Hello my Zebras and Spoonies! Thanks for visiting and hanging out with me today, I’m glad that you are here.
Today I want to talk about patients recording their doctor appointments. With about everyone having a smart phone these days, it is pretty easy to take photos, videos and audio recordings of about everything in our lives. Many have started including their doctor appointments in the list of things to record. There is a lot to this topic, but let’s start with the the legal stuff.
Most states in the USA are “one party” states which means that if one person within the conversation consents, the conversation can legally be recorded. There are some states that are “all party” states (California, Connecticut, Florida, Illinois, Maryland, Massachusetts, Michigan, Montana, Nevada, New Hampshire, Pennsylvania, and Washington) and require that everyone involved in the conversation consent to the recording. This means that in most places in the USA it is legal for a patient or provider to record an appointment. It is worth noting that HIPAA still applies. This means that any recording made by a provider may not require a patient’s consent, but will still be considered protected health care information under HIPAA. A patient however, is not limited by HIPAA rules. They have the right to use their medical information in any fashion that they choose.
Why are people choosing to record medical appointments? The overwhelming reason is for purposes of creating a personal record for improved recall and understanding. The truth is that most patients leave their medical appointments feeling unclear about what was said and often unsure of what they are supposed to be doing. Historically, patients have been bringing a support person with them for their appointments to help them with note taking so that they could have a better sense of what was discussed during the appointment. COVID has changed that. Most medical offices and hospitals are no longer allowing patients to bring a support person with them to their appointments. This has been a major hurdle for many in the chronic illness community who face many barriers when attending their appointments already such as brain fog, fatigue, anxiety, medical PTSD and information overload. Many of us attend a lot of appointments and can easily get saturated.
This has left many patients needing to find new strategies to ensure that they are getting the information that they need. Because the truth of the matter is that having a support person attend a medical appointment with you through zoom simply doesn’t work. I’ve tried it. The connections are often poor quality and make it hard for the support person to hear what’s being said. The provider usually forgets that the support person is attending the medical appointment and thus doesn’t ensure that they are properly included in the discussion. Some patients are filing paperwork for a reasonable accommodation to allow a support person at their appointments. This comes with its own challenges. The first being that it is a lot of work because it requires the paperwork to be filed with each office and hospital that you visit. Then you need to wait to see if they approve your request or not. If the request is denied the patient then has to decide if they are going to pursue it further. In the end, this isn’t a very practical option for most people with chronic illness because of the amount of time and effort required to accomplish acquiring this accommodation. This leaves many patients choosing to record their medical appointments. These recordings allow them to share their appointments with their support people and to review the recordings for note taking.
The other reason that patients desire to record medical appointments is for the purpose of collecting evidence of wrong doing or inappropriate behavior. The first thing to note about this is that while it may be legal to make a recording at your medical appointment, that doesn’t guarantee that the recording will be considered admissible in court as evidence. I think that the largest issue here is the demonstration of the lack of trust that a patient has for their provider if this is the reason they are considering recording an appointment. My advice in that situation would be to simply find a different provider rather then to make recordings of the appointments with them. You should never trust your care to someone that you do not trust.
Providers have started recording medical appointments to create a resource for their patients. Many offices and hospitals now have a platform where patients can access their medical records from home. Using these secure platforms, many providers are now also making recordings of appointments part of this record. It reduces the charting that providers have because there is no need to document what education was provided or topics reviewed as this is recorded. The documentation is solely the assessment of the patient. The benefit to the provider is that it saves them time by reducing the amount of charting required. The benefit to the patient is that they have access to the recording and can share it or take notes as desired. It is also one less thing for the patient to handle.
There are clear advantages to recording medical appointments. But there are also some down sides. The first being how to have that conversation with your provider. And you really should have that conversation, even if the law allows you to record the appointment with out their knowledge. Remember that trust is a two way street. If a provider discovers that you have been recording the appointments without telling them it will create a breech of trust and is likely to cause some major problems in the provider-patient relationship. Finding a good provider is difficult, so don’t risk loosing a good provider because you avoided a tough conversation. Just be up front with your request and explain the reasons that you want to record the appointment. If they decline, respect that. However, if they decline recording it might be a reason to re-evaluate if they are the right provider for you.
The other down side to recording appointments is that these recordings can be edited and things taken out of context. Because of this, I think the best option is to have a system were both parties have a copy of the recording. This is why I personally really like the idea of the provider doing the recording and making it a part of the medical record that is available to the patient. Then everyone has a copy and nothing can be taken out of context. The other advantage to it being a part of the medical record is that the recording will be admissible to court.
As technology changes it becomes more and more readily available; people are going to continue to use it to make their lives easier. Recording medical appointments is just another example of this. As this pandemic continues to stretch on and patients are continued to be denied having a support person present at their appointments, these recordings are only going to become more common. As providers, we need to realize the importance of the support people that we are denying our patients and we need to allow our patients the means to make up for that loss. As patients, we need to be respectful when making these recordings. With good conversations, we can make this technological tool a great resource to improve health care.