Summary
Federal US law is one-party consent, so a recording is lawful if one person in the conversation agrees. That is the rule most vendors quietly rely on. It is also not the rule in about a dozen states, and a clinic in one of them that follows the federal line is exposed.
The all-party consent states require every person in the conversation to agree before it is recorded. In a consultation that means the patient, every time, in a documented way. An ambient scribe records the patient, so this is not a footnote for these clinics, it is the whole compliance question.
The safe practice erases the map. Get clear, documented patient consent to record in every state, and the state-by-state distinction stops mattering. That is what a serious clinic does regardless of where it sits.
WA\ builds consent capture into the workflow, so the recording is defensible in any state. See it on a call.
Book a demoThe all-party consent states
Roughly a dozen states require all parties to consent to a recording. The commonly cited list includes California, Florida, Illinois, Maryland, Massachusetts, Michigan, Montana, Nevada, New Hampshire, Pennsylvania, Washington and Connecticut, though the details and case law vary by state.
If your clinic operates in any of these, one-party consent is not your standard. Treat all-party consent as the requirement and document it, and if you operate across state lines, adopt the strictest rule everywhere rather than tracking each one.
Why this is not theoretical
In January 2026 a California patient sued a health system alleging a consultation was recorded by an ambient scribe without consent, and sought class-action status. The allegations are untested, and the point stands. California is an all-party state, and the recording is exactly where the claim lands.
The consent duty sits mainly with the provider rather than the vendor, which means the clinic carries this risk, not the software company. That is the strongest possible reason to get consent capture right rather than assume the tool handles it.
What safe practice looks like
A short, plain explanation before the consultation that it will be recorded to help with documentation, an easy way for the patient to decline, and a record that consent was given. That is it. It is quick, it is universal, and it removes the state-by-state exposure entirely.
It also aligns with what patients want. People are far more comfortable with a recording they were asked about than one they discover later, and the ask itself builds trust rather than costing it.
How WA\ handles it
WA\ builds consent capture and an audit trail into the workflow rather than leaving it to a sticky note. The recording is documented as consented, which is what a claim in an all-party state would test first.
It does not remove the clinic's responsibility, and it is not meant to. It makes meeting that responsibility automatic, in any state.
Frequently asked questions
Do I need patient consent to use an AI scribe in the US?
Yes, and in some states you have no choice. Federal law is one-party consent, but around a dozen states, including California, Florida, Illinois and Washington, require every party to agree before a conversation is recorded. Since an ambient scribe records the patient, the safe and simple practice is to get clear, documented patient consent in every state, which removes the state-by-state distinction entirely and aligns with what patients prefer.
Which US states require all-party consent to record?
The commonly cited all-party consent states include California, Florida, Illinois, Maryland, Massachusetts, Michigan, Montana, Nevada, New Hampshire, Pennsylvania, Washington and Connecticut, though the details and case law vary. If your clinic operates in any of these, one-party consent is not your standard. If you operate across state lines, adopt all-party consent everywhere as the strictest and safest rule.
Who is liable if a patient is recorded without consent?
Mainly the provider. The consent duty for recording a consultation sits with the clinic rather than the scribe vendor, which means the clinic carries this risk. That is exactly why consent capture should be built into the workflow rather than assumed, and why a documented consent trail, like the one WA\ records, is the protection that matters if a claim is ever made.
Consent, handled in every state.
Thirty minutes and you will see how WA\ documents consent so the recording is defensible wherever you practise.