PRACTICE OPERATIONS
How One Startup Is Standing Out in the Crowded AI Scribe Market
Abstract: Tom Kelly, CEO of Australia-based Heidi Health, a tech company startup specializing in AI scribe services, says that the only way to achieve large-scale clinical adoption of AI scribe tools is to design products that serve doctors in a way that feels natural and personalized. Large health systems, with deep capital resources, often jump at “first-generation” tech products and base their selections on ease of integration rather than on usability and clinical relevance.
That need to focus on usability and the likelihood of clinician adoption is more critical than ever when it comes to comparing and evaluating AI scribes in this increasingly competitive space. Kelly describes the unique challenge this way: “[AI scribe tools are trying to] replace what the doctor is doing in their head.” When you attempt to write the note that they were going to type or dictate, you have to “get inside the mind of the doctor and think like them.” If you fail at that, the doctor will abandon the system eventually.
Transcribed notes that are too diluted — too generic — hide the clinician’s distinct voice. There is more artistic creativity involved in clinical notes than we realize. As AI develops, the finer nuances of communication must become more apparent. These subtleties contribute to a more natural “feel” for clinicians — and that encourages them to embrace the technology.
Kelly differentiates Heidi Health by encouraging health systems to look at adoption rates more realistically. He points out that when a tech developer executive tells a demo audience that their company is generating notes for 500,000 sessions across 600 sites per week, the simple math reveals that it translates to about one session per week per provider. Heidi Health sets its benchmark at 25 sessions. At the level, he says, you have identified “a real user of the product.” In pursuit of that higher goal, the company offers a “free tier” that allows individual physicians to test out the tool on their own.
Expert Commentary: Have you ever wondered why it took 30 years for EHR to become the new standard for medical records? The mid-sized medical group I was serving in the early 1990s deployed an optional module as part of our practice-management/billing system. Essentially, it was nothing more than a LAN-distributed word processor. The doctors continued to dictate notes in handheld micro-cassette recorders, and our transcriptionists had to switch from WordPerfect to the new system. The “new” system was truly old-school — the typists stared at classic green monochrome monitors. Command keys were unlike any software they knew, and features like “auto-text” and “templates” were just cumbersome macros.
But beyond the lack of user-friendliness, the real problem lay with the fact that nothing changed. Doctors still dictated, transcriptionists still typed and printed the notes, and the notes were eventually printed and inserted into the thousands of manila file folders in the record room. It would be years before EHR integrated seamlessly into practice-management systems. That particular software company joined the dinosaur boneyard with dozens of other behemoth legacy systems that never understood the disconnect between developers and physicians.
Doctors are not anti-technology. They think of themselves as progressive, practical scientists. But software developers tend to design systems that “work” — but they fail to understand how the users of those systems work.
The idea of deploying an automated, AI-driven medical scribe gets passive resistance and actual pushback from a lot of clinicians. It is no wonder. But the leadership at Heidi Health are onto something with its strategy to allow providers to test-drive Heidi at no cost. I don’t have an opinion about Heidi’s performance, but it seems like a “no-brainer” for medical practices to give serious consideration to developing a pilot program that takes advantage of the free-tier offering.
Source: How One Startup Is Standing Out in the Crowded AI Scribe Market, Katie Adams, MedCity News, May 19, 2025; https://medcitynews.com/2025/05/healthcare-ai-clinical-documentation/
When Yelp Becomes a Source of Anxiety
Abstract: This short article, penned by critical-care pediatrician David Epstein, MD, opens this way: “Feedback is like fire — it can warm or burn, depending on how it’s delivered.” Nobody is going to respond well to feedback that sounds like a typical Yelp review.
Founded a little more than 20 years ago, Yelp has become a household term. Yelp reviews exert an incredible influence on consumer choices — from restaurants and hotels to physicians and hospitals. Shoppers pause to read five-star reviews, but scroll quickly past businesses with averages less than four stars. The format used by Yelp is designed for short and direct comments, positive or negative.
The author recounts the anxiety and frustration he and his wife experienced as they read Yelp reviews about a small business they owned. They took the reviews seriously, because they went out of their way to provide the best care and customer service possible. But when something went wrong, and a bad review ensued, it felt more like a personal attack rather than constructive feedback.
Epstein vowed, based on his own experience with Yelp reviews, not to ever give that kind of impersonal feedback. Instead, he calls for it to be very candid, personable, and sensitive — relayed with kindness — because there is a real human being on the other end receiving it. Perhaps Yelp-style reviews are appropriate for online comments, but they have no place in face-to-face conversations. He calls for us all to abandon the role of “anonymous critic” and to become “thoughtful humans invested in each other’s growth.”
Expert Commentary: A physician at the last group for whom I worked had a coffee mug bearing the words, “Be nice. Jesus said so.” She could get away with using a mug like that around the office because she was easily one of the nicest people I have ever known. She had strong opinions. She never backed away from challenging discussions or debates with her fellow board-members. She was strong and decisive in her clinical decisions and treatment. But she was nice!
Being nice seems like the exception — not the rule — these days. Common courtesy seems not to be so common anymore, and it is even worse when dissatisfied patients, clients, and customers can use multiple web platforms to anonymously snipe at any business with which they are disappointed. Add to this the generally accepted rule of thumb that says an unhappy customer is about three times more likely to write a review than a happy one.
