Should patients be allowed to record their office visit?

Should patients be allowed to record their office visit?
by DAVID TROXEL, MD | in PATIENT | 11 responses

Whether your office has wireless access or not, there will be patients texting, surfing the Internet, Facebooking, and otherwise engaging with the outside world on their smartphones while in your office.

These smartphones have another function: the ability to record audio or video. It is understandably tempting for patients to record consent discussions, medication and follow-up instructions, and other physician or staff interactions.

Recording a medical discussion via video or audio is no proxy for paying attention, however, and the practice puts you and your office at significant risk.

Video or audio recording should not be allowed in the office setting. It breaches the confidentiality rights of the other patients and infringes on the privacy rights of the physician and employees. In California, as in many other states, it’s illegal to record without prior consent.

To get a handle on patients taking smartphone recordings in your office, consider the following steps:

Post a sign at the reception desk, or wherever patients check in, that says: “To ensure confidentiality and privacy, any type of electronic recording is strictly prohibited at any location within these offices. Thank you for your understanding and compliance.”
Draw up a written policy prohibiting the use of recording devices during office visits and include the policy in patient intake handouts.
Keep watchful eyes out for patients potentially recording conversations. Politely request that they discontinue their recording.
Remind patients that they—or their caregiver—can take notes while meeting with the doctor in order to remember important information. Emphasize that the conversation will also be documented in the medical chart.

David Troxel is Chief Medical Officer of The Doctors Company.

http://www.kevinmd.com/blog/2011/08/patients-allowed-record-office-visit.html

COMMENTS:

Viv Martinez-Bianchi 1 hour ago

I think many patients would benefit from having a recording of the conversation they've had with their doctor. It would be helpful for them to remember and go back to it. I do see how -if the physician's advice was not correct, or unclear, this could put the physician in a difficult situation. What is David Troxel concerned with? Liability? I am afraid his approach: "prohibiting" recording, asking patients to stop doing so, etc, would actually get people to become suspicious of their doctor's actions.
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David Huntley 3 weeks ago
I think that for the purpose of retaining information discussed between the doctor and patient it's a great idea and most physicians would probably encourage it. However insurance companies will probably forbid it due to liabilities.
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Patience_Advocate 3 weeks ago
I don't understand how recording a private meeting between doctor and patient (with or without a HIPPA-authorized patient advocate present) is violating privacy rights, assuming the doctor has assented to the recording. In fact, because an office visit is such a rushed affair and because 90 million American adults are low-literate, recording the dialog might result in better treatment compliance and increased understanding of the patient's diagnosis and prognosis. Will you kindly elaborate?
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Jamison Barnett 3 weeks ago

The
statement "Video or audio recording should not be allowed in the office
setting" flies in the face of Healthcare Reform and the movement for
greater Patient Centered Care. While the decision to record the conversation
should be made between the doctor and patient, the benefits of doing so can
outweigh the risks that I am guessing the author is so concerned about.
Recording the conversation has been showed to improve patient recall, patient
satisfaction, and the coordination of care among caregivers. You see the
adoption of recording methodologies at UCSF and UTMB and you can easily find
the recommendation to record your office visit at sites like AHRQ, NIH, American
Cancer Society, and other popular and credible patient support sites. But that
is focusing on just half the benefit. I believe that health systems should
support audio recordings, not just as a tool for monitoring but for improving
the performance of physician communication. As the US Health System struggles
to define and support patient centered care i.e. hospitals mimicking the
practices of the hotel industry, one solution would be to capture the
conversations doctors have with patients and use them to improve the communication
style of physicians. Improving... show more
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Alice Robertson 3 weeks ago
Doctors do not want to held liable for their words. It is why our medical records often differ from their freedom to say things against management and the status quo during an office visit. It will limit them. One doctor on this board videotapes all his office visits....it is helpful...because the average patient forgets 70 % of what was shared during the visit....but, moreso, he understands the underbelly more than a patient would...he is wise.
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Matt Langan 3 weeks ago
A very close friend of mine went to an expensive healthcare clinic in the area for much-needed care. He is an older gentleman and didn't feel confident in his ability to transcribe the details of his visit while also trying to engage in a healthy conversation with his healthcare provider. He recorded the visit and still refers to it this day. It is a recording he uses for motivation and a reminder of what steps he needed to take. I think that making a blanket statement like, "Nobody can ever record a conversation in our facility" is unfair and perhaps doesn't have the patients' best interests in mind.
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dieterhoo 3 weeks ago
I am afraid that you do not understand the applicable law. You state: " It breaches the confidentiality rights of the other patients and infringes on the privacy rights of the physician and employees." Wrong.

In most states (not all), recordings are legal if one person in the conversation consents. In most states, therefore, patients have every right to record talk directed at them.

Doctors or their employees simply have no privacy rights in this context.

OTOH, recording conversations that other people are having puts you in more tendentious legal grounds in most states.
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Michael Rickert 3 weeks ago
Jason,

You do make a valid point and for recording. We probably all agree that it is a great medium to store info. What I struggle with is that my physician would lose their personality if they knew they were being recorded. I would rather be told in a somewhat inapproriate way to stop eating White Castles instead of a standard, cookie cutter recommendation.
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Michael Rickert 3 weeks ago
I agree with most of the article. Patients should make sure to pay attention during their visit and not be on cruise control. If your physician uses an EMR, patients can request (most everytime) a summary of their visit with patient instructions.
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Jason Evan Mihalko, Psy.D. 3 weeks ago
One size fits all policies are rarely sensible. I commonly encourage my older patients to ask permission to record conversations and instructions with their physician. When folks are getting a complicated diagnosis, or hearing that they are terminally ill, they are rarely able to take in all the information. Recording allows the patient to reflect or share it with a trusted family member. It helps a patient understand more and can increase the accurate compliance with the treatment plan.

This post seems to be more of a defense against a lawsuit rather than a thoughtful discussion about good medicine.

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Kristy S 3 weeks ago
How does a patient recording the visit with their doctor cause a breach of confidentiality rights of other patients, or infringe on the privacy rights of physicians and their employees if all the patient is going to do is use it for their own personal information to help them remember what went on in the visit? I know the answer to this but I am asking this because my mother is big on wanting to use a tape recorder (she's from a different generation than the ones that are younger than me) to record visits if she can to help her remember what happened on visits in case she forgets later.
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Erin Levier 3 weeks ago in reply to Kristy S
I agree! If the person is able to record another patients identifiable information, then the DOCTOR'S OFFICE is the one breaking confidentiality. I used to work in mental healthcare and have had extensive training in HIPPAA laws. The staff should not say anything that identifies the patient in front of other patients. They shouldn't leave charts anywhere visible. When calling patients back to the room, they should use first name only. Using first and last name is a violation of HIPPAA. The bottom line is that the doctor should not be saying anything to a patient that they would not want recorded and played in a courtroom.