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Audio-recording your consultations with NHS doctors

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Tee hee. I'm not guilty of fanning the flames in Pulse on this occasion, Sali. I took the view that the protesting medics were doing such a good job of making asses of themselves all on their own, they needed no further assistance from me.

………………………………………………………………………………………

 

For those that missed it, here's a link to Mr Clarke's case, as Sali mentions.

 

http://www.dailymail.co.uk/health/article-3057449/Nurse-suspended-removing-alarm-buzzer-brain-damaged-patient-kept-calling-help-tells-disciplinary-panel-doesn-t-care-isn-t-interested-case.html

 

The case continues, but it's exactly the sort of vital, covert surveillance involved here which Shaw Healthcare is trying to prevent, of course.

………………………………………………………………………….

 

Further to which, I mentioned some factoids derived from their latest published report and financial statements (31 03 14) a little while back. Here's few more.

 

The adverse publicity stemming from the Wright family's covert recording of abuse at the Granary in 2012 caused Shaw to write down the value of that unit by over £2m during the latest reported financial period. When you are balancing £97m of debt on net assets of less than £6m (that is, of a value less than the annual cost of servicing that debt), £2m is not a bottom line loss you can afford to take very often, or perhaps ever, again.

 

But Shaw Healthcare's chief executive (Jeremy Nixey) wrote to relatives following the latest round of severely adverse publicity complaining that it was unfair, indeed defamatory, of the media to imply that in trying to remove recording devices without the permission of residents or their relatives Shaw was "trying prevent covert filming to protect its own staff and public image" when, far from it, the letter claimed, Shaw was just 'looking after the best interests of residents'!

 

Have they never heard of the adage 'when in a hole stop digging'?

………………………………………………………………………………….

 

Here's a link to yet another failed inspection of a Shaw Healthcare care home (Victoria House), published on 22 04 15. Inadequate in 4 of the 5 service levels assessed:-

 

http://www.cqc.org.uk/sites/default/files/new_reports/AAAB6580.pdf

 

The keen-eyed may have spotted that in all the Shaw Healthcare care homes where there have been (sometimes seriously) adverse reports the same person is mentioned as the 'responsible person' and that is Jeremy Nixey, the aforementioned chief executive of the Shaw Healthcare "Group".

 

This prize clearly carries the can for a lot of substandard care.

 

I wonder if he's read the new regulations which came into force for all 'service providers' on the first of this month with particular reference to 'fit and proper persons' to be directors or carry out the function of directors of such a provider. Such individuals must not (inter alia) have:-

 

"… been responsible for, been privy to, contributed to or facilitated any serious misconduct or mismanagement (whether unlawful or not) in the course of carrying on a regulated activity…"

 

See section 5 of the statutory instrument available here:-

 

http://www.legislation.gov.uk/uksi/2014/2936/contents/made

 

Food for thought.

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Shaw Healthcare were able to open/operate a new care home when they already had question marks over the safety and standards of care in existing homes? How was that allowed to happen?

 

Mr Nixey's, Shaw's Healthcare's Chief Exec, claim that Shaw was 'looking after the best interests of residents', (by removing hidden cameras) is shameful in the light of what happened to Gladys Wright. Oh, what a tangled web they weave, when first they practice to deceive.

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I think that one reason behind the new regulations about 'fit and proper persons' may be to strengthen the CQC's hand when it comes to approving or declining applications for the registering of new facilities providing 'regulated services'.

 

The trouble is, in my book, that the CQC is ineffectual in wielding the powers it already has, so why should one expect the situation to change because of a bit more statutory print?

……………………………………………………………………………………..

 

Now here's an interesting new ('medical research') article bang on our topic. It comes from the (New Hampshire) 'Dartmouth Institute' team whose members include Prof. Glyn Elwyn - no stranger to regular readers of this thread. It was published only two days ago:-

 

["Patients covertly recording clinical encounters etc."]

 

http://journals.plos.org/plosone/article?id=10.1371/journal.pone.0125824

 

"…It seems that the growing emphasis on patient engagement [3] [4], health activism and consumerism [5], coupled with the ubiquity of recording devices, has given rise to a new trend of patients recording clinical encounters, with some acting covertly…"

 

If some of the quotations the article includes seem vaguely familiar, it may be because they have also been excerpted in this thread over the years.

 

This thread itself came within the purview of the authors' research. The entire set of posts here (which at the date of the research numbered 606) is labelled T24 (T= 'text') in the table 'S3 ' noted at the end of the article. (One has to feel a bit sorry for the researcher who had to read all of that lot!)

