Dictation vs Ambient Recording: Which AI Scribe Workflow Is Right for Your GP Clinic?

Understanding the Two Workflows

Post-Consultation Dictation

With dictation, you see the patient, conduct your consultation without any recording, and then dictate a summary after the patient leaves. A typical dictation takes 60 to 90 seconds for a straightforward presentation and 2 to 3 minutes for a complex case.

The dictation captures your clinical reasoning in your own structured way. You might say: 'Forty-two-year-old male presenting with three-week history of progressive right shoulder pain, no trauma, worse with overhead activities. Examination reveals painful arc 70 to 120 degrees, positive Neer and Hawkins tests, strength preserved. Impression is likely supraspinatus tendinopathy. Plan is conservative management with physio referral, ibuprofen 400 three times daily with food for two weeks, review in four weeks, consider ultrasound if not improving.'

The AI scribe converts this into a formatted SOAP note or structured clinical record within seconds.

Ambient Recording

With ambient recording, you start the recording before or when the patient enters, and the AI captures the entire consultation. The system transcribes the conversation and generates a clinical note that synthesises the dialogue into structured documentation.

You consult as you normally would, speaking to your patient rather than dictating to a device. The AI extracts the conversation content and structures it into your selected note template format.

A Real Day: 10-Minute Standard Appointments

Consider a typical morning session with 10-minute appointments and a target of 20 patients before lunch.

Dictation Workflow

With dictation, your 10-minute slot is entirely for the patient. After they leave, you have a natural gap while the next patient walks from the waiting room to your consulting room — typically 30 to 60 seconds. You use this transition to dictate.

• Simple acute presentation (URTI, UTI, skin check): 45 to 60 seconds of dictation
• Medication review or repeat scripts: 30 to 45 seconds
• Moderate complexity (new hypertension, diabetes review): 90 seconds to 2 minutes
• Complex presentation (multimorbidity, mental health): 2 to 3 minutes

For a morning of 20 patients with a typical case mix (60 percent simple, 30 percent moderate, 10 percent complex), the total dictation time is approximately 25 minutes. That time is spread across the session and mostly fits within transition gaps.

Ambient Recording Workflow

With ambient recording, you start recording at the beginning of each consult and stop at the end. There is no additional dictation time required. The AI processes the consultation audio and generates the note automatically.

However, there is a critical review step. Because the AI is interpreting a two-way conversation rather than a structured dictation, the generated note requires more careful review. You need to check that the AI correctly identified the presenting complaint, examination findings, assessment, and plan. It may also include extraneous conversational content or miss something you said to the patient in passing.

Review time per note is typically 30 seconds for simple cases and 1 to 2 minutes for complex cases.

For the same 20-patient morning, total review time is approximately 15 to 20 minutes. However, this review often happens at the end of the session or during a break, creating a batch of notes to process rather than completing each note in real time.

When Ambient Recording Excels

Ambient recording is particularly well suited to longer, more conversational consultations where the clinical content emerges organically from dialogue.

Chronic Disease Management Reviews

A 20-minute CDM review involves extensive history-taking across multiple body systems, medication reconciliation, lifestyle discussions, and care plan updates. Dictating all of this after the consult would take 3 to 4 minutes and requires you to remember every detail. Ambient recording captures it all as it happens.

Mental Health Treatment Plans (MBS Items 2715/2717)

Mental health consultations are inherently conversational. The patient describes their symptoms, you explore severity and duration, you discuss treatment options. An ambient recording captures the richness of this exchange, which is particularly valuable for demonstrating the clinical rationale behind your treatment plan — important for Medicare compliance.

Health Assessments

The 45 to 75+ health assessment involves systematic questioning across multiple domains. Ambient recording captures each domain as you work through it, producing comprehensive documentation without requiring a lengthy dictation afterward.

New Complex Patients

When a new patient presents with a complex history involving multiple specialists, medications, and comorbidities, the consultation often involves extensive information gathering. Trying to dictate a complete summary afterward is both time-consuming and error-prone. Ambient recording preserves the detail.

When Dictation Is Superior

Dictation is faster, more controlled, and often more accurate for shorter, more structured consultations.

