The Procedure Heard Around the World
In April 2013, Dr. Tiffany Ingham, an anesthesiologist, was accidentally recorded as she worked on a sedated patient during a routine colonoscopy. In the recording, Dr. Ingham insults the patient, making fun of his personality, his education, his appearance… and his body. In the end, she decides to add a false diagnosis of hemorrhoids to his chart, presumably for fun.
Needless to say, the patient, upset at being the butt of all the jokes, sued. He was awarded $500,000 in damages. The vicious nature of this recording made it go viral on the internet, bringing major attention to the issue of patients recording doctors’ visits.
Although this procedure was recorded accidentally, pressing the “record” button on cell phones, laptops, tablets, and hand-held video game devices make it easier than ever to record medical appointments. Chances are, if you’re a healthcare provider, you too have been recorded without knowing it.
Why are Patients Recording Doctors’ Office Visits?
Relax, it’s not because they are looking for a law suit, or because your handwriting is terrible. Patients generally want to record medical office visits because they can’t remember what was said. In fact, according to the Centers for Disease Control and Prevention, 50 percent of patients walk out of their physician’s office not clear on what they were told or are supposed to do.
Sometimes, there are legitimate reasons for recording a medical appointment. It probably wouldn’t bother you if an elderly person, caring for a spouse with dementia, asked you to record the office visit to help remember your instructions. It may, however, surprise you to know that there are currently articles in popular magazines, such as Forbes, suggesting that all patients should record their doctors’ visits, to avoid “false memories”.
Why will some patients record you secretly? Perhaps they are not aware that this may bother you or break any laws. Perhaps they are too shy to ask. Maybe they are afraid that you will say no. Whatever the reason, patients are doing it. The problem is that the fear that recordings can be used for frivolous lawsuits places yet another strain on the doctor-patient relationship.
Is Recording Doctors’ Office Visits Legal?
Patients have the legal right to record office visits without your permission in all states except California, Connecticut, Florida, Illinois, Maryland, Massachusetts, Michigan, Montana, New Hampshire, Nevada, Pennsylvania, and Washington. In these states, all parties have to be informed the conversation is being recorded, so your patients must inform you of their intent to record you.
Isn’t Recording Medical Visits a HIPAA Violation?
HIPAA protects patients from having their Protected Health Information (PHI) disclosed to anyone without their permission. But patients can share their own PHI with anyone.
As a physician, you can’t demand that your office visits remain confidential. However, if you do let your patient record the office visit and the recording picks up any conversations regarding another patient in an adjacent room, you may be liable for a HIPAA violation … talk about a double standard!
How To Manage Office Visit Recordings:
With video cameras popping up in surgery rooms across the nation, it is possible that some day, in the not-so-distant future, all office visits will be recorded for quality assurance as well as to protect physicians. Recording appointments can actually be a good thing if done properly. Recordings can help you keep better documentation, and they can help improve patient adherence, engagement and outcomes. Additionally, they make sharing information with colleagues much easier.
So what can you do to manage office visit recordings before they manage you? Here are some strategies:
- Assume that everything you say in any office visit is being recorded. This will ensure that you choose your words wisely.
- If a patient asks to record the office visit, allow them to record a summary of instructions at the end of the visit.
- If you feel that allowing recording devices in your office may lead to accidentally violating HIPAA laws, offer your patient a notepad and pen to take notes. Or, hire a transcriber and give your patients transcripts of the visits.
- If you are worried that unofficial recordings might be altered and used out of context, start recording your office visits yourself and offer the recording to your patient. This will ensure that you are the owner of the original, unaltered recording.
- If you know you are being recorded, ask the patient to repeat back to you what you’ve said. Correct any misunderstandings your patient has. This will improve compliance and protect you from potential issues.
It is clear that the medical landscape is changing in unforeseeable ways. Finding a way to empower yourself in the face of these changes will help you use office visit recordings to your advantage and may even take your medical practice up a notch.