Lemmy, I really would like to hear your opinions on this. I am bipolar. after almost a decade of being misdiagnosed and on medication that made my manic symptoms worse, I found stable employment with good insurance and have been able to find a good psychiatrist. I’ve been consistently medicated for the past 3 years, and this is the most stable I have been in my entire life.
The office has rolled out the use of an app called MYIO app. My knee jerk reaction was to not be happy about the app, but I managed my emotions, took a breath and vowed to give it a chance. After being sent the link to validate my account, the app would force restart my phone at the last step of activation. (I have my phone locked down pretty tight, and lots of google shit, and data sharing is disabled, so I’m thinking that might be the cause. My phone is also like 4-5 years old, so that could also be the cause.)
Luckily I was able to complete the steps on PC and activate that way. Once I was in the account there were standard forms to sign, like the HIPAA release. There was also a form there requesting I consent to the use of AI. Hell to the NO. That’s a no for me dawg.jpg.
I’m really emotional and not thinking rationally. I am hoping for the opinions of cooler heads.
If my doctor refuses to let me be a patient if I don’t consent to AI, what should I do? What would you do? Agree even though this is a major line in the sand for me, or consent to keep a provider I have a rapport with, who knows me well enough to know when my meds need adjusting?
EDIT: This is the text of the AI agreement. As part of their ongoing commitment to provide the best possible service, your provider has opted to use an artificial intelligence note-taking tool that assists in generating clinical documentation based on your sessions. This allows for more time and focus to be spent on our interactions instead of taking time to jot down notes or trying to remember all the important details. A temporary recording and transcript or summary of the conversation may be created and used to generate the clinical note for that session. Your provider then reviews the content of that note to ensure its accuracy and completeness. After the note has been created, the recording and transcript are automatically deleted.
This artificial intelligence tool prioritizes the privacy and confidentiality of your personal health information. Your session information is strictly used for the purpose of your ongoing medical care. Your information is subject to strict data privacy regulations and is always secured and encrypted. Stringent business associate agreements ensure data privacy and HIPAA compliance.
Edit 2: I just wanted to say that I appreciate everyone here that commented. For the most part everyone brought up valid points, and helped me see things I had not considered. I emailed my doctor and let them know I did not want to agree to the use of AI. I let them know that I was cool with transcription software being used as long as it was installed locally on their machines, but I did not want a third party online app having access to recorded sessions for the purposes of transcription. They didn’t take issue with it.
Thank you everyone!
Yes I would but only if I can be sure the LLM wasn’t listening. Collection of personal information requires consent in Canada and I wouldn’t be giving consent.
I don’t believe for one second the conversations aren’t uploaded to a datacenter nor that those transcripts will be deleted.
Imagine charging $300 then outsourcing your note taking to a machine that barely knows shit and has nothing to lose
Can you ask how AI is used in the app?
It records the sessions then makes a transcript for “note taking.”
I can, but in truth I don’t care. I don’t want my data being used to train AI, and I don’t want my treatment to be guided by AI.
So ask about those two specific points.
And in the session you can (probably) go over the generated notes with your doctor to double check.
The term AI is very broad and generic, today it’s used to refer to LLMs and fancy denoisers. But AI has been around for decades in some form or another. My point is, speech transcription has been around longer than the current LLM fad, so it might not be an LLM doing your transcription. Would that allay some of your concerns?
If it were a locally ran transcription software, would a healthcare provider still be required to ask your permission to use it?
I very much hope so, because in neither case can thry guarantee that the data won’t be transferred elsewhere
The “fine print” you added doesn’t say the automated transcript will be used for training a model. I’d highly, highly doubt HIPAA protected clinic notes would be use for training an LLM. If they did, the clinic would go bankrupt from lawsuits.
Also, if they only use AI for automated transcription, would you feel the same instead of “AI” it were a dedicated automated transcription tool?
If you abhor all things AI, your feelings of not continuing with this clinic are valid. However, I don’t think they are using AI in ways you think they are.
If they did, the clinic would go bankrupt from lawsuits.
for that, patients would need to be able to prove that their data was used. how would you be able to prove it?
I’d highly, highly doubt HIPAA protected clinic notes would be use for training an LLM
It doesn’t sound like AI is being used for either. It’s just summarizing the encounter at the end as a note, and not storing any data to train on.
And to piggy back this question: what alternatives do you have and are they actually viable?
The alternative is finding a different provider. I already have a long list of offices to call. Getting a list together was the first thing I did when they notified me about rolling out this app.
I would nope the fuck out and change doctors. A regurgitation machine prone to hallucinations has no place in medical care.
Yeah, though that’s about 4/5 of the actual people I’ve met working in psychology.
If this was for a GP, I would agree with this stance. But a good, fitting and competent mental health professional can be harder to find.
