Videotaping of general practice consultations

BMJ 1995; 311 doi: https://doi.org/10.1136/bmj.311.7010.952a (Published 07 October 1995) Cite this as: BMJ 1995;311:952
  1. Jacqueline E Bain,
  2. Neil S D Mackay
  1. Research assistant Department of Social Sciences, Glasgow Caledonian University, Glasgow G4 0BA
  2. General practitioner Surgery, Alexandria G83 0NB

    EDITOR,--L Malcolm Campbell and colleagues state that the consent rate for videotaped consultations in their study was 91%, which shows the vulnerability of patients to coercion.1 The method of obtaining consent has an important bearing on this figure and is not described by the authors. When coercion and bias are removed, consent rates in the order of 4-10% are to be expected.2 3 Last year the General Medical Council issued guidelines on videotaping consultations to offer patients some protection from exploitation, and Campbell et al have noted that adherence to a similar protocol has resulted in falling consent rates.4

    We also take issue with the authors' unquestioning acceptance of the results of their questionnaire survey on patients' satisfaction. The subjects' responses are likely to have been influenced by a perception that their doctor's participation in a videotaped consultation renders this an acceptable or desirable exercise, particularly in practices in which consultations are habitually videotaped. In addition, there is the phenomenon of patients who agree with every statement, which was recognised by the designer of the questionnaire used in the study, who warned of the confounding effect of “the acquiescence response set.”5

    Furthermore, in these days of widespread ownership of and exposure to camcorders it is fatuous to argue that patients who have not previously been asked to take part in a videotaped consultation cannot give a valid opinion about their expected response to such an event. While most of us have never broken a limb, this does not stop us giving an authoritative statement on whether we would expect this to have a beneficial or detrimental effect on our quality of life.

    Campbell and colleagues have failed to address inherent biases that have corrupted other, similar studies. Their results are therefore misleading and do not refute our evidence that patients are vulnerable to coercion into participation in videotaped consultations in which they expect to feel uncomfortable or inhibited.


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