 

What goes around comes around, however, and I am now going to check all the references in table 3 to see if there is anything I have missed; and I will also to produce the article and the table to my next ''patient participation group' meeting as an illustration of the extent of online commentary on the issue.

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Hello,

Thank you for this very useful thread. I've read through the last 15 pages. I am considering recording covertly but would prefer to do so openly, however I've been told that my care co-ordinator would refuse to work with me if I recorded appointments and the mental health trust I use says it does not allow staff to be recorded. Covert recording is listed as a grounds for labelling someone a vexatious complainant (two grounds needed out of a long list) so I don't want to put myself in that position.

 

 

So, I have two questions

1) Can anyone recommend a very, very discrete recording device for covert recording (simply for me to use to check my own memory)

2) Does anyone have any suggestions about how I can challenge the trust or get it to change it's policy so that I can record openly and refer openly to my recordings if there are difference in opinion.

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Welcome to this thread, tillandsia - and, indeed, to CAG.

 

Site rules say we must be careful not to do anything that looks like advertising. So I won't say which exact type of recorder I use currently, but it's a device quite a lot like this:-

 

http://www.amazon.co.uk/eSynic%C2%AE-Digital-Recorder-Dictaphone-Aluminium/dp/B00GRKC3YI/ref=sr_1_7_m?s=electronics&ie=UTF8&qid=1430667020&sr=1-7&keywords=recorders+digital

 

In fact, following the example of a contributor here called 'My Turn', I use two of them at the same time in case of accidents.

 

As regards Trust policies, there is a difference between someone covertly recording parts of a complaints process (where the relevant, written, 'policy' quite often has the silly 'vexatious complainant' terminology) and someone wishing overtly to record their own consultations, which is perfectly legal and sensible.

 

You could start by writing to the Trust Head Office asking to see any written policy of theirs which forbids the latter. They may not actually have one.

 

As regards resisting any 'informal' or 'ad hoc' refusal to let you record openly, you might find the various statements by e.g. the GMC BMA, NICE , medical insurers etc. over recent years of assistance. You can find a useful compendium of many of those at a post of 29 08 14 in this BMA thread:-

 

https://communities.bma.org.uk/bmaspace/f/21/t/314.

 

You could pursue this by way of formal complaint to the Trust (without even bothering with the delay of asking for any written policy first). Write to the Chief Executive setting out the facts, insist on calling your protest a 'complaint' (not a mere 'concern') and chase them for formal answer in due course.

 

We have had contributors here who have fought and won on this issue. Arguably - very arguably, see the 'compendium' - it is the doctors and\or the NHS bodies that are acting against best medical practice, not you. And I know for a fact there are mental health trusts that permit recording by their patients during (one-to-one) consultation. There is no good reason why they shouldn't do this for their personal and family purposes. It's THEIR information.

 

The very best of luck, and do hope you will come back here and let us know how you get on.

 

 

.

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Thank you very much for replying :)

 

 

The complaints policy says 'Are known to have recorded meetings or face-to-face/telephone conversations without the prior knowledge and consent of other parties involved.' So, if there is disagreement during a complaint it becomes impossible to refer to recorded evidence of a consultation unless the consultation has been recorded openly....which isn't possible if staff won't allow that.

 

 

I will try your suggestion of writing and asking for written policy on recording consultations and staff refusing to continue treatment if there is a recording. So far they have said verbally that they do not record, and staff involved in my care have said they will refuse to be recorded. I'll let you know how I get on.

 

 

Thanks again

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Hi Tillandsia and All,

 

 

just wanted to add I finally got Two (thanks to myturn and Nolegion :-) ) of these:

 

 

http://www.amazon.co.uk/gp/product/B005SCYQGE?psc=1&redirect=true&ref_=oh_aui_detailpage_o04_s00

 

 

And am very happy with them - crystal clear. Amazing little gadgets and very easy to use. But there is a red light when the device is turned on which lasts five seconds or so and then goes off - I think some lights may stay on and flash and may show through a pocket or an envelope....so something to be aware of. Also be careful to voice date and time stamp the beginning and the end of the recording.

 

 

First time mine was used recording a consultation - I didn't actually know it!

 

 

There was a conflict that arose and my friend switched his on. Unfortuantely, it missed the initial problem (Lesson learned - REMEMBER TO SWITCH IT ON!) but after listening back to the consultation, I was shocked at how graceful, diplomatic and relaxed I remained throughout the stress as the medic back tracked and lied.

 

 

I need to be quicker off the mark and firmer in tone. I also need to project my opinions and objections just a little stronger, but not much more. Other than that I am uncharacteristically impressed with myself and in awe of these little, friendly devices!

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

'staff will refuse to continue treatment if there is a recording' That sounds so wrong to me and personally makes me lose trust in the competence and honour of The Medic.

