I have considered using voice recognition but I complete my notes in front of the patient so that by the time I leave the room my note is signed, delivered to the front, orders sent, scripts faxed (or printed) and superbill generated. I can listen and type at the same time without too much apparent distraction to the patient. I would be uncomfortable "dictating" my note in front of the patient and I certainly cannot talk and listen to them at the same time. For me, typing, using templates and short-keys macros is optimal.
Leslie