Someone Looking Over Your Shoulder

Dr. Adam Tabriz

The Increasing Prevalence of Recording Medical Visits
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According to a recent study (where 456 clinicians and 524 public respondents completed surveys) more than one-quarter of clinicians (129/456, 28.3%) reported that they had recorded a clinic visit for patients’ personal use, while 18.7% (98/524) of the public reported doing so, including 2.7% (14/524) who recorded visits without the clinician’s permission. Amongst clinicians who had not recorded a clinic visit, 49.5% (162/327) would be willing to do so in the future, while 66.0% (346/524) of the public would be willing to record in the future. Clinician specialty was associated with the prior recording: specifically oncology.

According to a publication by Dartmouth Institute, a study reveals public and physician attitudes on recording clinical visits: “Recording clinical visits could help us tackle some of the biggest challenges in healthcare. It could help patients with chronic conditions better adhere to their treatment plans, potentially lowering costs. It could help alleviate the documentation burden many healthcare providers currently face,” Assistant Professor Paul Barr says.

“But, we urgently need to have some policy guidelines in place for clinicians and patients — we needed them yesterday.”

But on the other extreme, a recent publication in the Journal of Medical Economics sheds light on some medical, legal, and ethical challenges that recording may bring to the table. Health information is sacred, valuable, personal, and most of all extremely private. It is of utmost importance to protect it.

When it comes to recording certain communication that would otherwise have no relevance to patients direct visits may accidentally be recorded that may induce invasion of privacy of the physicians' office or other patients within the vicinity.

The other concern is mutual consent between treating physician and patient required or can a patient record without provider knowledge. And in the extreme scenario is that recording held valid in the court of law and if so is the content of the recording in synchrony with the content of the health record? And legally under state, local or federal jurisdictions how would that translate. These are very valid concerns and questions when looked at objectively.

What does recording mean from a patient's perspective and what does physician feel about it?

Obviously, the above articles did focus on the benefits of sharing visit recording from the compliance point of view but we should never forget and sure not be presumptuous that trust and relationship are also may play a significant role. The reasons for recording a visit can be influenced by the specialty.

For example, in plastic surgery, it could lead to litigation but in primary care may represent simply a tool for better compliance. Physicians are people and have comfort zones by which they can practice at top of their expertise.

There is no doubt that patients are entitled to their health information. I personally believe they have entitled to the entire record and not just a copy. And it is very much known that most states respect the patient's right to hold a full copy of their record but even in those states the practice is still not prevalent. Question is, do patients really need to record their visits?! Do we really need to take the hard route to maximize patient compliance or even gain their trust?!

I believe not!

I personally believe the increasing prevalence of clinic visit recording stems from a variety of reasons:

  • Physicians are unable to spend enough time with patients due to increased workload, which in turn creates a poor doctor-patient relationship causing less than optimal trust
  • Patient fear of forgetting the doctors' recommendations
  • Alternate legal motives
  • Or simply being able to have a quick copy of the record

The 21st century is an information-rich era. Patient's access to health data and every other type of information is just a click away. Millennials are information conscious and have higher expectations. Consumer attitudes are at their highest ever. So why not control their own health records and share the common pieces with physicians and providers.

Patients are the most up-to-date source of their health data there is and there will ever be!

Based on that it only makes sense to give them what inherently belongs to them. This will ensure their full compliance based on referring to their record. It will also reduce health information piracy, invasion of privacy. It will increase the quality of the physician-patient relationship and trust. Casual recording whether consented or not, offered by a physician or requested by the patient, for whatever reason is unnecessary under basic clinic circumstances unless there is a clear-cut reason to do so. Even then a mutual agreement is vital to ensure a healthy relationship.

Refusal of recording by treating physicians must not reflect as negative, just as it should not be perceived as disrespect requested by the patient.

It is imperative to empower patients, support independent physicians and promote personalized medicine, because that is what our healthcare system is asking for and not an old-fashioned population-based model burdened by shortcuts, bureaucracy, and piecemeal solutions. It is time to create healthcare without borders using technology, strategy, and hands-on support.

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Adam Tabriz is a Physician, Writer, Entrepreneur, and public health policy, expert. He is an advocate for Personal liberty. The combination of his experience and expertise underlines his passion for advocating true “Personalized Healthcare” and “Healthcare without Borders.” His favorite slogan is: “Peace of mind would come to all people through the universal respect for the basic human rights of everyone”

San Francisco, CA

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