From: Lawrence Kosova, DPM
Dr. Freedman, this is an excellent response on many levels. In the medical AI community, this is all discussed and dissected. I was at a Becker's Healthcare meeting last year in Chicago with just about every hospital and administrator in the US. I listened to a panel for Cleveland Clinic and a few other hospitals and they went over their implementation of AI, starting with AI scribe to coding etc. If done correctly, the results are impressive and the adaptation from the doctors are impressive. The system I am involved with has Beth Israel's entire hospital system with close to 5,000 physicians, but a pilot study has to be implemented to address the extensive list you wrote about. This doesn't happen overnight with many pitfalls in between, but honestly, those are becoming much less with experience. But this is at a hospital level.
When lecturing, I address the physician private clinic situation where everything still applies, but addressing workflow and efficiency is key. Not all AI scribes and systems are the same. The built-in AI, regardless of company implemented, seems to be poor. Then the doctor thinks all systems are the same. They are not. I was just at my GI at a major hospital in Chicago and the system is so poor very few are using it. That's a shame. Yes, each doctor has to review their own notes regardless of technology implemented. Also, doctors should not be using "open" AI systems like many of the knowns Chats. This can leave them exposed to legal issues. Closed systems tend to protect against that. I also hope the patients are signing written consents and not verbal ones before use in the office setting.
Lawrence Kosova, DPM, Chicago, IL
From: David J. Freedman, DPM
I just came back from the 2026 AAPC Healthcon Conference where AI was a significant topic of discussion to over 3000 attendees. The purpose of my post was to explain to the masses who use templates created by them or their EMRs was really about the pitfalls and warnings they need to be aware of in charting. So, let's be honest, doctors do not change quickly when it comes to charting opportunities. On the flip side, those who are engaging AI need to understand it and the fact of issues that have been brought up just at this very conference this week.
While on the surface, AI can make each visit "unique" to that patient's visit as you stated Dr. Kosova, what the auditors are seeing is old habits do not die. For example, "Copy & Paste"; to save time, many doctors just bring forward old information even using AI. What most do not understand is that information does not necessarily count toward...
Editor's note: Dr. Freedman's extended-length letter appears here.