I don’t believe that. They just don’t want to pay them what they’re worth. Machines don’t ask for days off.
That’s the last fucking profession who should be using LLMs… People can gaslight themselves with chatbots without paying for a trusted professional to reinforce that bullshit.
OP didn’t state this clearly, but I went and looked. The app is not for replacing consults, only billing etc. so I’d put it in the “annoying, but not world ending” category.
By god they’re going to make OP change doctors just because they hate “le stochastic parrot”. And op is probably in the US which makes the whole thing even crueller.
Literally a horde of teenagers playing with a bipolar’s head because they have big feelings about stuff.
And all this for a fucking note taking app Jesus Christ. Yeah sure OP is probably risking their mental health in the process but who gives a shit about that when you have an occasion to proclaim that le AI bad.
you seem to have no clue about the problem at hand. It’s the lesser of issues that the AI transcriber could hallucinate. the worse problem, which is irreversible, that the treatment session and every private detail that gets discussed is funneled to at best questionable companies who will do whatever they want with your private information. once that happened, you can’t just make them delete what they stored in the process, it is completely unveriable what they do besides offering the original service. everything that was told in the session will not stay between the two of you.
accepting this unknowingly is very dangerous. accepting it knowingly will alter what you say and the results with it, like going to a therapist who you know personally, which is not allowed for very good reasons.You think therapists and doctors in general don’t use Docs or Notes services that are hosted or backed up in the cloud ? You think having your medical data leaked to tech companies is new ? Just because the notes transcription app is AI doesn’t make it magically worse. In fact it makes the data harder to access as you need to re-infer the whole enchilada if you want to mine it (as opposed to, say, Google Drive who can just make a SQL query on your data and get it structured and ready to use).
It’s nice that mental health is so inconsequential to you that you can balance it against privacy purity politics. It’s really cool for you that you’re in this position of privilege. It’s not cool to be pushing on someone with a clinical condition in a way that will probably get them worse off, in a country with absolutely no mental health safety net. Just like antivax it’s coated in fake concern, but you’re playing a dangerous game with someone else’s life and you’re cool with it because you’re insulated from the consequences.
You guys really are a pure product of those amoral hyper-individualistic times.
It’s nice that mental health is so inconsequential to you that you can balance it against privacy purity politics.
oh now I’m a privacy purist! oh god what have I become! I want totally unreasonable things!!
or, it seems you by default don’t care about privacy at all because surely who needs it, and also already forgot the case of woman in USA using online period tracker apps that outed them for having an illegal abortion.
Just like antivax it’s coated in fake concern,
fake concern, sure… my concerns are very real, and OP has come for advice, asking among others what could be the consequences. well, this is one of the consequences there will be.
You guys really are a pure product of those amoral hyper-individualistic times.
yes, blame me, not the system that made this situation. don’t you want to call the cops on me?
i would probably report him, and leave him a bad yelp review, warning others.
you do know at some point the whole ‘hallucinations’ line is going to be as fresh as calling things ‘woke’, right?
the ‘does this thing have ai in it’ is already a fucking blur as businesses link to each other via private and public APIs… healthcare is no different.
these things are already in place in many places. if youre a part of any nation wide health services, youre already impacted.
its like the fact that a huge % of our GDP is tied to like 10 companies… you cannot live your life in the modern united states without suffering products or services from those 10 companies, full stop. your life with ai will look the same.
can you work hard avoid shit and cry about it? yep. yep you can… but thats about it.
you cannot live your life in the modern united states without suffering products or services from those 10 companies
Well, its good that I don’t live there.
lucky bastard
lets hope the humans in your area are less greedy than those here, else its only a matter of time
you do know at some point the whole ‘hallucinations’ line is going to be as fresh as calling things ‘woke’, right?
The truth doesn’t care whether it’s “fresh” or not.
As long as AI still hallucinates, it will be useful for entertainment purposes only and never for anything as serious as healthcare.
haha, k. its clear you dont, but thats ok.
Dude must be some MBA crypto bro AI slop jock. His grammar isn’t good enough to be one of those idiot CEOs who just learned what artificial intelligence is. Maybe he’s a shareholder for one of those soul-less companies. Probably not that either though. Perhaps he’s just a terrible artist or programmer who uses AI slop for all of his works of shart. The possibilities really are endless these days.
im an ex corp drone whose value was replacing humans with automation.
it sucks, its already exists, it will happen more. llms are already in these pipelines and theres nothing any of us can do to avoid it.
im not saying its good. im not saying it should be. im saying, it exists right now cuz ive been a part of it.
“let yourself be exploited! do not resist!”
…your value is replacing humans with machines?
Explain to me the value of that.
maybe youre new here but big business likes it when they save money. value.
