Patients Will Record Encounters, and Docs Must Adjust
http://www.medpagetoday.com/PublicHealthPolicy/Ethics/50564?xid=nl_mpt_DHE_2015-03-20&utm_content=&utm_medium=email&utm_campaign=DailyHeadlines&utm_source=ST&eun=g578717d0r&
Physicians must accept the possibility that every conversation with a patient may be secretly recorded by the patient, wrote two physicians and a lawyer in the Journal of the American Medical Association.
That is the first step for physicians to protect themselves from possible negative consequences of such encounters, said Michelle Rodriguez, JD, who is also a medical student, and colleagues at the University of Texas Health Science Center in San Antonio, in a Viewpoint.
Federal law allows the recording of a private conversation as long as at least one party to the conversation consents to the recording. Some states, such as California and Massachusetts, require the consent of all parties to record.
Trying to change the law would be a long, expensive, and not necessarily fruitful process, wrote authors.
Instead, they urged physicians to “embrace” the situation, arguing that they should use it as an opportunity to refine their communication skills and strengthen the patient-doctor bond.
If a doctor suspects that a conversation is being recorded, he or she should ask the patient. “Then, regardless of the answer, the physician can express assent, note constructive uses of such recordings, and educate the patient about the privacy rights of other patients so as to avoid any violations,” authors wrote.
Rodriguez and colleagues acknowledged that recording without asking physicians first may change the nature of the patient-physician relationship. For example, doctors may feel vulnerable or mistrustful with current or future patients.
Personal accounts by physicians reflect these feelings. “I feel violated,” wrote one pseudonymous blogger. “It angers me, and I automatically lose trust in that patient and their family.”
Some posters on a popular online forum for physicians agreed. “Personally I really dislike this and it makes me awkward/uncomfortable,” wrote one poster.
“I had a report one day that one of my patients was recording me with a tape recorder in his pocket. When I confronted him, he would not confirm or deny it. ‘So what if I was?’ he asked. I sent him a discharge letter because he was so smug and asinine about it,” said another poster.
But ultimately, Rodriguez and colleagues argued, the motives of patients and families are irrelevant. Physicians must continue to establish good relationships with their patients, be compassionate, and act professionally regardless.
This is not the first time physicians have suggested their peers use the rising tide of recording to their advantage.
The fear of recording for use in litigation is a legitimate one, Deep Ramachandran, MD, a pulmonary and critical care physician in Michigan, wrote in a post on KevinMD.
But he encouraged doctors not to assume the worst about patients who record conversations. The practice may be beneficial for recall of information by patients or family members.
At the same time, he encouraged patients to ask before hitting record. “So to my patients who feel the need to secretly make recordings of our conversation, please feel free the ask the question, ‘May I record this conversation?’ You’ll find the answer is often ‘Yes, please do!'” Ramachandran wrote.
Roger Kirby, MD, a urologist and director of The Prostate Centre in London, wrote that physicians have an obligation to treat patients even if they discover covert recording. “… you may be upset by the intrusion, but if you act in a professional manner at all times, then it should not really pose a problem,” he wrote in post in BJU International.
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