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Front Desk

by Stephanie Sisk

  • September 14, 2016

Can you speak louder?

smartphone

Audio and visual recording of professionals doing their jobs has been a hot topic here. Exhibit A: the Chicago Police Department.

Dentists aren’t pointing guns at anyone, but the prospect of patients recording a visit with their dentist isn’t unlikely in the age of the Smartphone.

An article in the Journal of the American Medical Association last spring touched off a flurry of response, positive and negative. Arguments swirled around legality, privacy, ethics, implications and responses to recordings.

Recording audio and video, literally, is in hand. Nearly 60 percent of Americans have Smartphones – make that 83 percent among young people – with amazing built-in capabilities, to say nothing of the dizzying array of “apps” available. And recording someone, even without their knowledge or consent, is legal in all states except California and Florida.

That takes care of the legal parameters, but opinions run strong on the issues of privacy and ethics. A few physicians who reacted to the issue in an article in Medscape last year welcomed recorded exam room discussions as a way for the patient – particularly one who may be groggy or stressed – to have accurate information on prescriptions or follow-up directions as well as the ability to share the doctor’s instructions with family members or caregivers. 

Most others felt otherwise. They strongly objected to being recorded “secretly” and believed the recordings irrevocably violate and damage the doctor-patient relationship. They worried that recordings could be used and even manipulated in the event of a malpractice lawsuit. 

"There is a lot of uncertainty in what we do,” wrote one emergency room physician, “uncertain diagnoses, uncertain responses to treatment, and uncertain outcomes. I can see an audio recording of a visit being edited to remove any precautionary uncertainty conveyed. . . and used to present an alternative view to the written medical record. Which one should then take precedence if and when a case goes to court?"

Still, others recommend finding a way to work with recordings. 

The JAMA author advised physicians to ask whether the conversation is being recorded. “Then, regardless of the answer, the physician can express assent, note constructive uses of such recordings, and educate the patient about the privacy rights of other patients so as to avoid any violations. Taking such an approach would demonstrate the physician’s openness and desire to strengthen the relationship with the patient. The physician could also ignore any suspicions and provide care as he or she normally would without letting the possibility of recording affect either attitude toward the patient or medical decision-making.” 

Failing to accommodate audio recordings in the exam room seems akin to holding back an ocean wave in this Smartphone age. If recordings – made by patient or doctor – would be acknowledged and shared between both parties, no one would have the “upper hand” and the benefits to the patient – an accurate account from the doctor – would be valuable. Ultimately, isn’t that good patient care?

The views expressed in this column are those of the writer and not necessarily the opinions of the Chicago Dental Society. CDS presents Front Desk, a column addressing problems dentists and staff members experience in the office. Front Desk is prepared by Stephanie Sisk, a freelance journalist. Suggestions? Email suggestions for topics to be covered to the Chicago Dental Society.
© 2016, Chicago Dental Society
Photo: Dmytro Gilitukha / Shutterstock.com