Thoughts from a Surgery Chairman: Recording Your Doctor's Visit | Renaissance School of Medicine at Stony Brook University

By <a href="/surgery/people/faculty/dr-mark-a-talamini">Mark A. Talamini, MD, MBA<a>, Chairman of Surgery, Stony Brook Medicine

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Dr. Mark A. Talamini</div></div>

Most everyone has an iPhone, or equivalent, in their pocket these days. So, it's pretty easy to record a conversation without the other person knowing. Surgeon's visits can be stressful. Unfortunately, they are often far too hurried, but critical information is being presented.

Patients often tell me that they had questions that weren't answered, either because they didn't think of them until later, or because of the stress of the visit.

Surgeons want their patients to have as much information as possible about their situation, and about the risks and benefits of surgery, but the communications of surgeons are not always perfect, and sometimes things are not as clear as they could be.

So, why not record the conversation?

Having a conversation or interaction be recorded without your knowledge is not a pleasant situation. It is easy to feel like you have been tricked, and you immediately wonder if what you said with the best of intentions might be used against you. It is almost impossible to not feel defensive if this happens to you.

But do patients record their surgeon visits? Do they do so without informing the doctor? Are there cases where doctors are recording the appointment conversation without the patient knowing? These questions bear on all concerned.

Now we have some data to speak to the issue of recording doctor's visits. A new article in JAMA, titled "<a href="http://jamanetwork.com/journals/jama/article-abstract/2643728" target="_blank">Can Patients Make Recordings of Medical Encounters? What Does the Law Say?</a>," addresses this issue head-on. It presents data from the United Kingdom showing that 15% of patients had secretly recorded their doctor's visit.

<div class="callout">Recording doctor's visits should probably be okay, particularly if all agree, but there are likely even better ways to better educate patients.</div>

Eleven percent of physicians reported being aware of someone covertly recording an appointment.

Although I am not a lawyer, my understanding of the legal concerns associated with the issue is that the laws regarding the recording of private conversations vary from state to state.

In some states, all parties must consent for a recording to be legal (California, for instance). New York is a "single consent" state, meaning that an individual can record a conversation without obtaining the consent of the other participant(s) in the conversation.

However, what is legal and what is best for an effective physician-patient relationship is another matter.

Any physician recorded without their knowledge is likely to be upset on learning of the occurrence, suspecting an attempt at gaining a legal advantage for a lawsuit. However, as the JAMA article points out, patients have some very legitimate reasons for recording.

Doctor's visits are high-anxiety events for most patients. Details are easily forgotten. The volume of new information is often overwhelming.

It seems perfectly reasonable that a patient would want a means of better understanding their health situation following a doctor's visit. In 2017, with a recording device in virtually every pocket, it is no surprise that patients resort to recording.

How can this situation be improved? I would suggest that if patients want to record their visits, they should simply tell their physicians that is what they wish to do, and why. Most physicians will easily agree. They can also make the situation of their patients better by providing them with enduring materials with key information, either on paper or on the web.

Patient education materials are often best provided prior to the doctor's visit, so that the visit can focus on important questions as well as transmitting information. Recording doctor's visits should probably be okay, particularly if all agree, but there are likely even better ways to better educate patients.

Clearly, the challenge of how best to provide patients and those who care about them with all the information they need from their doctor's visits has to be addressed fully and carefully in order to advance patient care.

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"Patients' prime motivation for recording is to enhance their experience of care, and to share it with others. Patients know that recording challenges the 'ceremonial order of the clinic,' and so some decide to act covertly. Patients wanted clearer, more permissive policies to be developed."
— Elwyn G, Barr PJ, Grande SW. <a href="http://bmjopen.bmj.com/content/5/8/e008566.long" target="_blank">Patients recording clinical encounters: a path to empowerment?</a> BMJ Open 2015;5:e008566. [This study is the source of the data cited above, and is the first to estimate the extent to which patient recording of medical encounters, covertly or openly, is occurring in the UK.]
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Dr. Talamini invites comments from the public, as well as from the medical community, on the issue of recording doctor's visits. What do you think about it?