From the advice line

Dr Rachel Birch shares a recent case, where a member asked for advice on how to deal with a request from a patient to record his consultations

Miss T, a practice manager, telephoned the Medical Protection medicolegal advice line to seek advice on an unusual situation. Mr D was a new patient of the practice. He had seen Dr F twice with symptoms of anxiety and depression and had been signed off from his work as a teacher.

A few days after his second consultation, he telephoned Miss T and told her that he wanted to record his future consultations with Dr F. When she asked him why he wanted to do this, he became defensive and told her it was his “right” to do this.

She explained that she would have to discuss this with Dr F and get back to him. He suggested that if Dr F didn’t agree, he would record the consultations secretly on his mobile phone.

The request was discussed at a practice meeting, but opinion was divided on whether to allow Mr D to record consultations. It was therefore suggested that Miss T seek further advice from Medical Protection.

Expert advice

Miss T called Medical Protection and spoke to Dr M, an expert medicolegal adviser who had worked for many years as a GP, and had also studied for additional law qualifications.

Dr M advised it would be prudent for Dr F to agree to Mr D recording his consultations. She suggested that otherwise, Mr D may record them covertly, and it would be better for doctor and patient to be honest with each other. Dr M also recommended that Dr F should not refuse to consult with Mr D, as he has a duty of care to Mr D and would be criticised if subsequent harm came to Mr D.

She advised that if Dr F felt uncomfortable with the request, he may wish to discuss his discomfort with Mr D and explore further Mr D’s reasons for the request. It could have been that Mr D’s current mental health symptoms were affecting his memory and that recording the consultations could be helpful to him.

Finally, Dr M also suggested that If Mr D records his consultations, Dr F should ask for copies of each recording, so that they can be placed in Mr D’s notes to form a permanent record of what was discussed.

Learning points

• Legally, patients do not need to seek a clinician’s consent before recording a consultation, because they are processing their own personal information. A consultation should not be terminated if a patient is found to be recording it; instead, it is an opportunity to explore whether the patient has any concerns about their care or has a lack of trust in their treatment.
• A study published in the BMJ¹ demonstrated that 69% of patients expressed a desire to record clinical encounters; this was split equally between those who wished to do so covertly and those who wished to seek permission.
• It is likely that technological advances and the ability to record easily with mobile devices will lead to increasing requests from patients to record consultations.
• Patients may wish to record consultations so that they can replay them and remind themselves of what was discussed, rather than trying to take notes or bringing a friend or relative with them.
• The recording of consultations may be advantageous to clinicians too, as it is likely to be more complete than a written clinical note and could therefore provide helpful evidence if the account of events is disputed.
• Clinicians acting ethically and professionally should have no reason to be concerned about being recorded in consultations. It is possible that in many years’ time, the recording of consultations, with copies held by doctor and patient, will be commonplace.

To contact Medical Protection with your own query, contact our 24/7 helpline on 0800 561 9090

References

1. Elwyn G, Barr PJ, Grande SW Patients recording clinical encounters: a path to empowerment? Assessment by mixed methods BMJ Open 2015;5:e008566. doi: 10.1136/bmjopen-2015-008566