Recording medical consults has benefits for doctors and patients, but only when done with consent, experts say.
A recent paper published in the Journal of the American Medical Association suggests that patients can widely benefit from the practice, citing a UK survey in which 15% of respondents said they had secretly recorded a consult, and 69% wanted to record one.
The motivation to record “is often reasonable” with patients citing a desire to improve recall and understanding of what their doctor told them, and share information with family members, according to the authors led by physician researcher Glyn Elwyn from the Dartmouth Institute for Health Policy and Clinical Practice in the US.
In the few health care organisations in the United States that offer patients recordings of consults, clinicians and patients report benefits, the authors say.
“In addition, liability insurers maintain that the presence of a recording can protect clinicians,” they wrote.
In Australia, the law governing recording is complex and differs between jursidictions (see break out box below) and there is a big difference between those obtained covertly and with consent.
|What the law says:
Source: MDA National
MDA National medicolegal manager Dr Sara Bird said taking a recording in secret erodes trust in the therapeutic relationship and is also illegal.
But recordings obtained with consent can be useful tools, and given patients’ desire for them, and the prevalence of smart phones, doctors should consider how they would respond to a patient requesting one and what their caveats might be.
One caveat might be asking the patient who they plan to share the recording with.
“They (the doctor) might say ‘I don’t want it distributed beyond you and your family.One caveat might be asking the patient who they plan to share the recording with, she told the limbic.
“We have had cases where patients posted covert recordings on youtube. I certainly think there would be cases where it’s not appropriate, for example a patient with paranoid personality and mental health issues it would be quite reasonable to say no”.
“There’s no obligation to say ‘yes’.”
Taking a recording may have a negative impact on the quality of the consult if the doctor feels nervous and consequently does not conduct it in their usual manner, she said.
“That’s not going to be in the patient’s interests.”
Recordings can be useful in high stakes consultations, such as in the case of specialists obtaining consent for treatment where there is a complex consent discussion going over risks, benefits and options.
In the US a neurosurgeon has developed software that can record consent called Medical Memory.
The practice of recording consults to document discussions around end-of-life care between a patients and doctors is already used in Australia, especially in cases where family members are unable to attend but want to be involved, she said.
This kind of documentation could be useful as evidence in disputes.
“In a lot of the claims we get there is often a difference in recollection between doctor and patient… the courts often put greater emphasis on the patient’s account if there are not adequate records.”
“If the allegation is a failure to obtain consent it would be extremely useful.”
Specialists already record various procedures, such as endoscopies, and there are cases where doctors encourage patients to take medical selfies.
The medical profession needs to have an open discussion about recording, and consider setting guidelines for patients and doctors about what is appropriate and when.