so many third-parties involved with managing PHI, it’s impossible to secure it.

For sure! I got notified my PHI was breached. By a company I never even heard of! And certainly never directly used. I never even figured out the chain, from health services I used, to the breached co. Might have been multiple others between. Given how often these breaches happen, defacto we have no medical privacy.

And no doubt people are trying to grab live audio of doctors visits

Happens already, yah! New England Journal of Medicine has a paper about the privacy risks. Prob lots of other papers too, that's just what I had in my bookmark list.

These systems capture audio of clinical encounters and generate transcripts and structured clinical notes, yet vendor practices differ substantially in how long each data type is retained and whether it is used for AI training.

Offices are supposed to have signs, and/or the dr should tell the pt. But drs are human, right? They may forget! And sometimes, you may be there in your worst, vulnerable moments. When you are badly injured, or distressed.

It chantges the whole trust relationship between dr & pt.