Ambient Scribe or Dictation: Which Mode, When
When to let an ambient AI scribe record the visit and when to dictate the note yourself, visit by visit. Both modes are on every VoiceboxMD plan, from $49/mo.
The Short Answer
Use the ambient AI scribe when the note comes out of a conversation: a new patient, a long history, a visit with several problems. The scribe records the visit and drafts a structured note for you to review.
Use live dictation when you already know what the note says: a procedure note, a short follow-up, a letter, or one field in the chart. You speak, and the words appear where your cursor is.
When you compare AI scribe software for physicians, check which of the two modes each product offers. You do not have to pick one with VoiceboxMD: it includes both modes on every plan, from $49 per month, in the Windows, Mac, iPhone, Android and web apps. For the product itself, see the VoiceboxMD AI medical scribe. For how the ambient category works across vendors, see ambient clinical documentation.
Ambient vs Dictation, Side by Side
| Question | Ambient AI scribe | Live dictation |
|---|---|---|
| Who talks | You and the patient, as you normally would | You, to the computer or phone |
| When | During the visit | During or after the visit |
| What you get | A structured note (SOAP, H&P or your own template) | Your words, as text, where you put the cursor |
| What you do next | Read, edit, then place or copy the note | Keep dictating, or edit as you go |
| Languages | English | English (medically tuned) plus 7 more languages |
| Gets into the EHR (desktop) | Whole note, or one section at a time, into the field you are in | Typed at the cursor in any field |
| On VoiceboxMD | Every plan, from $49/mo | Every plan, from $49/mo |
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Try it freeWhen the Ambient AI Scribe Is the Better Mode
New patients and long histories
The history comes out in conversation, often out of order. The scribe hears all of it and drafts the HPI, exam, assessment and plan into your template, so you do not reconstruct the visit from memory at the end of the day.
Visits with several problems
When a patient brings three or four concerns, the note has to cover each one. Recording the whole visit means the draft starts from everything that was said, not from what you remember to dictate afterwards.
Visits where you want to face the patient
With ambient recording running, you do not type or narrate during the visit. You talk to the patient, then review the draft once they leave.
Notes that follow a fixed structure
The scribe writes into SOAP, H&P or a template you build, with your own sections and instructions. The same structure comes back every time, ready to read top to bottom.
When Live Dictation Is the Better Mode
Procedure notes and short follow-ups
If you could say the whole note in under a minute, dictating it is usually faster than recording a visit and reviewing a draft.
One field in the chart
Dictation types at the cursor. On the Windows and Mac apps it works in any text field: an EHR order comment, a message to a colleague, a single box in a template.
Letters, reads and anything you compose
Referral letters, imaging reads and addenda are written by you, not drawn from a conversation. Dictation keeps your exact wording.
Languages other than English
Live dictation on the desktop and web apps offers English, Spanish, French, German, Portuguese, Italian, Dutch and Hindi. Only English is tuned for medical terms. The ambient scribe works in English only.
When the patient does not want to be recorded
Dictation does not record the conversation, only what you say while you dictate, so it still works when a patient declines an ambient recording.
Turning Your Own Words Into a Structured Note
VoiceboxMD does not have a separate "post-visit dictation scribe" mode. If you prefer to speak a summary after the patient leaves and still get a structured note, these are the ways to do it today:
Record your summary in ambient mode
Start an ambient recording after the visit and speak your summary. The scribe treats it like any other recording (15 seconds minimum) and drafts the note into your template.
Use AI Format in the web app
Dictate or type into the web app's editor, then press AI Format. It rearranges the text into your chosen template's sections, and one undo puts your original text back.
Use macros and dictation templates
Macros and dictation templates insert blocks of text you have written in advance, such as a normal exam. Saying "insert", the template's name, then "template" works in the web and mobile apps.