Quick Acute Presentations

A patient presents with a sore throat. You examine them, diagnose viral pharyngitis, advise symptomatic management. The entire consultation takes 5 minutes and the clinical content is straightforward. A 30-second dictation produces a perfect note. Running ambient recording for this adds unnecessary processing overhead.

Skin Checks and Procedures

Procedural consultations involve a lot of physical activity and minimal conversation. The clinically relevant content — lesion description, location, procedure performed, specimen sent — is best captured through a structured dictation. Ambient recording of a skin check would capture a lot of 'look up at the ceiling for me' and 'you will feel a small sting' without adding clinical value.

Medication Reviews and Repeat Prescriptions

These are often brief, focused encounters. The clinical decision is usually straightforward: continue current medication, adjust dose, or switch. A 30-second dictation captures the decision and rationale efficiently.

Telehealth Consultations

Telehealth introduces an additional consideration. Ambient recording of a telehealth call requires capturing both sides of a phone or video conversation, which raises consent and technical complications. Dictation after a telehealth consult is simpler and avoids these issues entirely.

Time-Per-Patient Calculations

Here is a comparison at different patient volumes, assuming a typical Australian general practice case mix.

30 Patients Per Day (Standard Full-Time)

50 Patients Per Day (High-Volume Clinic)

At high volumes, ambient recording has a clear time advantage because it eliminates the dictation step entirely. However, the batched review creates a backlog that must be cleared before end of day.

The Hybrid Approach

Many GPs who use platforms like Grounded Scribe find that the best workflow is hybrid: use dictation for quick, straightforward consultations and ambient recording for longer, complex ones.

A practical rule of thumb:

• Appointment under 10 minutes or straightforward presentation: Dictation
• Appointment 20 minutes or longer, complex, or highly conversational: Ambient recording
• Mental health, CDM, health assessments: Ambient recording
• Procedures, skin checks, telehealth: Dictation

This hybrid approach lets you match the workflow to the consultation rather than forcing every encounter into the same mould.

Decision Framework

Ask yourself these questions to determine your primary workflow:

1. What is your average consultation length?

If most of your consults are under 10 minutes, dictation is likely more efficient. If you regularly run 15 to 20-minute appointments, ambient recording becomes more attractive.

2. How conversational are your consultations?

If you take detailed histories through dialogue, ambient recording captures nuance that is hard to reproduce in dictation. If your consultations are more structured and examination-focused, dictation is cleaner.

3. When do you prefer to complete notes?

If you want each note finished before the next patient, dictation (done in real time) is better. If you are comfortable reviewing a batch of notes at lunchtime or end of day, ambient recording works well.

4. What is your patient volume?

At 40 or more patients per day, the cumulative time saving of ambient recording (no dictation step) becomes significant. At 20 to 30 patients per day, the difference is modest.

5. Do you see many complex or mental health patients?

Higher complexity favours ambient recording. A practice focused on acute presentations and skin clinics favours dictation.

Privacy and Consent Considerations

Regardless of which workflow you choose, Australian Privacy Principles require that patients are informed about how their information is collected and used. For ambient recording, this means informing the patient that the consultation is being recorded for clinical documentation purposes. Most practices handle this through a notice in the waiting room and verbal confirmation at the start of the recording.

Dictation does not involve recording the patient directly — you are dictating your own clinical summary after the consultation — so the consent requirements are different and generally less onerous.

Grounded Scribe deletes all audio files immediately after transcription, meaning no permanent audio archive exists regardless of which workflow you use. This is an important privacy safeguard for both approaches.

Getting Started

The best approach is to try both workflows over a week and see which feels natural. Most GPs settle into a hybrid pattern within a few days. The goal is not to find the theoretically optimal workflow but to find the one that fits your consulting style and makes documentation feel like less of a burden.

Visit Grounded Scribe for GPs for more information about how the platform supports both dictation and ambient recording workflows in Australian general practice.

Disclaimer

*Grounded Scribe is a documentation tool that assists practitioners in structuring their clinical notes. All AI-generated content must be reviewed, edited, and approved by the practitioner before it becomes part of the clinical record. The practitioner retains full professional responsibility for the accuracy, completeness, and clinical appropriateness of all documentation.*

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