AI adoption in medicine is accelerating: more than 12,000 primary care clinicians have enrolled in Canada Health Infoway’s national AI scribe program, about 5,000 Ontario physicians use AI scribes and roughly one in five Canadian physicians now use AI tools. Almost 60 per cent report a cut in administrative time.

AI scribes are tools that, with the patient’s consent, listen to a clinical visit and automatically draft the physician’s notes.

We’re writing as an emergency physician who has led digital transformation in emergency departments for six years and advises on AI readiness (Ali Abdalvand), and an organizational psychologist studying burnout and responsible AI adoption (Ehsan Etezad). Our observation is that AI keeps its narrow promise of saving time. But without proper frameworks, it quietly adds new burdens that absorb those savings. We believe the fix is organizational.

Burnout stems from mismatches in workload, control, reward, community, fairness and values; not from any single task such as paperwork. One study found electronic health record design and use accounted for just 6.8 per cent of the differences in burnout between clinicians. When work conditions such as a chaotic atmosphere and lack of control over workload were also considered, that number rose to 36.2 per cent.

In emergency medicine, physicians are interrupted 7.9 times an hour, and prescribing error rates nearly triple with interruptions. No scribe changes that.

How AI quietly adds to physicians’ work

I think we can all relate to the idea that when you complete one task efficiently and save some time, new demands fill the space, making it seem as though nothing was saved in the first place. But as AI introduces new ways of reducing the time physicians spend on documentation, it comes with novel ways of adding work, too.

The time dividend gets spent. Saved time rarely comes back to clinicians. In Canada’s national AI scribe program, half of clinicians put the time they saved into other administrative work, and one in five used it to add appointments. Studies from the United States show the same pattern: AI scribe adopters across five health systems saved 13.4 minutes of daily EHR time and delivered 0.49 more visits per week.

The time dividend gets spent. Saved time rarely comes back to clinicians. In Canada’s national AI scribe program, half........

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