About 20 years ago, a lot of online advice could be found for doctors who wanted to know how to deal with scathing reviews and accompanying fallout. As we got used to the harsh comments from armchair critics, the panicky resentment subsided to some extent. But we still need to have a strategy for maintaining a decent online reputation. There is more to managing criticism than growing a thicker skin.
In the meantime, we can all choose to be part of the problem or part of the solution. Following Epstein’s example described in this article is a good start. Recognize the human being on the other end of the critique and deliver your constructive criticism the same way you would face-to-face.
Source: When Yelp Becomes a Source of Anxiety, David Epstein, MD, MS, FAAP, SoMeDocs, May 12, 2025; https://doctorsonsocialmedia.com/when-yelp-becomes-a-source-of-anxiety/
FINANCE
Hospital Merger and Acquisition Deals Dip Amid Economic Uncertainty
Abstract: A large healthcare merger and acquisition consulting firm, Kaufman Hall, released its first quarterly report for 2025. That report concludes that economic uncertainty and market volatility surrounding potential seismic policy shifts accompanying the new administration and Congress has produced a “chill on healthcare decision-making.” The five transactions announced in the first quarter represent the lowest quarterly total since the pandemic.
None of the announced deals would qualify as “mega-mergers,” and only one acquisition involved a for-profit acquirer.
The financial performance of hospitals remained stable in the quarter. Month-to-month fluctuations in operating margin or EBITDA (earnings before interest, taxes, depreciation, and amortization) aside, year-over-year performance was up modestly. Hospital volumes remained strong, but information from Moody’s, S&P, and Fitch indicate that more nonprofit hospitals experienced credit downgrades (compared to upgrades) in 2024. Many of those downgrades were because of outsized increases in debt-to-fund growth strategies.
Expert Commentary: A consulting firm specializing in healthcare M&A deals will logically be more sensitive to trends in the number and value of such deals. As Kaufman Hall looks at the first quarter of this year, it sees a decline in consolidation deals (and, I would assume, engagements) despite the generally stable financial performance among hospitals. Looking for reasons behind the somewhat disappointing numbers, the company concludes that economic turmoil (not uncommon in the first months of a new government) and scary topics like “tariffs” are the likely culprits.
There is likely some truth in that. Mergers and acquisitions carry a good amount of risk — often inflated in the minds of the parties at the table — so anything that increases unpredictability will easily trigger a “wait-and-see” approach for entities considering consolidation. If the consultants’ conclusions are accurate, that also means the dip in new deals is transient, too. It is probably a dip in the road — not a drive off the cliff.
Source: Hospital Merger and Acquisition Deals Dip Amid Economic Uncertainty, Jeff Lagasse, Healthcare Finance News, April 9, 2025; https://www.healthcarefinancenews.com/news/hospital-mergers-and-acquisitions-deals-dip-amid-economic-uncertainty
Survey Insights: What To Know About the Clinician Workforce Today
Abstract: The Advisory Board, a respected research group that has served the healthcare industry for over forty years, reports on its survey of over 700 physicians and advanced practice providers conducted this past February. In an effort to help organizations in their recruitment and retention strategies, Advisory Board sought to understand clinicians and their current job priorities and perceptions, and why they choose certain employers over others.
The survey consisted of three questions:
1. What is the current state of clinician satisfaction and intent to leave? The survey found that satisfaction does not guarantee retention. While three-quarters of respondents said they are satisfied, some 28% of the satisfied respondents plan to leave. Surprisingly, that attitude transcends age groups — it is not just the younger workers.
2. What do clinicians value, and how can employers better compete for talent? Physicians consistently ranked their value priorities as follows:
Compensation
Geographic location
Schedule flexibility
Work-life balance
Non-compensation benefits
Interestingly, non-physician clinicians did not rank geography as high. Both schedule flexibility and work-life balance were valued more highly.
3. How do clinicians perceive different employers and their ability to meet clinician preferences? Responses did not produce a clear “winner” as to the best employer type. They did indicate a belief that corporate employers offered better compensation and work-life balance, but that independent employers did a better job at cultivating clinician loyalty as well as positive work environments.
Expert Commentary: In many ways, job-related elements most valued by medical professionals align pretty closely with what we have seen for years. But there are a few notable exceptions or new developments. For example, the fact that non-physician providers assigned higher value to work-life balance and scheduling flexibility probably reflects the difference between the autonomy associated with doctors and the usual mindset of a non-physician who, by definition, is part of a team under some sort of supervision. That difference may be behind the somewhat paradoxical finding that about 28% of physicians claiming satisfaction with their current positions expressed their intent to leave those positions.
There is greater volatility and higher turnover among physicians today than a couple of decades ago. Perhaps this phenomenon is an echo of the major shift away from practice ownership to physician-employee status. Today, only about 25% of working doctors own their own practices, while in the 1980s, only about 25% were employed by hospitals or health systems. That is a 180º shift in less than 40 years. Building a business with your own two hands in your own community creates a deep investment — roots that are hard to abandon.
Source: Survey Insights: What To Know About the Clinician Workforce Today, Mahaya Walker and Eliza Dailey, Advisory Board, May 13, 2025; https://www.advisory.com/sponsored/survey-insights-clinician-workforce