I accompanied my husband to an office visit with his orthopedic surgeon. Jamie had been experiencing setbacks in his recovery from major surgery. I went with him because I understand how hard it can be to distill medical information on the spot, much less remember it. Documenting what the surgeon said would allow us both to reference it later. The more information Jamie had about his condition, the more of an informed choice he could make about treatment options. My husband was in pain, something that complicates information recall even in the best of situations. I hoped that just being with him might also help him feel more at ease.
Since I suspected this office visit might contain some complicated and possibly stressful information, I considered recording what the surgeon said by using an app on my iPhone. I envisioned asking the doctor’s permission to record the conversation and decided against it because he might not have responded well to that idea. Some physicians and other providers react with suspicion and a defensive medicine posture when asked by patients to record what they’ve said.
My husband’s surgeon had a reputation for highly successful surgeries but not the greatest bedside manner. He’d always been pleasant with us, but since my husband’s recovery had been compromised with episodes of severe pain, I decided that an audio device could have instigated alarm. That would have interfered with the doctor’s focus on Jamie. With only 7 to 10 minutes, we had to make the most of this office visit. I wanted my husband out of pain.
In place of an audio recording, I took notes instead.
Health care professionals are well aware that patients experience anxiety in their exam rooms. It’s called white coat syndrome or white coat hypertension.
Anxiety interferes with cognitive function, especially memory, making it difficult not only to process medical information, but to remember it. Besides, medical information can be complex. It’s difficult to understand, especially in a foreign and uncomfortable medical environment such as a doctor’s office.
40 to 80 percent of medical information conveyed by health care practitioners is forgotten immediately by patients. Half of information retained by patients is incorrect. That’s such a small percentage that you’d think doctors would be handing out their own recordings to patients at every office or hospital visit. It might actually help with discharge planning from hospitals.
In theory, it should be perfectly acceptable for patients to record conversations with their medical providers. It’s a known fact that physicians are plagued by their patients’ lack of follow through with treatment recommendations. But recording brings up fear of medical malpractice lawsuits for some physicians, even if permission is requested ahead of time. According to American Medical News, recording the visit between doctor and patient could “exacerbate physicians’ temptation to practice defensive medicine.”
If patients want to record conversations with their providers, it’s hard to imagine that they wouldn’t ask permission and instead record in secret. According to the KPCC article, “When is it OK to record your doctor’s orders?” patients are in fact secretly recording conversations with their doctors without asking permission first.
Talk about a blow to the doctor-patient relationship.
I understand the hesitation to ask permission to record an office or hospital visit with a medical provider as I experienced it myself. But secretly recording is a violation of trust. In California, the law specifies that both parties must be aware that a recording is in place. Doctors are already afraid of being sued. Why would any patient surreptitiously tamper with the relationship with their doctor, something that is considered the cornerstone of quality care?
Documenting information your doctor gives you is essential because it’s just too easy to misunderstand or forget the medical information conveyed. It’s helpful if a doctor or other provider has a patient portal with access to notes and medical records, but that doesn’t take the place of your own documentation.
Tips to remember what the doctor tells you
1. Prepare questions ahead of time for your doctor. This allows you to think about what you want out of the doctor visit.
2. Document diagnosis, recommended treatment plan, treatment options, and suggested next steps.
3. If you want to record what the doctor tells you, keep in mind that it might hamper the conversation for you and for your physician. Both of you might be less willing to be candid. Instead, consider asking to record important facts at the end of the visit instead of the entire conversation. But ask permission to record first.
4. If you decide not to record, take notes in a notebook, on your smartphone or other device.
5. Bring a loved one with you to take notes for you.
6. Some physicians offer a summary of your visit. Ask for it if it isn’t offered. But in addition take your own notes.
Martine Ehrenclou is a patient advocate. She is the author of Critical Conditions: The Essential Hospital Guide to Get Your Loved One Out Alive and the Take-Charge Patient.
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