AI Medical Scribe for
Colorectal clinics move fast — cancer referrals, diverticulitis reviews, post-op checks — and every consult ends in a note carrying operative planning and consent detail. Medical Scribe drafts it from the consultation itself.
A real example of the documentation Medical Scribe generates for lower gastrointestinal surgeons — ready before your patient leaves the room.
64F referred with 3 months of altered bowel habit and intermittent rectal bleeding. Colonoscopy last week identified a sigmoid mass; no obstructive symptoms, no weight loss. Past history: hypertension on ramipril 5mg daily; no prior abdominal surgery. Ex-smoker, quit 10 years ago. No anticoagulants. NKDA.
Risks discussed with patient and husband: anastomotic leak, bleeding, infection, possibility of temporary defunctioning stoma, conversion to open surgery. Expected recovery and enhanced recovery pathway explained. Patient understands and wishes to proceed; formal consent to be completed at pre-admission.
Illustrative example. Every note is fully editable, and you control the format — SOAP, DAP, or your own custom template.
New referrals and post-op reviews are packed into the days between lists, and each one needs a note detailed enough to plan surgery from — usually written after hours.
Anastomotic leak, the possibility of a stoma, conversion to open — what you actually told the patient before a colectomy is the part of the chart that gets litigated.
Colonoscopy findings, biopsy histology, CT staging, CEA, and MDT outcomes all have to be woven accurately into the consult note before a plan can be made.
Real-time transcription that understands medical terminology and clinical context.
Recognizes terms, conditions, and procedures specific to your practice area.
Generate comprehensive clinical notes in minutes instead of hours.
Enterprise-grade encryption and security to protect sensitive data.
These aren't generic formats — they ship in the product today, structured around how you actually document.
Plus 280+ templates across every specialty — or build your own in minutes.
A colorectal practice cycles through new cancer referrals, benign disease reviews, and post-op checks — each with different documentation demands. Medical Scribe records the consultation, in clinic or by telehealth, and drafts the note that carries the case forward: history, workup, operative plan, and what the patient was told.
The built-in Lower Gastrointestinal Surgeon’s note template maps the conversation into Subjective (presenting complaint, surgical history, medications including anticoagulants, allergies), Objective (examination and investigation results with dates), and an issue-by-issue Assessment & Plan covering the planned procedure, pre-operative preparation, and post-operative care — plus consent and education notes.
If an anastomosis leaks or a stoma becomes permanent, the chart is read backwards to the consent conversation. Medical Scribe documents exactly what was discussed — the specific risks you named, the questions the patient asked — and never inserts findings or warnings that weren’t spoken.
Yes. The risks, alternatives, and stoma discussion you actually voiced are documented in the note's patient education and consent section — only what was said, never a boilerplate risk list you didn't cover. You review and sign before it stands.
The Lower Gastrointestinal Surgeon's note template files colonoscopy findings, biopsy results, imaging, and labs under Objective with dates as you state them, then structures each surgical issue into its own Assessment & Plan.
Yes. Record any spoken encounter — new consults, post-operative follow-ups, telehealth reviews — on iOS, Android, Web, Apple Watch, or Mac, and each becomes a structured draft note.
Medical Scribe is HIPAA compliant, encrypted in transit and at rest, and generates editable notes you approve before anything enters the chart. It is free to get started.
Join thousands of healthcare professionals who save hours every day with Medical Scribe.