I used to spend half a day to a full day every week finishing my charts.
I’m not a great typer, and I don’t automatically organize my thoughts in the moment. So I’d have to go back after each patient visit and remind myself what happened, piece together disorganized notes, cement the details into my brain. On one hand, I was remembering more about my patients. On the other hand, they were taking up enormous mental real estate, and I still had cognitive overload. I’d forget to do things I promised. Look things up, follow up on something, or send a referral. I’d say I’d do it and then it would slip through the cracks because there was no fallback to remind me.
I almost quit practicing at several points. Partially because the math wasn’t working, but also because the minutiae of running a practice was slowly wearing me down.
Then AI got good enough to actually help.
What AI Actually Gave Me
I’ve been using AI charting for three or four years now, way before a lot of people. It started as just a backup to capture the substance of visits. But recently it’s become more like a clinical assistant. It suggests ICD-10 codes, isolates the tasks I say I’ll do, writes referral letters. The versatility matters because these seem like little tasks, but they add up to death by a thousand cuts in a clinical day.
Even for me, seeing just five patients a day (I’m on the lower volume side) if there are five tasks from each visit, that’s 25 tasks accumulated by the end of the day. That’s a lot. And though I’m not necessarily doing them all myself, I need to make sure information gets where it needs to go so things happen in a way that supports the patient.
The state I was in before: at least a day a week on charts, or leaving them open for weeks with mounting anxiety and guilt. A lot of mental drag. Now, because these tools have gotten so much better, I actually feel supported by them. That’s new.
Other things that have helped: I set up an AI lab interpretation assistant over the summer, kind of on a lark because I was curious about AI and automation. I run it for every patient within a HIPAA-compliant system. It gives me a head start on what the labs mean without using the cognitive bandwidth of interpreting the same patterns over and over again. It helps me start ten steps ahead and ask deeper questions. Think more broadly about what might be going on for a specific patient.
And then there’s communication. Using AI as a communication assistant to help me provide measured responses to difficult patient questions or triggering scenarios. Everyone in the healing professions has some wounding that either landed them in the seat they’re in and often shows up in relationship with patients. AI helps me identify when people are asking questions with a level of complexity I’m not comfortable answering over messaging. Before, when I was tired, I’d violate my own boundaries; over-give in an email and resent it later. Now I can identify my highest standards and maintain them whether or not I’m tired or overwhelmed. It doesn’t save time exactly, but it conserves emotional bandwidth so I don’t reach the breaking point as often.
The result: with each load-lightening task, I have a little more bandwidth for other things. I recently took on a research project for my state’s legislative committee to modernize our state’s outdated medication formulary. I never would have had capacity for that two years ago. The tools didn’t exist in that way for one, and I didn’t have the mental space to even consider it.
AI has freed me up to think about bigger problems. And in turn, bigger solutions.
What It Can’t Do
But here’s what it can’t do.
I recently considered seeing patients one more day per week to pay off debt faster. AI could help me get the facts. What the earnings increase would be, what my schedule would look like, the financial projections. But it couldn’t help me decide how to feel about it. Even though the math made sense, my body was saying, don’t do this.
AI can help me get information together and look at it objectively. I could have made the spreadsheets myself, but AI helped me do it faster. But ultimately, it couldn’t tell me the embodied decision I needed to make.
It’s like when I used to ask my mom which outfit I should wear. I would almost always go with the one she didn’t pick. I didn’t need her judgment to follow—I needed input so I could feel my own judgment in response. AI can help me do that more quickly now. But it’s a little too close in the mirror to always be the most useful thing.
In the presence of another person who has your best interests in mind, who knows what you’re trying to do but isn’t enmeshed in your life—that external relational input is very valuable. It can leapfrog you from one way of thinking to another. Sometimes it’s instantaneous. Someone says something and it clicks in a way it never did before. They were able to do that because there was relaxed, focused attention, presence, and response in the moment.
AI can’t do that. It’s always trying to follow your thinking. You can ask it to challenge you, to roast you, to give you adversarial input. But that takes effort, and sometimes subconsciously you just don’t want that, so you don’t go there.
And then there’s this: everyone has their own energetic signature that’s completely irreplaceable.
AI excels at elevating our understanding of information. It’s transformative there. But elevating our understanding of relationship—the physical presence, how we interact with other people—that’s different. I don’t even know if I have all the words for it yet, but this is why I’m writing about it. I want to articulate what it is that we do so we can feel confident moving forward into this emerging landscape. So we can trust—self-trust—that what we’re offering to the world is needed and valuable and irreplaceable.
There’s an alchemy of exchange that happens when two people share ideas. It has a physical substance that transforms both people so they can bring something into the world they wouldn’t have individually. Whether that’s healing for one person, understanding, an actual physical project, a mindset shift—that doesn’t just happen with an app or a computer.
AI has a collective spirit—it’s the collective public knowledge of humanity, which is huge. But it doesn’t need our mutual care. It will evolve, and I guess it needs direction and stewardship, but it’s not the same as the dance of mutual support in a relationship. There’s a lack of aliveness to information that comes from an AI platform. You can express it, but it’s different than that relational thing that happens between humans.
Why This Matters Now
This question matters to me right now because whether we like it or not, things are changing.
We’ve inherited a legacy of scarcity, of staying small, of unnecessary infighting, of trying to prove our worth in ways that will never match up to what could be if we owned our worth internally. Going for credibility from external sources. Fighting for scraps.
What if we paused in this moment and asked: What are we actually doing here? How does this differentiate us from algorithmic medicine?
I think this is an opportunity to reevaluate where we’re at and where we’re going. To change the narrative, change the inheritance we’ve been given of struggle and shame and less-than. To really become leaders in the way we think about solving problems—both for individuals and as a collective.
Healthcare as a whole is broken right now. But there are seeds of what could be within integrative medicine. If we can really understand the type of work we’re doing, give ourselves space and financial stability and presence, I think it could have a lot of impact—not just on how we relate to each other in healthcare, but societally. How we think about problems holistically.
That’s a big goal. But I think that’s where we’re at.
And it takes curiosity, humility, and a willingness to explore.
The Polarity I’m Exploring
What I’m interested in is understanding the polarity between what AI can do for us and what it can’t—not in a limiting way, like “it’s not good at X, Y, Z,” but in a way that redefines the value of human relationships. Not just as information transmission, especially in the context of a care experience, but as something else entirely.
What can we do in our businesses and our lives to increase our capacity for real presence in that encounter?
Offloading administrative burden is one piece. Taking care of ourselves physically, emotionally, and financially is another. Cultivating our sources of insight and information is another.
AI can have a collective spirit, but it can’t have presence.
AI can have a spirit, a collective spirit, but it can’t have presence. It can’t really witness things. The pattern recognition, the deducing of information, the processing of knowledge, understanding what needs to happen when and how to predict behavior—excellent. But embodied presence? Not available.
And I think by understanding what embodied presence is, we can also understand what it isn’t. We don’t need to be worried. We don’t need to fear replacement. We can feel grounded and confident that there are aspects of what we do that AI can never replace. And we can let it come in where we’ve adopted patterns of administrative drudgery and lighten the load. So we have time and space to think about bigger problems. And in turn, bigger solutions.