“Doctor, can I record this conversation?”

It’s happened to me a couple of times already. But the question in the title of this post was never asked. Rather I was informed later on that my conversation with a patient or family was recorded without my knowledge. Smart phones have made it all too easy for patients to secretly record conversations with their healthcare providers. Simply hit a button,  lay it innocently down by your side in the office or hospital, and patients get an instant video or audio capture of a conversation with their physician.  When my medical team and fellow physicians found out about the unauthorized recording of our conversation, the news was met with a combination and anger and disgust.

That reaction, it seems,  is typical of what most physicians would feel in the same situation. Why would a physician be upset about a patient secretly recording a conversation with them?

Well, simple, really. Most physicians are in chronic fear that the next person to hear/view that recording will be a malpractice lawyer, dissecting it,  consonant by consonant,  probing for potentially actionable material. The recording, in the physicians mind, changes the nature of the physician-patient relationship. It makes the patient a potential adversary, it makes the doctor feel as if they are in front of a jury and can not speak frankly, it makes them feel as if they are unworthy of trust. In other words, physicians do not like being recorded because they assume that the person recording them has negative motivations.

But let’s pause for a moment and look at this a different way. . . what if they don’t have negative motivations?

What if it’s the 74 year old husband, who I counseled extensively about how to help keep his COPD at bay? And the next time when he came in with his wife she tells me “he said you didn’t tell him anything!” What if it’s the woman, whom at every visit, can’t seem to remember which medication I told her to stop and which one to start? And how about the concerned adult children who couldn’t make it to their parent’s appointment and want to talk to me about how their parent is doing?  Might those people benefit from the ability to record a discussion with the physician?

That that end, Cullman Regional Medical Center instituted a plan that created audio recordings of the instructions that patients received at the time of discharge from the hospital. The audio was a verbatim recording of what the patient was told as part of their discharge, which was administered by a nurse or case manager.  The recordings were uploaded to a cloud, where they could be accessed by calling in, or via the web. The hope was that the recording could help clarify any confusion that the patient or their families may have about the numerous questions that often arise after leaving a medical facility. They called the program, appropriately enough, “Good To Go”.  The program turned out to be a great success, not only did it improve patient satisfaction scores but surprisingly  reduced 30-day readmissions by 15%.

So to my patients who feel the need to secretly make recordings of our conversation, please feel free the ask the question, “May I record this conversation?” You’ll find the answer is often “Yes, please do!”

– Deep Ramachandran is a Pulmonary, Critical Care, Sleep Medicine physician and a Social Media Section Editor at Chest Journal.  I am on twitter @caduceusblogger.