Endocrinology runs on trends. An A1c means little as a single number and everything as a trajectory, and the same goes for a thyroid panel followed across months of titration. An ambient AI medical scribe drafts your diabetes and thyroid follow-up notes from what you say during the visit, then hands them back about two minutes after the patient leaves. One thing to know up front: the scribe has no memory of the last visit, so any trend you want in the note is a trend you speak out loud. You review the draft, fix anything off, and sign.
Key takeaways
- The scribe drafts endocrine follow-up notes plus ICD-10 suggestions about two minutes after the visit; you review and sign.
- It has no memory of prior visits, so A1c trends, TSH history, and dose changes over time must be spoken during the visit.
- It captures insulin titration and levothyroxine adjustments from your dictation. It does not interpret lab values.
- It runs alongside Epic, athenahealth, and any EHR. Copy or export. No integration.
- Audio is discarded the moment the note drafts. Nothing is recorded.
From end of visit to drafted note
Assist tier, per clinician, annual billing
Prior-visit data the scribe stores or recalls
Source: Patient Square product specifications, 2026.
How an ambient scribe fits an endocrine follow-up
A diabetes follow-up is mostly conversation and adjustment. You talk through the last few months of glucose logs, the fasting numbers, the hypoglycemic episodes if any. You look at the A1c. You change a dose. You order labs and set the next visit. Thyroid follow-ups run the same shape: symptoms, the panel, a titration, a recheck interval.
The scribe listens through all of it. When you say the A1c came down from 8.4 to 7.6 and the fasting sugars are running in the 130s, that goes in the note. When you say you are bumping the basal insulin from 20 to 24 units, that lands in the plan. Two minutes after the patient walks out, you have a draft that reflects the visit.
Because the scribe carries nothing between visits, the note is only as complete as your dictation. That is a feature more than a limitation. It means nothing gets pulled in from an old visit and asserted as current. If the A1c trend matters, you say it, and it is right because you said it.
The no-memory design, and why it changes how you narrate
This is the single most important thing to understand about scribing an endocrinology visit. The scribe does not know your patient. It did not see last quarter’s labs. It has no line into your EHR’s flowsheets.
For most specialties that barely matters. In endocrinology it changes your habits, because so much of the clinical story is longitudinal. The A1c at 7.6 is only meaningful next to the 8.4 three months ago. The suppressed TSH matters because the last one was normal and you just raised the dose. If you want that arc in the note, narrate it.
In practice this looks like a slightly fuller spoken summary during the visit. You are probably already saying most of it to the patient anyway. “Your A1c is down from 8.4 to 7.6, good progress, but we are not at goal yet, so I want to add a bit more basal insulin.” Say that and the trend, the interpretation, and the plan are all in the draft. Skip it and the scribe writes only the single number you mentioned.
Some clinicians find this discipline actually improves their notes, because it forces the reasoning into the record instead of leaving it in their head.
What an endocrinology scribe must capture
The vocabulary of an endocrine note is specific, and the scribe has to land it when you speak it.
| Note element | What you say out loud | What the scribe drafts |
|---|---|---|
| A1c trend | ”A1c down from 8.4 to 7.6 over three months” | The trend as narrated |
| Glucose pattern | ”Fasting sugars in the 130s, occasional lows overnight” | Home monitoring summary |
| Insulin titration | ”Raising basal glargine from 20 to 24 units” | Dose change in the plan |
| Thyroid panel | ”TSH suppressed at 0.1, free T4 upper normal” | Lab values as stated |
| Levothyroxine adjustment | ”Dropping levothyroxine from 125 to 100 micrograms” | Med change in the plan |
| Diabetic foot exam | ”Monofilament intact bilaterally, no ulcers, pulses present” | Foot exam findings |
| Retinopathy screening | ”Referring to ophthalmology for dilated eye exam, overdue” | Referral in the plan |
| Follow-up interval | ”Recheck A1c and TSH in three months” | Labs ordered and interval |
The foot exam and the retinopathy referral matter because they are easy to skip and easy for an auditor to notice missing. If you do the monofilament check and say so, it is in the note. If you decide the patient is due for a dilated eye exam and say you are referring, the referral is drafted.
Labs are captured, not interpreted
Worth being precise here. The scribe does not read the thyroid panel and tell you what it means. It writes down what you say about it. If you say the TSH is suppressed and that means the patient is slightly over-replaced, that reasoning is in the note because you spoke it. The scribe never decides on its own that a value is high, low, or clinically significant.
The same holds for the A1c. The scribe does not fetch the number or grade it. You state it, you interpret it, the scribe records both. The interpretation stays yours, which is exactly where clinical responsibility belongs.
This matters most when a lab result would change management. The decision to raise or lower a dose based on a value is a medical judgment. The scribe documents that you made it. It does not make it for you.
ICD-10 suggestions for the endocrine visit
After the visit the scribe offers ICD-10 suggestions from what you said. Common ones in this specialty:
| Condition | ICD-10 suggestion |
|---|---|
| Type 2 diabetes without complications | E11.9 |
| Hypothyroidism, unspecified | E03.9 |
| Type 2 diabetes with diabetic polyneuropathy | E11.42 |
| Hyperthyroidism, unspecified | E05.90 |
These are suggestions to speed your coding, not a final answer. You confirm the specificity, because a diabetes code with the right complication captured is what supports the visit level. Our explainer on how ICD-10 suggestions are generated goes into the mechanics.
Titration and the prescription draft
When your plan includes a medication change, the scribe drafts a prescription to match. If you raise the basal insulin or drop the levothyroxine, that draft reflects what you said. It is a draft only: the scribe does not screen it for interactions or dosing, so the safety review stays with you.
The draft never leaves the app. It is not e-prescribing, and it does not transmit to a pharmacy. You act on it in your own prescribing workflow. For endocrine patients with renal impairment, where metformin dosing and insulin sensitivity both shift, the renal call is exactly the kind of judgement you make when you read the draft and sign, not something to hand to a rule engine. We describe reviewing an AI-drafted prescription in our post on prescription draft safety.
When it fits your practice
If you run high-volume diabetes and thyroid clinics and your evenings disappear into charting, the trade is straightforward: narrate the trends you already discuss with the patient, and the note drafts itself for your review. If your visits are lighter or your notes are already fast, the gain is smaller.
Pricing starts from $79 per clinician per month on the annual Assist plan, and steps up to the Copilot and Autopilot tiers as you add a bundled AI EHR, messaging, and receptionist and follow-up automation. On Assist the scribe works alongside whatever EHR you already run, so there is no IT project and no go-live. See our comparison of AI medical scribes and our primary care scribe overview if you co-manage with primary care, and read how to evaluate an AI scribe before you commit to anyone.
Want to watch it draft a real diabetes follow-up? Book a demo. Pricing is on the pricing page, and the compliance details are on the security page.