 

 

'Vexatious' ought to be a word banned from use by our medical community as they simply can't use it correctly.

 

Best Of Luck,

Clear33

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I apologise if this article has already been posted. 'A survival guide to the NHS' by Dr Phil Hammond. He advocates recording consultations and there are some useful tips.

 

 

http://www.dailymail.co.uk/health/article-3027921/Survival-guide-NHS-patients-read-leading-doctor-s-insider-tips-getting-treatment-need.html?ITO=1490&ns_mchannel=rss&ns_campaign=1490

 

 

 

 

I have enjoyed some of the IRL :-) comments of this article though in contrast. I think on the whole patients are fed up colluding in their own subordination to try to beg decent treatment.

 

 

The fact is that this is my body, my life and my right to make sole, informed choices/decisions about my health care. How this simple concept has been infected.

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That recent article hasn't been mentioned in this thread before, Clear 33, and I think it is eminently worth having a link to it here. Thanks for spotting it.

 

It all comes from the right direction, and right in the middle has a highlighted para:-

 

" TAPE YOUR CONSULTATIONS

 

Many mobile phones have a recording facility, and your GP or consultant shouldn't mind if you record a consultation for personal use and to inform your carers. Some patients say it helps to listen back, away from the stress of the medical setting. Also, most people forget most of what was said in a consultation..."

……………………………………………………………………………………….

 

Truly, it seems that, as C33 says, increasing numbers of patients are" fed up colluding in their own subordination", and recording how one is treated behind closed doors, every time and as a matter of routine, is a very powerful aid to the autonomous patient – and one made almost ridiculously easy to deploy by these small, relatively inexpensive, digital recorders now readily available (even more so than by mobile phones).

 

Quaint how the word 'tape' persists into this digital age.

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'Quaint how the word 'tape' persists into this digital age'.

 

 

Yes! I shudder that I did not spot that.

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Think nothing of it C33!

 

I was at a, somewhat brittle, meeting a few weeks back (about care of relatives, Court of Protection, ya-de-ya) and I wanted explain my objections to the receipt of a clearly 'standardised' letter, concerning highly personal matters, which took no account of my relative's individual history\circumstances.

 

My mind sought, but failed to find, the expression 'word-processed'. What I actually came up with was ''roneo-ed" Now that can date a chap.

 

Still, I take comfort from the fact that half the world uses "cc" and "bcc" in connection with e.g. emails, and has next to no idea where the usage comes from.

 

https://answers.yahoo.com/question/index?qid=20070307145239AALEO93

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'Think nothing of it' - my new life mantra and epitaph for my e-grave stone.

 

 

Roneo-ed is a bit of a creative, vintage brain moment, for sure! Gave me a giggle when I looked it up.

 

 

As for standardised letters as a lazy replacement to compassion, sensitivity and knowledge, it is certainly like banging the head against a brick wall. Best thoughts with you as you travel through these challenges.

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Squirming doctors.

 

When three USA doctors (Michelle Rodriguez, JD; Jason Morrow, MD, PhD; Ali Seifi, MD) collaborated to produce as article for the Journal of the American Medical Association ('JAMA'), entitled 'Ethical Implications of Patients and their Families Secretly Recording Conversations with Physicians', published 12 03 15, I have to admit I was more than a little 'underwhelmed'.

 

For the most part, it seemed to me a fairly pedestrian piece, partly 'fence-sitting', and not really covering much new ground.

 

The full text of the original article has now disappeared behind a subscription wall, but you can get a fair flavour of what I mean by the extracts still available here:-

http://jama.jamanetwork.com/article.aspx?articleid=2204226&utm_source=reddit&utm_medium=social_jn&utm_term=031215&utm_content=article_engagement&utm_campaign=article_alert-jama

 

I underestimated, however, the impact the article's conclusions would have on some (querulous) American doctors. You see, in its last two paragraphs it actually suggests that, in the end, it might be better if doctors were 'to...er... grow up and get used to it,' to borrow the phraseology of an earlier commentator on our subject:-

 

" If a physician suspects that a conversation is being recorded, that physician could handle the situation in several different ways that could benefit all parties. Doing so would first require that the physician be aware of the possibility of secret recordings. The physician can ask the patient if he or she is recording the conversation. Then, regardless of the answer, the physician can express assent, note constructive uses of such recordings, and educate the patient about the privacy rights of other patients so as to avoid any violations. Taking such an approach would demonstrate the physician’s openness and desire to strengthen the relationship with the patient. The physician could also ignore any suspicions and provide care as he or she normally would without letting the possibility of recording affect either attitude toward the patient or medical decision making.