I exited purposefully
Oh okay, so your only value is the pursuit of material bullshit and not the well being of human beings. Good luck getting AI to pay for your shitty wares when nobody makes money to afford them. 🤭
I have no idea what it’s like to be you, and I’m glad I don’t. Enjoy your cold empty heart! 🙂
It’s almost like the very businesses that creamed their pants about being able to replace workers and endless “blue ocean” profits exaggerated, lied, and forced AI into every. single. product. That’s not consumers’ faults…
i cant understand why people are oblivious to the multi-faced war-front that is AI.
theres the shit you hear about and see every day (oh look copilot shit the bed! claude cant add! teehehee look at all the extra fingers!) and then theres the shit that is actually being implemented in process models all over the place in nearly every department. from inventory to healthcare analysis to customer service, this shit is in daily use now … and you cannot avoid it.
ai is just an api call away and software companies suck.
Ummm, hallucinations are literally how LLMs work. Everything they generate is confabulation, though sometimes it’s useful confabulation.
I think we should stop using their terms.
Llms spout BULLSHIT half the time. They don’t hallucinate. They confidently state incorrect garbage.
Given how captured our data is by the lack of regulation even in the medical space in the US. I simply do not want my personal data to be used in anything but in house signal to noise improvement for diagnosis.
Anything else, which is most of it, is unacceptable and I do not consent.
You’re probably not suffering mental health crises desperate for bare minimum psychiatric care. It is an absolute jungle here and it can literally take years to find the right person and they are almost never on insurance.
Privacy and your rights to it and your own autonomy/med care are important.
However, some may have to weigh the safety of themselves and those around them to determine whether they should be standing on principle and refusing care.
You do not know me nor my medical needs. Don’t be so presumptuous. Even (and especially!) folks with acute medical needs deserve privacy. Urgency often presents as a moment where people can be taken advantage of.
I would be out of that office faster than the speed of light.
nope
For note taking only, id be fine IF it was all run locally with no ability to be trained on.
Id want assurances from the Dr that they also carefully review the notes immediately after or that I get to see the notes before leaving due to the risk of hallucinations that could cause future care problems.
They could have it visible on a screen while youre in the room with you to help you be sure its accurate.
Edit: id care less about it being local if it wasn’t medical/legal in nature.
You’re asking a forum that’s in a strongly anti-AI bubble, so the answer you’re going to get is both obvious and useless. You might as well be asking a bunch of Vegans whether you should have steak for dinner. You admit yourself to having a strong knee-jerk reaction.
However, it looks to me like their use of AI is a perfectly reasonable one. It’s just making transcripts and summaries of sessions. I do that all the time with personal logs and meetings, I’ve got a couple of local models that run entirely on my computer. So I don’t see the big deal here.
If you feel you really need this medical help then maybe don’t rely on the advice of a bunch of people you know are going to instantly react negatively to AI regardless of any other details.
Sounds reasonable, until the transcripts end up totally incorrect because the AI misinterpreted something or hallucinated.
As I said, this is something I do all the time myself. Even with just my piddling little graphics card it works fine, the technology is quite good these days. I’m sure a professional setup being used by a doctor would be a much higher standard than that.
I get the impression no level of quality and no kind of human involvement with the results will likely satisfy you, though. Which means your negative view of AI is not particularly useful here.
It is useful because it’s a protection against AI messing with our futures.
To illustrate the point re: transcriptions:
https://pubmed.ncbi.nlm.nih.gov/40326654/
The Unexpected Harms of Artificial Intelligence in Healthcare: Reflections on Four Real-World Cases
Kerstin Denecke et al. Stud Health Technol Inform. 2025.
Results: The incidents discussed include: Whisper’s harmful hallucinations; UNOS’s algorithm delaying transplants for black patients; the WHO’s S.A.R.A.H. chatbot providing inaccurate health information; and Character AI’s chatbot promoting disordered eating among teens.
That article is from May 2025, almost a full year ago. In AI terms that’s the stone age.
One of the major problems of getting information about AI inside an anti-AI bubble is that nobody here is actually using it, so they don’t know what its actual quality and capabilities are like now. As I said, I actually set up a system like this for myself on my own personal computer and I keep it updated as new models come out, so I’ve seen what the state of the art (or near-state-of-the-art at any rate) is actually like.
Nothing is perfect, of course. But perfection is not the standard this system is to be compared against. The alternative is the doctor’s handwritten notes and personal memories. Those are almost certainly not as good.
Agree to disagree. I trust the research more than anecdotes.
However, it looks to me like their use of AI is a perfectly reasonable one. It’s just making transcripts and summaries of sessions.
its “just” uploading all your therapy session to faceless companies that are impossible to be sued when (not if) it turns out they used your sensitive information for their own gains. yeah, it’s not a big deal! It’s perfectly reasonable. are you OP sick that you may care about your privacy? its not a normal concern nowadays!
From OP’s post:
Stringent business associate agreements ensure data privacy and HIPAA compliance.
