Should patients be allowed to record their office visit?

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.

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  • http://pulse.yahoo.com/_3CY2U67646G7UIAHBQVTT2UP4Y Kristy S

    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.

    • http://www.facebook.com/elevier Erin Levier

      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.

  • http://www.drjasonmihalko.com Jason Evan Mihalko, Psy.D.

    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.

  • http://twitter.com/michaelrickert Michael Rickert

    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. 

  • http://twitter.com/michaelrickert Michael Rickert

    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.

  • Anonymous

    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.

  • http://www.cadencemed.com Matt Langan

    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.

  • http://www.twitter.com/alicearobertson Alice Robertson

    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.

  • http://twitter.com/JamisonBarnett Jamison Barnett

     

    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 physician
    communication has been shown to impact the metrics previously mentioned as well
    as reduce malpractice suites, the category tag of this post.  So I vote to embrace the recording of office
    visits, I cofounded a company (Verilogue) that does just that, We have
    audio-taped over 60,000 medical consultations over the past 5 years and have
    developed methods of analyzing physician-patient communication and have
    produced a variety of solutions designed to enhance communication during office
    visits.  We have produced a mobile
    application that supports shared decision making during the office visit,
    improve coordination of care among caregivers, and improves the overall office experience
    for a patient.  At the center of this
    product, CareCoach, is the ability to record your office visits.  I see the future where we all have the
    ability to record our doctors’ visits, not for legality reason with malicious
    intent, but in a greater effort to reform healthcare and provide a true patient
    centered care experience.

  • http://pulse.yahoo.com/_VL62LF622IHPTSCIU4VHSECP4E Patience_Advocate

    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?

  • http://www.facebook.com/profile.php?id=1691603247 David Huntley

    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.

  • http://twitter.com/vivimbmd Viv Martinez-Bianchi

    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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