An office policy addressing their use can ensure mutual understanding
It is becoming increasingly common for patients to want to record their medical appointments via audio, video or photography. In many cases, these recordings can benefit patients by helping them understand and remember the information they are being provided. However, recordings also have the potential to raise broader issues.
Dr. Keith Hay, a family physician, and member of CPSO’s Policy Working Group, says physicians may wish to have an office policy about recordings intended to capture the information and guidance doctors provide to patients about their health condition.
“I can see a recording being a great tool for compliance. For example, if my patient wants to record me for the purpose of better helping them follow my advice, then I would more than welcome that,” he said.
Where recordings are made, the fact of the recording should be documented in the patient’s medical record, including the duration of the recording and a summary of the content of the encounter, said Dr. Hay.
But recordings can also present concerns and the development of an office policy could allow physicians to clarify the appropriate use of recordings in their office. “It should be clear to patients, for example, that recording in public areas of the office is not appropriate as it could capture people not involved in the patient’s health care encounter. Patients may not be aware that such a recording presents a potential privacy breach,” said Dr. Hay.
There are other concerns about recordings. If done without the physician’s knowledge, it could impact the physician-patient relationship. “If it was done without my permission, it would suggest a lack of confidence in the relationship on the part of the patient. If I were to become aware of the recording, I could point at the violation of my office policy and suggest that we work together to address how we can improve our relationship,” said Dr. Hay.
“It should be clear to patients, for example, that recording in public areas of the office is not appropriate”
The Canadian Medical Protective Association (CMPA) sets out further guidance for responding to patient requests regarding audio and video recordings in its document, Smartphone recordings by patients: Be prepared, it’s happening.
The CMPA stated it has seen cases in which video taken by a patient in a doctor’s office without the physician’s knowledge has appeared on public websites and on social media.
When patients ask to record their visit, the CMPA suggests physicians consider exploring the patient’s motivation to do so with a view to arriving at a mutually agreeable understanding as to whether it is appropriate to proceed.
When patients ask to record their visit, the CMPA recommends:
- Ask them why they want to record the encounter to determine what they hope to achieve.
- Consider whether better alternatives exist, including recording part, but not all, of the encounter, and discuss these options with patients.
- Accept or decline the request. If declining, explain the reasons for the decision and offer to continue with the encounter regardless. If the patient insists on recording, physicians will have to use their discretion on whether or not to continue the appointment.
- If a recording is made, note this fact in the medical record and, when possible, ensure a copy of the recording is maintained along with the clinical documentation.
