You've got to understand: clinic visits are very stressful, time-limited, and high-pressure. Doctors don't write anything down, but it's crucial that the patient rememberd everything that was said, with high accuracy and confidence. Audio recording is our best tool to these ends.
The problem isn't your PHI, nor is it a legal problem for you. The problem is them knowingly permitting you to record in a situation where you may capture someone else's PHI. (As in the "shared hospital rooms" example we're in a discussion thread of.)
You've also mixed up what's legal for you to do (record, in a single-party state) and what's legal for them to permit by policy (knowingly agreeing to recording). You won't get arrested in a single-party state for recording; it can still violate the clinic's policy, and they can make the decision not to continue doing business with you after.
No one's going to stop you from writing down a note, though. Thinking "doctors don't write anything down" is universal may indicate you need a better one; mine definitely does, and I get sent the summary shortly after my visits.
What is the moral difference between me hearing someone's PHI, and writing it down in a note, and my phone hearing it? Let's stipulate that all smartphones are always and everywhere listening to everything, and sending it to someone; it may as well be me.
> What is the moral difference between me hearing someone's PHI, and my phone hearing it?
In a court, hearsay is inadmissible; a recording (critically different than mere hearing) is far more likely to be admissible. That's for a good reason. (HIPAA compliance is also not a strictly moral question, but a legal one.)
> Let's stipulate that all smartphones are always and everywhere listening to everything, and sending it to someone...
Even if you're using something like "hey Siri" or "OK Google", that's not how they work.
HIPAA is a baseline rule set. Providers are free to set more restrictive rules than what HIPAA defines. They often do so they have buffer room better their rules and HIPAA violations.
Further, HIPAA is not the only rule governing you and your providers interactions. A private institution is free to set its own rules (with its legal obligations) and can have you leave if you don’t follow them.
