deepened. Patients feel heard, understood, and actively involved in their care.
My Uncomfortable Transition
As an emergency physician with over 15 years of experience, I’ve witnessed firsthand the evolution of healthcare technology. The introduction of electronic health records (EHRs) promised increased efficiency and accuracy, but it also inadvertently created a barrier between doctors and patients. I recall treating a critically ill patient, where I found myself struggling to document everything accurately while also providing urgent care. Instead of focusing fully on the patient, I was distracted by the need to navigate through checkboxes and drop-down menus to order critical testing and labs, highlighting how EHRs, despite their benefits, can sometimes detract from direct patient interaction in critical moments.
When I first started using the ambient AI documentation solution, I felt a profound sense of discomfort. It wasn’t just about learning a new technology; it was about unlearning years of ingrained habits. I had to consciously remind myself to verbalize everything, to engage in active and reflective listening with my patients.
Rediscovering the Art of Communication
As I adapted to this new way of working, I explained test results, diagnoses, and treatment plans in much greater detail to my patients. Instead of saving this information for the computer, I was sharing it directly with those who needed it most — the patients themselves while capturing it for documentation purposes.
For instance, I began explaining EKG results, blood work findings, and even my thought process behind ordering certain tests. Previously I might have said, “Your EKG, chest x-ray, and blood work were fine, and you are feeling better after the medication we gave you, but your troponin level, which checks on your heart, was elevated. So, we are going to admit you to the hospital to talk with the cardiologist and make sure everything is okay.” Now, I engage in a much more detailed conversation with the patient:
Hello. I wanted to check on you and see how you’re doing. It looks like you’re doing better now. Let me reexamine you.
On reexamination, your condition has improved, and I see that your chest pain has resolved. Here’s what we did:
We gave you aspirin 324 mg by mouth and nitroglycerin 0.4 mg under your tongue. It seems like your pain went away after that.
Regarding the results we have:
Your EKG from 2:30 PM was normal, with a heart rate of 79, which is good news.
Your CBC was normal, ruling out any infection or anemia.
Your BMP was normal, indicating proper electrolyte balance and healthy kidney function.
Your liver function tests were normal, showing no issues with your liver.
Your BNP was normal, indicating no signs of heart failure.
Lastly, your 1-view portable chest X-ray was also normal.
Unfortunately, your troponin level was slightly elevated at 0.6, which raises some concern about your heart.
All of this suggests that there might be an issue with your heart, so we’d like you to come into the hospital.
I’ve spoken with Dr. Jones from our hospital service, and he agreed to see you. I’ve also consulted Dr. Smith, a cardiologist, who will discuss the appropriate next steps with you given our concerns about your heart.
Based on these findings, my diagnosis is NSTEMI (Non-ST Elevation Myocardial Infarction). This means I’m concerned that you may have had some damage to your heart, although I didn’t see any alarming changes on your EKG.
For your care plan, we’re going to admit you to the telemetry unit under the care of the hospitalist. The cardiologist will serve as a consultant to ensure everything is okay.
This level of transparency and communication not only improved patient understanding but also enhanced their trust in the care they were receiving. All the detail in the conversation is captured by the ambient dictation system so that it can document my normal EKG reading taken at 2:30 pm along with all other relevant information. This enables the AI to generate a comprehensive, detailed note. Now, if I want something included in my note, I need to say it out loud to the patient — a change that feels a bit strange at first.
The benefits of this shift in communication style have been multifaceted:
Improved Patient Experience: Patients feel more involved in their care when they receive detailed explanations about their condition and treatment. They also appreciate the thoroughness and high-level of care because they can understand what was actually done for them and why.
Enhanced Efficiency: Contrary to initial expectations, talking more to patients has actually made me faster at seeing patients overall. I was initially concerned that I would end up spending more time in the room with the patient when I was busy. I was right, I spent an extra few minutes in the room. But I don’t spend any time documenting because everything I need in the chart I talked about with the patient. So now I only spend my time in three places: at the bedside listening and communicating with my patient, putting in orders, and coordinating care. You know what I don’t spend time doing? Charting.
Better Documentation: The AI-generated notes are comprehensive and accurate, reflecting the detailed conversations I have with patients. More importantly, it accurately captures the conversations and communication with the patient rather than my recollection of a conversation I had 25 conversations ago if I were charting at the end of a busy shift.
Increased Job Satisfaction: Spending more time engaging with patients and less time on documentation has significantly improved my job satisfaction. Amazingly, the number of times that patients express appreciation for me taking the time to be thorough and explain everything has increased once or twice a shift to almost all the time. I have never been thanked so much until this new patient care approach!
The Broader Implications for Healthcare
This experience highlights a crucial point: AI in healthcare should enhance, not replace, human interaction. It should free healthcare providers to focus more on patient care, not less.
However, the transition isn’t always easy. Many of my colleagues, just like me, find it challenging to give up their familiar macros and dot phrases. They’ve invested significant time in optimizing their computer interactions, making it uncomfortable to shift their focus back to patient conversations.
Looking to the Future
As we continue to integrate AI into healthcare, it’s crucial that we prioritize solutions that improve both clinical efficiency, job satisfaction and more importantly the patient-provider relationship. The future of healthcare lies not in replacing human interaction with technology, but in using technology to enhance these vital connections.
Conclusion
My journey with ambient AI documentation has been transformative. It reminded me of a fundamental truth in healthcare: our primary interaction should always be with our patients, not our computers. As we continue to innovate and integrate new technologies into healthcare, we must ensure that they strengthen, not weaken, the human connections at the heart of medicine.
By embracing these changes, even when they’re uncomfortable, we can create a healthcare system that’s not only more efficient but also more humane. After all, healthcare is about people, not computers. It’s time we remembered that!
In our rush to adopt the latest technologies and increase efficiency, we can’t lose sight of the core values that define healthcare: empathy, connection, and trust. No matter how advanced our tools become, they should never replace the human touch. It’s not just about delivering care quickly or documenting efficiently — it’s about building relationships, understanding the person behind the symptoms, and ensuring that patients feel heard and cared for. After all, the true essence of healthcare is found in these personal interactions, and it’s crucial that we preserve that in our pursuit of innovation and efficiency.
