A journalist who had unearthed one of my blogs written three years ago recently contacted me. In that post I explored how patients and doctors could benefit from recording appointments. So, what prompted the journalist to reach out? She had discovered an article in The Journal of the American Medical Association about the ethical implications of patients, who unbeknownst to their doctors were recording their conversations. She was interested in digging deeper – as to why patients would choose to be secretive.
I chose not to speak to the surreptitiousness of recording appointments, which we all know is unethical and breeds mistrust – but to focus on the benefits of using a recording device as a means of helping patients and families review the consultation with the intent of better understanding critical information. We all know – and it is a scientific fact- how difficult it is to process and retain medical information, especially in a heightened emotional state. I explained to the journalist that the recording allows patients (and family caregivers) to play back the conversation and identify their questions and concerns in preparation for following up with their doctors. With the increasing demands on healthcare providers, recording can help patients communicate exactly what they do and do not understand, which could both improve quality of care and save time.
I also noted in my blog that recording was considered a radical suggestion and it continues to be controversial. Just last week an article appeared in the Washington Post about how often doctors’ first reaction to recording appointments is based upon a fear that it could be used against them. Yet, Dr. Glyn Elwin, a physician and scientist at Dartmouth Center for Healthcare Delivery, tells us, “Doctors who agree to go on the record can boost their patients’ trust and strengthen their relationship.”
Perhaps, this is an opportunity to re-visit my blog and some of the comments. I did. The comments included a plea from a clinician to clinicians to please ‘bridge the gap’ by inviting patients to record the consultation. Why Every Patient Should Be Recording Appointment
Maybe it’s an idea whose time has come?
Liz Scott
The fear of the power doctors and litigators hold costs lives
no legion
The JAMA and the Washington Post articles have certainly moved things forward. Perhaps I could add a few other recent articles into the picture, as well:-
http://journals.plos.org/plosone/article?id=10.1371/journal.pone.0125824 (From the Dartmouth Center team)
http://www.mirror.co.uk/news/uk-news/man-left-terrified-after-paranoid-5733989 (Concerning a doctor whose behvior could well lead him to be prosecuted for false imprisonment under UK law)
It has now been said many times and in many places: if clinicians want to to stay in the loop of this patient initiative, they simply need to put up a notice – on the office waiting-room wall, say – telling patients they are welcome to take an (overt) audio recording of a consultation home for their personal purposes.
They can also prepare to provide copy recordings to patients who don’t come equipped to take them. See for instance this recent article:-
http://medcitynews.com/2015/05/video-replay-patient-education/
Hostility from doctors to recording patients will sooner rather than later reduce the number of patients who wish to consult with such doctors at all. And ‘ostrich behavior’ – saying nothing and pretending it isn’t happening – will only prompt patients to record covertly rather than openly.
What clinicians provide is often some of the most important advice that a patient will ever hear. It belongs to them as the advised, and they should be able to take it home in whatever fashion they find most useful. The time for doctors to get thoroughly used to this idea has most certainly arrived.
MJ Kwiatek
When I was first diagnosed with breast cancer 15 years ago, I went to the Second Opinion Program at UCLA Medical Center. You provide them with your doctor’s information, tests, x-rays/mammograms, diagnosis, etc. A panel of experts looks them over, and one at a time, they meet with you to discuss your options and make their suggestions. If I remember correctly, there was a surgeon, an oncologist, a plastic surgeon, and a psychologist. (It was a long time ago! I’m sure there is information about it online.) Each one meets with you separately in a room; it is recorded for you, and you take the recording with you to listen to. They don’t want you to worry about remembering what was said or taking notes. It was wonderful. I have since suggested to friends that they record their appointments when faced with this situation, and it often is met with skepticism and fear that it will offend their doctor. My reply is always, “If it offends your doctor, then you need a new doctor.”