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I contend that there is NO valid reason for trying to raise objections to this in practice, and that clinicians so attempting risk, at the least, being 'named and shamed' for their efforts.
Any views on the subject?
I have no problem with this. However it should be declared that the patient intends to record the matter. Some people are making covert recordings
In reply to Anonymous:
Thanks for the response. Yes. Even though it is legal for patients to record consultations without announcing that is what they are doing, no clinician – or anyone else come to that – much likes the idea of being recorded covertly.
I've been prompted to follow up the reactions on the net to Glyn Elwyn's 'patientgate' article (about recording by patients, printed in the BMJ last March), and I found e.g. this opinion, posted a few days ago from a (non-medical) contributor to the huge discussion thread on which that article was actually based.:-
"I don't think covert recording implies an intention to 'catch out' a doctor. It's more likely to mean that the patient is fearful of how a request to record is likely to be received - perhaps with refusal, resentment and hostility and that certainly would affect the doctor/patient relationship. Is asking worth that risk? "
I conclude, as a handful of other comments appended to articles etc. elsewhere also indicate, that there remains an initiative in medical hands to 'close the communication gap'. Tell patients that they are welcome to take their own audio-recording home for their 'personal, family and domestic purposes' (the wording of the relevant exemption in the Data Protection Act) – and the easiest way to get that across is simply by waiting room\area notice-board.
If one has some Luddite colleagues (or, worse, officious hospital 'administration') to deal with – so be it. Better to proceed confidently with candour than risk brittle doctor-patient relationships, potentially snapping to the detriment of all parties. Whatever those consulted do, patients will record – indeed, no doubt already are recording. Let's make sure that they feel confident to do so overtly. I would much prefer to know about it.
I have had patients ask me if they could record the consultation. I have no problems with it as long as I know about it.
Perhaps we could also record our consultations with the patient's permisssion, and with modern technology the recording could be attached to the patient records; easy to access if doubts or complaints arise.
In reply to KAUSER KAZEM:
That sounds like a reasonable project, subject entirely to a patient's consent, as suggested; and, very specifically, a patient's ability to take a recording home for personal purposes should never be considered as in any way dependent on such consent being given.
However, given that the NHS has written off more costs in its failure to achieve a uniform and centralised IT system over the last 10 years (£10bn) than CERN spent in the decade it took to build the Large Hadron Collider ($9bn), I would estimate that the chances of its being put into practice successfully throughout the NHS this millennium are sub-atomically small.
A bloke is know is a train driver. Some years ago they introduced data recorders on all trains; I think after an accident. Initially there was a lot of hostility to them - they were seen as a management spy tool designed to catch drivers out. However, he tells me, they have saved more drivers than condemned them. If the driver is working competently then he's nothing to fear. It also seems they've stamped out some bad practices like speeding!
Maybe they can actually protect us from complaints?
In reply to Aaron Chandra Borbora:
I don't understand why the ethics of this appear to be contentious. It's the law. I can covertly record MY consultation. I don't need to justify it. But I do concur that some may possibly would prefer to declare it and fear the GP response. Ironically they are likely to be those GPs that think this is an ethics issue.
I agree with the previous post. In case anyone missed it, they might be interested in both the medico-legal article and the comments appended to it, as linked below:-
PATIENTS AUDIO-RECORDING THEIR CONSULTATIONS
Standards, law and opinions: some chapter and verse, all in one place
"Patients sometimes tape-record consultations for a variety of reasons. Usually it is to help them remember and cooperate with important advice or share it accurately with family members …recording should not be banned but should be done openly…"
Extract from Everyday Medical Ethics and the Law 2013, published by the British Medical Association ('BMA') Ethics Committee
GENERAL MEDICAL COUNCIL ('GMC')
Doctors should or must:-
- give patients the information they want or need to know in a way they can understand.
- make sure that arrangements are made… to meet patients’… communication needs.
- treat patients fairly and with respect whatever their life choices
- support patients in caring for themselves to empower them to improve and maintain their health
(Extracts from the GMC's publication Good Medical Practice, 2013).
- work in partnership with… patients… sharing with them the information they will need to make decisions
- discuss with them their condition and treatment options in a way they can understand, and respect their right to make decisions… no single approach to discussions about treatment or care will suit every patient, or apply in all circumstances
- tailor [their] approach to discussions with patients according to [patients'] needs, wishes and priorities
- not make assumptions about… the information a patient might want or need
- share information in a way that the patient can understand and, whenever possible, in a place and at a time when they are best able to understand and retain it - give the patient time to reflect, before and after they make a decision …make sure, wherever practical, that arrangements are made to give the patient any necessary support. This might include, for example: using an advocate or interpreter; asking those close to the patient about the patient’s communication needs; or giving the patient a written or audio record of the discussion and any decisions that were made.
