Walk into any physician's reception area and the patients waiting to be seen will be texting, emailing, surfing the internet, Facebooking, or Tweeting, with their heads buried in their smartphones. Most of these offices have posted placards indicating a "cell-free zone," but that in no way hinders communication otherwise.
In addition to all of the above mentioned capabilities, today's smartphones also record via audio or video. CAP member physicians often share in Hotline discussions that patients have asked to record informed consent discussions prior to surgery, medication instructions, and post-op or discharge instructions.
Still, the question remains: Should audio or video recordings be allowed in the physician's office? And if so, where should the line be drawn?
Given that time with the physician is brief, visits are often rushed and the patient's understanding of the doctor's instructions and explanations are not always easily understood or retained. Advocates for allowing the recording of the patient visit say it enhances patient retention of the information shared, greatly improves patient treatment compliance, and results in an increased understanding of the patient's diagnosis, treatment plan, and follow-up.
In addition, for those patients receiving a complicated or upsetting diagnosis, patients say recording their conversations with the physician enables them to share the information accurately with family members. And, in low-literacy patient populations, taking home written materials that can't be read or understood often cannot be used.
Opponents of allowing such recordings argue that they could become the expert witness testimony against the physician in a malpractice suit, thus increasing the physician's temptation to practice defensive medicine.
As the physician-patient relationship is a partnership based on mutual trust, any secret recordings would undermine and destroy that trust, which could result in suspicion and future prevention of open disclosure between the physician and patient. And we would be remiss if we did not consider confidentiality issues. Just how protected is the recorded information from winding up on the web or going viral? HIPAA restrictions do not apply to the voluntary release of information by the patient, but would there still be repercussions of such information going public? More than likely, yes.
Smartphone recordings are probably taking place in physician offices everyday, with or without the physician's knowledge or consent. Therefore, it is prudent for the physician practice to develop policies with clearly defined guidelines concerning when, where, or if such recordings are permissible to protect themselves as well as the privacy of the physician-patient relationship and to make patients informed of these polices.
If your practice chooses to allow recordings, make it a mandatory policy that there be open disclosure concerning when, where, what, and how much will be recorded. Make certain that there is physician pre-approval of the recording.
If your practice chooses to not allow recordings of any kind in your office, post a highly visible, easy-to-read sign at patient check-in that clearly states, "This office strictly prohibits electronic recording or videotaping of any kind in consideration of the privacy and confidentiality of the physician-patient relationship. We sincerely appreciate your compliance with our request." Be sure also to include this information in your new patient intake materials.
Authored by
Linda Sue Mangels, BSED, MSED, CPHRM
Senior Risk Management & Patient Safety Specialist
If you have questions about this article, please contact us. This information should not be considered legal advice applicable to a specific situation. Legal guidance for individual matters should be obtained from a retained attorney.