External USB microphones — which one to buy
This is the single upgrade that changes your note quality more than any other thing you can do. Built-in laptop microphones were designed so someone on the other end of a Zoom call can hear you; they were never designed for a medical-grade record of a conversation between two people across a desk.
An external USB microphone, properly positioned, does two things at once: it picks up both voices clearly, and it rejects most of the background noise that confuses transcription. We don't sell microphones and we're not affiliated with any of the brands below. These are just the ones our customers have consistently had good results with, ranked by how common the answer is when we ask clinicians what they use.
What to Buy
We recommend an Omnidirectional USB Desktop conference microphone. Pretty much any brand will do. The higher the pick up range, the better. A longer USB cable can help you beter position the microphone relative to you and your patient.
Amazon has quite the selection from as little as $26
What to avoid
Gaming headsets with RGB lighting and noise-cancellation. These are tuned for gaming voice-chat, which means they often compress and process the audio in ways that actually make transcription worse, not better. Boom-arm headsets meant for call centres or office use are fine.
Bluetooth microphones. They add a layer of lossy compression that makes speech slightly muddier. For recording purposes, wired USB is always better than wireless. (Bluetooth headphones for listening playback are fine — it's the microphone side that matters.)
"Studio" microphones that need a separate audio interface. XLR microphones like the Shure SM7B produce beautiful audio but need a separate USB audio interface box to plug into your computer. That's two pieces of gear instead of one. For clinical use, the convenience of a single-cable USB microphone outweighs the small quality gain of a studio rig.
Headsets in general as they are geared towards picking up the speakers voice at close range and will likely ignore your patient's voice.
Directional microphones of any kind - these are great for studio recordings and podcasts,, but the directionality means it will likely miss your patient conversations if you move outside of the directional pickup.
Where to put the microphone
Position matters almost as much as the microphone itself. Three practical rules:
- Relatively closer to your patient and further away from your computer (within reason based on USB cable length). This allows for louder speech pickup and less noise from fans and keyboards. Don't worry if the cable is short, just move it in the direction of the patient position and it should work just fine within a normal sized consultation room.
A quick sanity check after you set it up
Open any session page, click the microphone dropdown, select your new device. Then speak at a normal consultation volume without looking at the screen. Glance at the audio meter next to the record button — it should bounce into the green zone (roughly the middle of the meter) when you speak, and drop to near-zero when you stop.
If the meter barely moves, the microphone is too far away or its input volume is too low (check your operating system's sound settings). If the meter is pinning to the top constantly, you're too close or the input gain is too high.
Why this matters
We have the data across thousands of sessions: clinics using an external USB microphone produce notes rated "clinician-ready" at sign-off roughly 3× more often than clinics recording through a laptop built-in. That translates directly into less editing time per session and fewer re-recordings. The one-off $26–$120 cost of the microphone pays back in saved time within a couple of weeks.