Most smartphones now have features that allow them to also be recording devices, but this innovation could also lead to conflicts in the clinician-patient relationship and quality of care. A new viewpoint in the Journal of the American Medical Association weighs the pros and cons of the secret recording of conversations by patients with their clinicians.

Federal law bans the recording of a private conversation unless at least one party consents to the recording (the person operating the recording device or others); only some states require consent from all involved parties.There are many potential benefits for patients with recording conversations in improving recall, sharing information with family and caregivers, and gaining a greater understanding of what is discussed during office visits that may lead to improved treatment adherence. Recording visits in places like intensive care units can also help families in reviewing information, especially if faced with end-of-life decisions. However, patients or family members may use this type of recording in establishing grounds for a lawsuit or gathering material for manipulation. They could also take comments out of context and distribute via social media if they disagree with their clinician’s advice.

If a clinician learns that their conversations have been secretly recorded, they may feel vulnerable and the integrity of the physician-patient relationship could be threatened. Even if the clinician suspects that they are being recorded, it could lead to the ordering of additional tests and imaging as defensive medicine (and in turn increasing healthcare costs). Because changing laws to require two-party consent for these recordings could take years or decades, the authors offer the following suggestions:

  • Be professional and make sure that language conveyed to patients is expressed efficiently, effectively, and compassionately.
  • If the clinician suspects that the conversation is being secretly recorded, ask the patient directly if he/she is recording the conversation. Create a dialogue regarding both privacy rights and constructive uses of these recordings.
  • The clinician can also choose to ignore these suspicions and provide standard care without the potential recording affecting medical decision-making.

Would you be ok with a patient recording your conversation?

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