Which AI scribe note format do you actually need: SOAP, BIRP, HPI, or something custom?

Most AI medical scribes default to SOAP because SOAP is the most-recognised structure across medicine. SOAP is also, depending on the consult type, between mildly suboptimal and actively counterproductive. Here's when to pick what.

SOAP — the workhorse

Subjective, Objective, Assessment, Plan. Works for most acute-care GP consults. Standard chronic-care reviews. Anything where there's a coherent chief complaint, a focused examination, and a clear management plan.

SOAP starts to feel forced when the consult doesn't have a single chief complaint — multi-condition annual reviews, complex psychosocial presentations, paediatric consults that drift across topics.

BIRP — the mental health choice

Behaviour, Intervention, Response, Plan. Designed for mental-health and behavioural-health consults. Captures the patient's presenting behaviour and the therapeutic intervention more cleanly than SOAP. RACGP-endorsed for MHCP documentation.

If you draft MHCPs regularly, BIRP saves you 4-5 minutes per consult compared to forcing the same content into a SOAP template. Most GPs never switch because their scribe doesn't make it easy.

HPI — the focused acute

History of Present Illness. A more narrative format that captures onset, character, location, duration, exacerbating + relieving factors, and severity in flowing prose. Good for acute presentations where the chief complaint is clear and the workup is straightforward.

HPI reads like a clinical letter. SOAP reads like a checklist. For some clinicians the difference is preference; for some it's a meaningful productivity gap.

What to look for in a scribe

Per-clinician format defaults. Per-consult-type override. The ability to switch format without re-keying the consult. Most scribes get format choice wrong by making the clinician commit at the start of the consult. The right design is to let the format be chosen at sign-off, with the underlying transcript reformatted on demand.