Sure, they could break HIPAA. They could do that with any records, not just transcripts or summaries of sessions. If this is a showstopper for you then no medical practitioners will meet your standards, you’re basically advocating crawling away into a hole to die alone whenever you get sick.
i wonder if they hallucinate notes post-appointment, i notice that there have been complaints against certain providers that the “doctors” did other examinations that they dint do in-person and it appeared on their records.
Nope nope nope
I’m a therapist and I use SimplePractice for my practice. They recently added an AI note taker that is HIPAA compliant, and the consent form they suggest giving to clients sounds okay, but I read the actual privacy policy and the language used is way too vague for me to trust, so I don’t use it.
In your position, I would:
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Ask if you have to sign that, or if you can opt out. Your specific provider may be open to just not enabling the AI note taker for your profile, and they may be able to remove that form from the app for you on their end. This may not be in their control, but if they’re a good person who cares about you, they’ll make an effort to get it done anyway.
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If not, ask for a link to the actual privacy policy and see if it sounds acceptable to you. Not the practice’s Privacy Practices, not the Patient Portal privacy policy, but the actual privacy policy for the AI note taker (whoever you ask might have to do some digging to actually find it)
I can share my experience here.
I initially opted-out. I did not want a LLM in charge of summarizing something as important as a medication consultation. I’ve seen the kinds of errors it makes, the way parts of its training data make their way into your file without you having any knowledge or agency.
My provider then came back to me and said it was an error that the original form said you could opt out. Everyone had to sign it, it was HIPAA, it was nothing to worry about, etc.,
I tried explaining my reasons, but they didn’t care. I said that if they couldn’t budge, I would have to change providers. They gave me 90 days of my prescription. My primary care physician agreed to continue my prescription as long as I needed them to. And not long after, I was able to find another psychiatric provider who did not require an AI release.
Also, my primary care doctor asks if I will allow AI transcription every office visit. I feel bad that by saying no, she has to do more work typing. But I feel that the harms are too great, the risks are too much to say yes. While I have the choice, I want humans to be end-to-end responsible for what words are in my medical file, and not by pressing “yes” to agree with llm output.
Good for you, that’s awesome dude!
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I would only be ok with an AI note taking app if the model is running on hardware the doctor physically has in their office because otherwise any privacy assurances don’t mean that much.
It takes more time to make sure the summary isn’t a hallucination than it takes to just write notes.
Every waiter can do it live without AI for 10 drunk idiots at the same time. Every doctor I’ve ever known just takes notes as we went without ever slowing the interaction down.
This tool cannot help and can only harm, using AI in medicine practically violates the Hippocratic oath doctors take.
Maybe there’s an argument to be made there, but to me the privacy issues with all of the source material being sent to the servers of some AI company, and that company having the ability to put their thumb on the output in addition to the risk of the data being misused or leaked, are so much more of a thing to worry about. Those issues exist independently of how doctors use these tools and what risks those particular uses may have, which honestly I know nothing about, definitely not enough to argue that it is ok, it just isn’t something I would personally stress over as much as the other stuff.
My medical provider started doing that when I last had a video conference with them, and I declined to allow the use of AI. They took no issue with that – didn’t even bring it up. It’s very unlikely that your provider will care that you declined either. I recommend saving your energy for other problems and dealing with this later in the unlikely event that they do actually make an issue of it.
out of curiosity, what platform do they use for the video conference?
Last time I talked to them, they used Zoom.
No. Absolutely not. I csnnot trust any current AI model with HIPPA compliance.
Find another doctor. I just had to fire my therapist because when I went in for this week’s appointment they were playing some jesus worship service and song. I told her that it was our last session because I no longer had trust in their offices and added that I had no faith any progress would ever be made after I was triggered waiting to see my therapist. It could have been the receptionists choice in music or someone else from their office but since they do not advertise as a faith based therapy group they should have left that shit at home or should expect more of the same from people like me.
It’s worth researching a therapist’s credentials, some states allow “pastoral counseling degrees” and so on to be a path to “mental health therapist.” You want LISW, a licensed social worker. I’m not saying there aren’t weirdos, or that your experience wouldn’t happen with a social worker… just that many folks don’t realize some therapists went to theology classes instead of psychology classes, which is a prime setup for problems.
I didn’t know about the theology to therapist route. My therapist herself never indicated their faith leanings, so credit due to them there. They have a Masters and are a LPC. As I mentioned before, it’s entirely possible she had nothing to do with nor endorses the music choice in the building, but tacit endorsement by not stopping it from happening is enough for me to leave.
Maybe, just maybe, let’s not play music from the loudest hate group in the USA in the lobby of the therapist office.
probably better to look for a licensed psychologist/psychiatrist, or someone with a PsyD. dont really want to risk when someone isnt in the field.
