For much of their childhood, Joel and Josh Freiberg knew where they would find their father after a long day in the clinic: at the kitchen table, reviewing referral letters.
The consultations were finished and the letters had been typed, but each one still came back to David for correction, approval and sign-off.
In respiratory and sleep medicine, where correspondence often needs to capture complex histories, investigation results and detailed treatment plans, getting every clinical detail right takes time.
Years later, the problem they had watched follow their father home became the inspiration for Medow.
Today, David’s correspondence is generated during the consultation and ready to review before the patient walks out the door.
The letters still reflect his clinical judgement, preferred structure and professional voice. They simply no longer follow him home.
Dr David Freiberg is a respiratory and sleep specialist based in Sydney, with more than 25 years of experience in the specialty.
He is the founder and Medical Director of Meredith Respiratory and Sleep Centres and has held senior thoracic physician roles across public and private hospitals.
A respiratory consultation can bring together symptoms, imaging, lung function results, treatment response and years of disease history. Sleep medicine adds another layer, including sleep study findings, CPAP recommendations and communication with both the patient and referring GP.
Across approximately 40 patients each week, that creates a significant volume of detailed correspondence. For years, David managed it with the support of an internal typist.
David had worked with the same internal typist for years.
She knew his terminology, understood the structure of his letters and was familiar with the level of detail he expected. The process was established and reliable, but it still involved delay, handovers and repeated review. Like every employee, a typist also needs to take sick leave and holidays throughout the year, which left David with significant delays.
David would dictate each letter and send it to the typist. Once it had been transcribed and returned, he had to revisit the patient’s case, review the letter line by line and make sure it accurately reflected the consultation and his clinical reasoning.
Straightforward letters were often quick to approve. More complex cases could require clarification, corrections and another round of review.
If the typist was busy, the letter waited. If David was busy when it came back, it waited again.
The typist did the typing, but every letter still came back to me. I still had to make sure it said exactly what I wanted it to say. The consultation was finished, but the work it created was still waiting for me.
The system worked, but every consultation remained open until the correspondence had passed through the full typing and review process.
That was the work Joel and Josh saw at the kitchen table.
David was not actively looking to replace a process that had supported his practice for years.
He trusted his typist and valued the consistency they had developed together. The question was not simply whether AI could generate a letter. It was whether it could produce correspondence of the same standard without creating more correction work.
When you have worked with the same process for a long time, there is a natural reluctance to change it. It may not be perfect, but you know how it works.
Medow is built specifically for specialist medicine in Australia and New Zealand. Its AI models are developed around the terminology, structure and clinical detail required across different specialties, rather than applying the same generic approach to every clinician.
Before David began using the platform, a dedicated Customer Success Manager worked directly with him and his practice team to configure Medow around his existing letters, terminology, preferred level of detail and the way he communicated with referring doctors.
By the time he went live, the core workflow was already in place.
I was surprised by how straightforward it was. Most of the setup had already been done before I started, so I was able to use it from the first day. And if something needs adjusting, I can just contact my Customer Success Manager and they sort it out.
The result was not a generic AI draft that David had to rebuild. It was correspondence already shaped around his specialty and the way he worked, with a direct point of contact available when his preferences or workflow needed adjusting.
Medow removes the separate dictation and transcription stages from David’s routine correspondence.
Instead of dictating a letter and waiting for it to return typed, he receives a structured first draft immediately after the consultation.
He can review it while the patient conversation, investigations and clinical reasoning are still fresh.
There is no separate audio recording. No transcription queue. No document returning later for another round of work.
The biggest difference is that I only have to deal with the consultation once.
Because Medow has been configured around David’s specialty, structure and professional voice, the drafts require minimal editing before they can be approved.
For David, that means less dictation, less correction and fewer cases to mentally reopen later. For the practice team, it means fewer documents moving back and forth before correspondence can be completed.
David estimates that Medow saves him around 20 minutes per patient.
Across approximately 40 patients a week, that represents more than 13 hours previously spent dictating, revisiting cases and correcting letters.
I would estimate that I am saving around 20 minutes per patient. Across a week, that is a very significant amount of time.
The difference is not only how much time is saved, but where that time comes from.
David is no longer returning to consultations days later or reviewing a backlog of correspondence in the evening. The letters are completed closer to the consultation, while the clinical context is still clear and the working day is still underway.
Joel and Josh did not first learn about the documentation burden through customer interviews or market research.
They had watched it at home.
They saw their father finish long clinical days and then begin another round of work at the kitchen table. They saw that an internal typist could remove the typing, but not the responsibility that remained with the specialist.
Years later, they built Medow around a problem they had understood long before they had a name for it.
My sons grew up seeing me at the kitchen table completing letters after work. None of us imagined they would one day build something that solved that problem. I only wish we had had Medow then — there would have been fewer late nights working and more time with the family.
For David, using Medow brings that story full circle.
The product his sons built now allows him to complete routine correspondence during the working day, without giving up the care, detail or professional voice that mattered in those letters in the first place.
The kitchen table is still there.
The letters are not.
The letters still sound like me. They just no longer follow me home.
Still relying on internal typing to complete specialist correspondence?
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