There is an excellent article in the April 28, 2015 issue of the Journal of the American Medical Association (JAMA) by Michelle Ridriguez, JD, “Ethical Implications of Patients and Families Secretly Recording Conversations with Physicians.”
With the ubiquitous nature of smartphones today, recording (possibly in secret) and sharing a conversation with a physician is incredibly easy.
The article provides a straightforward answer to the following question: Can patients secretly record their conversations with a physician—legally.
The short answer is Yes, in all states Except California and Florida. In those two states, all parties must be aware if a conversation is being recorded.
Additionally, except in California and Florida, the patient can take the Protected Health Information (PHI) in those secretly recorded conversations and share it with whomever they want. It’s their PHI, they can do with it as they will.
- The article has some other interesting stats:
- 58% of Americans have a smartphone
- 83% of young adults have a smartphone (however, within your employee population, you could easily have 100% of your employees owning a smartphone)
- There are benefits to recording conversations with physicians (in secret or in the open): improved accuracy of information, patient adherence, patient engagement; ability to share information with family members or caregivers; ability to better absorb information if the initial conversation is particularly emotional (e.g. being told of a new cancer diagnosis)
- There are potentially negative consequences to recording conversations: the relationship between the doctor and the patient could be damaged, words on the recording could be taken out of context.
Now let’s address openly recording a conversation with a physician. There is certainly nothing wrong with recording a conversation with a physician and telling them you are going to do so. In fact, I recommended it in a blog back in 2012.
Here is that blog. It’s still relevant today:
According to the Centers for Disease Control, 50 percent of patients walk out of their physician’s office not clear on what they were told or are supposed to do. This can occur for several reasons.
First, physicians often overestimate the topics and duration of what they have discussed with their patients. Also, telling patients once is usually not enough to get the patient’s attention or buy-in. Finally, patients also filter what they hear from their doctor in a variety of ways that physicians usually know nothing about (the patient’s health beliefs, values and previous experience.) There is a great infographic by Orca Health on this subject.
What are a couple of common instances where this breakdown in communication occurs? In my experience, the following instructions can often lend to the doctor-patient communication statistic.
—Changes in how and when to take medications. Doctors will often change the number of pills or frequency of an existing medication—so what the pill bottle says is no longer what the patient should be doing. Communication breakdown: patient takes medication incorrectly.
—Steps to take to get labs drawn or test taken. The most common confusion here is that many blood tests (cholesterol, blood sugar, triglycerides) need to be completed while the patient is fasting. Frequently, either the patient will not hear these instructions or the doctor forgets tell them (or most common, the doctor assumes the nurse will tell the patient and the nurse assumes the doctor told the patient.) The end result? The patient eats and then has their blood drawn. The test result comes back indicating the patient has high cholesterol, high blood sugar or high triglycerides and the patient is needlessly put on medication… all because they ate by accident before the blood test. Independent of cost, these medications have negative side effects (most common of which is muscle pain and weakness.) I have absolutely seen patients experience this side effect and when their blood tests are completed again (this time while fasting), it turns out they do not need to be on the medication. Communication breakdown: patient takes medication they do not need.
So if people do not know what the doctor said or what to do 50 percent of the time, what can be done to change that? Make an audio recording of the office visit.
With the prevalence of smartphones, now almost everyone has an audio recorder on their phone. There are also numerous apps that are available.
This way after the visit, you can go back and listen to the conversation with your doctor and even email a copy of the conversation to a family member.
Of course, ask your physician if you can record the conversation. Some may object, but most will not. Often patients have family members in the exam room during office visits taking notes, so most physicians are used to that dynamic.
What do you think? What are some other ways to improved doctor-patient communication?
The US healthcare system is a quagmire of miscommunication. Recording conversations could help.
To learn more about how Compass helps employees become empowered healthcare consumers, visit www.compassphs.com.