Intended for healthcare professionals


Can video recording revolutionise medical quality?

BMJ 2015; 351 doi: (Published 21 October 2015) Cite this as: BMJ 2015;351:h5169
  1. Martin A Makary, professor of surgery and health policy and management,
  2. Tim Xu, medical student,
  3. Timothy M Pawlik, professor of surgery and oncology
  1. 1Johns Hopkins University School of Medicine, Baltimore, MD 21287, USA
  1. Correspondence to: M A Makary mmakary1{at}

It’s time to hit the “record” button

In June 2015, a man living in Virginia returned home from a routine colonoscopy to discover a big surprise. Hoping to record the instructions he received from medical staff, the patient had actually recorded the entire procedure on his phone. To his shock, he learnt that the anaesthesiologist and gastroenterologist had viciously insulted him while he was sedated and had entered a false diagnosis in his medical record.1 The man sued his physicians, and the jury awarded him a large payment for medical malpractice.

It seems unlikely that this type of behaviour would have been detected by any existing hospital mechanisms. Current systems to detect poor behaviour require staff to overcome their fear of retaliation and turn in a colleague. Rather than rely on individuals to report lapses in quality, new technology has the ability to record how we perform at our jobs. As well as detecting unprofessional behaviour it has the potential to radically improve quality through increased accountability—as witnessed in other businesses such as child care. Video recording …

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