How Each Mode Gets Into Your EHR
On the Windows and Mac apps, live dictation is pasted at your cursor in any EHR, including Epic, Cerner, athenahealth, eClinicalWorks and Practice Fusion. A finished ambient note can be placed whole with Cmd/Ctrl+Alt+0, or one section at a time with Cmd/Ctrl+Alt+1 to 9, into the field you are in. On a Mac, this needs the Accessibility permission turned on for VoiceboxMD.
In the web app and on iPhone and Android, you copy the note or share it. Those apps do not place text into another program. Your phone can also act as the microphone for the desktop app, so dictation spoken into the phone is typed at the desktop cursor. See EHR and EMR dictation for EHR-specific pages.
What Each Plan Includes
Both modes are on every plan. The higher plans add the paperwork around the visit, not access to the scribe.
| Plan | Price | Adds |
|---|---|---|
| Essential | $49/mo | Ambient AI scribe, live dictation into any EHR field (desktop), SOAP, H&P and custom templates, macros, dictation templates, custom vocabulary |
| Power | $79/mo | Everything in Essential, plus ICD-10 and CPT code suggestions, superbill (web), referral and prior-auth letters, after-visit summary, orders checklist, pre-recorded audio upload (web) |
| Premium | $99/mo | Everything in Power, plus a writing style learned from your own edits (after 10 notes, set up in the web app) |
Monthly plans start with a 7-day free trial and annual plans with 14 days, on the plan you choose. A card is collected at checkout and is not charged during the trial. A BAA is included on every plan. See pricing for details, or the AI scribe comparison for how other products price their scribes.
What Physicians Are Saying
“Voicebox MD has been a fantastic tool to improve my workflow. I’m seeing more patients than before, my charts are always completed by the end of clinic, and I get to spend time with my family in the evenings.”
“VoiceboxMD has improved my workflow tremendously. I find myself using it more and more, not just for lengthy consults, but for follow up appointment notes.”
Frequently Asked Questions About Ambient and Dictation Modes
What is the difference between an ambient AI scribe and dictation?
An ambient AI scribe records the conversation between you and the patient and drafts a structured clinical note from it. Dictation turns your own spoken words into text as you speak, with no rewriting. With ambient you review a draft; with dictation you compose the note yourself.
Which mode is faster?
It depends on the visit. For a long or conversational visit, reviewing an ambient draft is usually faster than dictating the whole note. For a short follow-up or a procedure note you could say in under a minute, dictation is usually faster.
Do I have to choose one mode when I sign up?
No. Both modes are included on every VoiceboxMD plan, from $49 per month, and you choose per visit.
Does VoiceboxMD have a solo or post-visit dictation scribe mode?
Not as a separate mode. You can record your own summary in ambient mode after the visit, or dictate into the web app and use AI Format to arrange the text into your template.
Does the ambient scribe label who is speaking?
No. The note is drafted from the visit transcript without speaker labels, so review the draft before you use it, as you would any AI draft.
Does ambient mode work for telehealth visits?
VoiceboxMD records from your microphone only. It does not capture call audio from Zoom, Teams or other video apps.
Can I use dictation in languages other than English?
Yes, for live dictation on the desktop and web apps: English, Spanish, French, German, Portuguese, Italian, Dutch and Hindi. Only English is tuned for medical vocabulary. The ambient scribe works in English only.
Which note formats does the ambient scribe produce?
SOAP and H&P are built in. You can also build your own templates (up to 50), with your own sections and instructions, which covers formats such as DAP or a procedure note.
How does the note get into my EHR?
On the Windows and Mac apps, live dictation is typed at the cursor, and a finished ambient note can be placed whole or one section at a time into the field you are in. In the web app and on iPhone and Android, you copy or share the note.
How long is audio kept?
Audio is deleted 7 days after it is recorded. Notes stay in your account.
Can I try both modes before paying?
Yes. Monthly plans start with a 7-day free trial and annual plans with 14 days, on the plan you choose. A card is collected at checkout and is not charged during the trial.
Try Both Modes on Your Own Visits
Record one visit with the ambient scribe and dictate the next. Both are on every plan, from $49 per month, with a BAA included.
Try it on your own charts
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