- in all cases… treat patients fairly and not discriminate against them. - maximise patients’ opportunities, and their ability, to make decisions for themselves - respect patients’ decisions.
(Extracts from GMC supplementary, "explanatory guidance'" Consent: patients and doctors making decisions together . )
"Ask the patient whether they want to be accompanied at consultations by a family member, friend, or advocate, and whether they would like to take notes and/or an audio recording of the consultation."
Guidance from the National Institute for Health and Clinical Excellence ('NICE') of Feb. 2012 entitled "Patient experience in adult NHS services: improving the experience of care for people using adult NHS services." (para.55.)
"…sound recordings could act in doctors' benefit 999 times out of 1,000. If the doctor is behaving professionally and responsibly they should not be worried."
Dr Nick Clements, director of medical services at the Medical Protection Society (the largest medical insurer in the world) reported in GP Online (then called 'the healthcare republic') in May 2010.
"Patients do not need their doctors' permission to tape a consultation as the information they are recording is personal to them and therefore exempt from data protection principles. Section 36 of the Data Protection Act 1998 states: "Personal data processed by an individual only for the purposes of that individual’s personal, family or household affairs (including recreational purposes) are exempt from the data protection principles and the provisions of Parts II and III"
"If you suspect that a patient is covertly recording you, you may be upset by the intrusion but if you act in a professional manner at all times then it should not really pose a problem. Your duty of care also means you would not be justified in refusing to continue to treat the patient. If you did, it could easily rebound on you and further damage your relationship with the patient. And remember that your refusal to continue with the consultation could be recorded."
Dr P. Zack, medico-legal advisor to the Medical Defence Union, the largest UK medical insurer; article at MDU website. Nov 2013
06 11 13 "Solicitors have warned GP groups such as Bedfordshire and Hertfordshire LMC that patients are within their rights to record consultations with or without their GP’s consent or knowledge."
BMJ (British Medical Journal):-
(i) "Patients had entirely different perspectives. What did doctors have to hide? What was their problem? Many patients said that they would love to have a recording, for many reasons. They wanted to listen again and also wanted to share the recording with their family. Others said that it would be the evidence they needed if they were dissatisfied, saying that their efforts to get better care in the past had been a waste of time…" "Having a record of clinical encounters changes everything: we might want to make sure the change is for better, not for worse".
Article, "Patientgate" by Prof., G Elwyn (11 03 2014)
The article is also available at:
(ii) "We recognise that digital recording of clinical encounters could greatly enhance the quality of patient care through improvements in clinician performance. Patients now have the motivation, the means and also the right to make & keep recordings of THEIR clinical encounters: they will take the opportunity whether we offer it or no…"
Drs Burgess & Davies, Royal Liverpool & Broadgreen University Hospitals NHS Trust. Response to patientgate article above. Reader responses are available from:
(iii) "The increasing use of patient-held devices to record consultations has to be accepted as a result of the technology-rich society we live in. In Oncology, we have used these developments to our advantage to help patients handle the increasingly large amounts of information that we have to give them."
Douglas J Adamson Consultant Radiotherapist NHS Tayside . 19 03 14 A further response to patientgate. See ((i) & (ii) above.
From "INSIDE HEALTH" with Dr Mark Porter (Radio 4 09 07 2014):-
Patient: "… I’ll record… when…I don’t have time to have somebody with me or maybe it’s so private I don’t want somebody with me. I feel I have to do it covertly because I don’t want to get the same reaction I had with my GP who effectively wanted to strike me off the list. The recordings have been more useful than you can imagine. I think that patients only hear half of what is said in the consultation and subsequently they remember even less. So when I’ve had quite long and detailed consultations I can play the recording back later; sometimes I actually write the recording out by hand. I find them invaluable.
" Dr McCartney: "I think absolutely I can see why it is that many patients might find it to be useful to have a permanent record of what the consultation was.".
From "HEALTH CHECK" with Claudia Hammond. (BBC World Service 18 06 2014):-
Prof. G. Elwyn:". I think we'll see this behaviour becoming normalized…" " …the fact that patients now are doing this covertly knowing in fact that they wouldn't be given permission is just a sign that something is not right in medicine"