Why I joined Symbal: a note from the new CEO

Hi, I'm Spencer Tolleson. I recently took over as CEO of Symbal Conversations, Inc., and I want to tell you why.

I joined because of two ideas the team had before I showed up. Neither is about fancy technology. Both are about who we build for and what the product should actually do.

Why did I say yes to Symbal?

I said yes because Symbal was built for small practices, not medical giants.

Big hospitals and 100-location groups get giant platforms with long lists of add-ons and prices built for a corporate buying department. A three-provider med spa gets that same bulky tool with a smaller discount. It is not worth the money. We built Symbal from day one for the practice with one provider, or a handful, in both what it does and what it costs.

The second reason is simple: the patient relationship is what matters. A scribe that saves time is nice, but it is not the goal. Time is just what you get back so you can spend it on the person in the chair.

Why is charting at night such a bad model?

Spending your evening writing chart notes wears you down. You finish your last patient, open your EMR, and type. Taking notes turns into something you dread every night. That dread follows you right back into the clinic the next morning.

Say you see 15 patients a day. At that volume, you might as well hire someone to handle the extra work each visit brings. A hospital can absorb that. A small clinic has to look at every line item on the budget and ask, every month, whether it is worth the cash.

An AI scribe fixes part of this problem. Plenty of companies sell them, and we have written about the options in other posts on this blog. What I want to do here is tell you what I think is wrong with most of them.

What are the two traps most AI scribes use?

Most AI scribes trap you with metered limits or lock their best tools behind higher tiers.

You either pay a hefty sum, or you buy a cheaper app that leaves you copying and pasting notes by hand at 8 pm. Here is how those traps work.

Trap 1: Metered sessions

They charge you more when you use the app more. It is the oldest scheme in the book because it works. The bottom tier is always a little too small for a normal work week, so you upgrade. Look at Freed's published pricing page. Their Starter plan costs $39 a month for 40 notes. If you see eight patients a day, that is five working days.

Trap 2: Gated features

Companies put the one feature you actually need on their highest tier. That feature is getting the note into your EMR. Freed's page lists EHR push in its Premier tier at $119 a month. Heidi's page puts EHR integration on its Teams tier. The basic scribe looks cheap until you try to make it finish the job.

Should you use the AI scribe built into your EMR?

You get what you pay for. If cost is no issue, a built-in scribe is a real convenience.

We have demoed enough EMRs to see where built-in scribes shine and where they fall flat. Direct integration is handy, and it is where some of the price comes from.

But the price is real. Aesthetic Record's ChartSmart AI add-on is published at $30 a month for 50 charts, $50 for 100, or $75 for unlimited, with a $0.75 overage per chart. PatientNow's scribe has no published price. And Boulevard, as of this month, says on its blog that it is still actively developing an AI scribe.

We took a different path and built a Chrome extension. It reads the EMR page on your screen, fills the fields, and moves through tabs and sub-modals. It is hard-mapped and tested on Boulevard, Aesthetic Record in the browser, and PatientNow. Other browser EMRs run in a generic mode with a copy-paste fallback. We do not claim the whole market. Just the ones we have tested, and we will tell you which.

How does Symbal fix your charting routine?

Symbal records the visit, fills your EMR fields, and tracks the personal details that keep patients coming back. It was not built to be only a scribe. Three things:

• Ask your notes questions. Symbal stores your notes securely. We are HIPAA compliant, and you sign a Business Associate Agreement when you create an account. Data is encrypted in transit and at rest. Before or during a visit, ask the app about a patient's history and get an answer from prior notes.

• Beyond the Chart. Symbal writes the structured note for the clinical part of the visit. It also keeps track of the small things that make the relationship stronger: her career, her kids, what she was up to. Remembering every personal detail for every patient is impossible. Symbal gives you a quick refresher before you open the door.

• EMR autofill. Copying notes into each patient record is one of the most tedious parts of a provider's day. No two EMRs are laid out the same. The extension reads the page and fills it, and you review every note before anything touches the chart.

How much does Symbal cost?

Symbal costs $65 per provider per month, or $52 a month if you pay annually.

We do not want to price clinics out, and we do not want a lower tier that quietly forces you to upgrade. So there is one plan. You get every feature, including the extension and EMR autofill. No custom quote, no separate add-on fee, and you can cancel anytime.

Frequently asked questions

Do I have to change EMRs to use Symbal?

No. Symbal sits on top of the EMR you already use. It fills the fields in your chart and does not store or replace your medical record.

Is there a cheaper plan if I only see a few patients?

There is one plan at $65 per provider per month, or $52 billed annually. We did not build a smaller tier, because the smaller tier is usually the trap. Multi-location groups can contact us about custom pricing.

What if my EMR is not one of the three you mapped?

If it runs in a browser, Symbal tries generic mode and falls back to a copy-paste box with the full note. Tell us which EMR you use during the trial, because that is how we decide what to map next.

Why should you choose Symbal for your med spa?

Because it was built for a practice your size, priced for a practice your size, and aimed at the thing that actually keeps your patients coming back.

The scribe is how we get there. The relationship is why.

That is what I signed up for. Try Symbal free for 7 days, no credit card required.