Head To Head

Should doctors encourage patients to record consultations?

BMJ 2015; 350 doi: https://doi.org/10.1136/bmj.g7645 (Published 08 January 2015) Cite this as: BMJ 2015;350:g7645
  1. Glyn Elwyn, professor, Dartmouth Institute for Health Policy and Clinical Practice, 37 Dewey Field Road, Hanover NH 03755 USA,
  2. Laurence Buckman, general practitioner, Temple Fortune Health Centre, London UK
  1. Correspondence to: G Elwyn glynelwyn{at}gmail.com, L Buckman l.buckman{at}ntlworld.com

Patients are doing it legally anyway, and it will lead to better practice and shared decision making, says Glyn Elwyn. But Laurence Buckman worries it could lead to defensive practice and risk the doctor-patient relationship

Yes— Glyn Elwyn

Some patients already use their smartphones to record clinical encounters; many do not ask for permission or make it obvious. In this situation, what should doctors do? Protest? No—doctors should encourage patients to record their meetings openly because it can help improve patient care, encourage more evidence based medicine and shared decision making, and increase trust and openness. It would also circumvent covert recording and support patients’ legal right to record clinical encounters. Arguing that doctors should not support patients who want to record their clinical encounters is like putting our heads in the digital sand.

Improved care

By far the strongest argument for encouraging patients to record consultations is that it is likely to improve the quality and safety of patient care. No studies have shown this, but it would be odd if clinicians did not adhere to good practice when being recorded. Evidence that patients like recordings comes from research done over the past 30 years in which clinicians have given patients audiotapes of their clinical encounters, typically in oncology and paediatric settings, and mainly in Europe.1 A review of more than 30 studies concluded that patients place a high value on receiving such recordings, their increased understanding, and the ability to share the recording with family members.1 Similar results would be achieved if patients were encouraged to record their own clinical encounters.

Granted, some negative effects could occur if recording became commonplace. Doctors might order more tests and generate more referrals and more follow-up visits. This kind of defensiveness may well lead to overdiagnosis, overtreatment, and increased costs.2 However, I …

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