Exam room today, YouTube tomorrow?

September 22, 2015

How will you react when a patient asks to record their visit to your practice?

Thanks to the advent of smartphone cameras, people now are able to document everything. My mom has a home health aide who writes out a shopping list for my wife, but then photographs it and sends it to me as a text message.

Law enforcement officers know only too well that their every word and action may be caught on camera during the course of doing their jobs and transmitted to the media before they even get back to the police station.

A few years ago, Peter (not his real name), a new patient in his 20s came in for a physical and I noticed a skin lesion on his upper chest that met criteria for suspicion of skin cancer. We arranged an appointment for him to return so that I could remove the lesion.

I entered the exam room expecting to find just the patient. He was waiting on the exam table with his shirt off. He introduced a woman in her 20s waiting with him as Gail, his girlfriend.

I was starting to pick up the written informed consent for the patient when he asked, “Would it be OK if Gail stayed in the room” while I did the procedure? I told them I did not have any objection as long as she did not get in the way. His next question: “Would it be OK if Gail shot a video of the operation?”

This was a first for me. I thought about it for a minute and agreed. I realized at that moment any error of omission or commission (in the words of a malpractice lawyer) would be duly recorded for a jury to watch later.

I agreed to the iPhone video and decided I would relax and do my job appropriately. From sterilizing my hands to closing the defect, I was deliberate and careful in all my movements. I ended by having the patient sit up and we posed together for the final screen shot: happy patient and relieved physician.

Would I agree to have one of my procedures video recorded again? Sure. I have no proprietary secrets in my clinical skills. Patients with a desire to have their procedure recorded are welcome to arrange it on their own.

New parents have been photographing and recording obstetrical deliveries for years. The only concerns: Is there any problem with not getting consent for the recording if it is being done by the patient or his or her agent? Are you being set up for an intentional mishap the patient can get on film and hold against you later?

The video recording can work both ways, however. In the event of a problem outcome, the video can serve as your proof that you did everything correctly as well as documenting the bad outcome. Remember that if you allow your patients to film you today, we all may be able to see you on YouTube tomorrow.

Jeffrey M. Kagan, MD, is an internist based in Newington, Connecticut, and a member of the Medical Economics Editorial Advisory Board. Do you allow patients to record video or audio during their visits? Tell us at medec@advanstar.com.