 

Unless federal or state laws change, physicians should be aware of the possibility that their conversations with patients may be recorded. If physicians embrace this possibility, establish good relationships with their patients, provide compassionate and competent care, and communicate effectively and professionally, the motives of patients and families in recording visits will be irrelevant."

 

That sort of 'relaxed' approach didn't go down well with this doctor, writing in Emergency Physicians Monthly:-

 

'…the authors then create nonsensical justifications for surreptitious recordings with statements like this: "If the possibility of recording causes physicians to refine their skills and, in their intimate moments with families, to pause and reassess their choice of words, then physicians should consider this possibility as an opportunity to grow as health care professionals and strengthen patient-physician relationships." That's like saying "If the possibility of getting robbed causes authors to refine their security systems, then authors should consider robberies as an opportunity to grow." What a bunch of BS. Justifying sneaky and sometimes illegal activity with smug statements like this show a lack of professionalism on behalf of the authors…'

(2nd subject 2nd post, http://www.epmonthly.com/features/current-features/crash-cart-march-10th-2015/)

 

Nor with several at http://www.medpagetoday.com/comments.cfm?tbid=50564 e.g.:-

 

"Simply, I flat refuse to be recorded. I would need signed, written consent from a patient if I wanted to video/audio record an encounter. I deserve the same courtesy.".

 

Well, I suppose in hindsight that sort of reaction was to be expected - at least from some - when a medical article on this 'issue' gets published nationally in America.

 

But there is no doubt who is well above and ahead of such pique when it comes to keeping the patients' preferences in the public picture – and that is the good Prof. Elwyn and the Dartmouth Center.

 

On 11 05 15 an article partly based on the JAMA piece appeared in the Washington Post:

 

http://www.washingtonpost.com/national/health-science/patients-press-the-record-button-making-doctors-squirm/2015/05/11/7c200306-f33a-11e4-b2f3-af5479e6bbdd_story.html

 

in which Glyn Elwyn gets his say. It's a good 'say', too, and well set-up by the journalist concerned (Christie Aschwanden).

 

I think one quick read leaves you with these salient points:-

 

1. Recordings can be very useful for patients.

2. It is legal to record covertly in most American States.

3. Angry re-actions from doctors are 'ill-considered' (a euphemism, perhaps, for irrational and unethical).

4. Trying to forbid recording will leave patients to vote with their feet (which will hurt doctors in their wallets).

 

Job done.

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I have been sent a link to a Boston Public Radio discussion broadcast earlier today, part of which was prompted by the Washington Post article referred to in the post above:-

 

http://wgbhnews.org/post/ask-ethicist-patients-recording-doctors-and-parents-protecting-overweight-kids

 

The bit concerned only runs from 11:00 to15:30 of the soundclip, but it is relatively easy to get to that point, and I think it is truly refreshing to listen to; and it says quite a bit more than the printed excerpts at the webpage.

 

In the commenting doctor's view, it is (medically) unethical to try to prevent patients having an audio recording of the advice given to them orally. Good man.

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That article in the Journal of the American Medical Association has certainly caused a lot of ripples in the States, and now that I have emphasised it here, I am being sent a lot of 'follow-up' links.

 

For those interested in the subject who have a little time to spare, here's one that I find among the more interesting so far:

 

http://tpr.org/post/source-would-you-record-your-doctor

 

The interest, in my view, mostly comes from the radio phone-in clip, where the doctors dealing with the questions are the same three who wrote the original JAMA article.

 

A degree of realism about, and indeed acceptance of, this patient entitlement really seems to be dawning in the USA. Can only help. See what you think.

 

(NB. The link at the webpage to the JAMA article itself won't work unless you have subscription to the publication)

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On the internet, 'all human life is bare', and you just have to take your laughs where you find them. I must admit I derived a mighty chuckle from reading an unlikely source for such: the January 2015 edition of "COMPLIANCE TODAY ( A Publication of the Health Care Compliance Association)".

 

According to the authors of an article (about patients recording their healthcare), if a 'compliance officer' is informed that a patient has made a secret recording of conversation with a doctor, the steps he or she is to take should include the following:-

 

"Once the compliance officer determines the applicable law and its requirements, he/she must perform an in-depth factual investigation surrounding the recording incident. This investigation should be very thorough and take place as soon as the incident is reported by the healthcare professional. The facts obtained can be critical to the determination of the whether the recording is legal. More importantly, the facts may shed light on the reliability of the recording.

 

One of the crucial areas of inquiry will be for the compliance officer to have the healthcare professional recall or recollect the interview that was recorded. The healthcare professional should then immediately prepare a written summary of the interview. This summary should cross-reference the medical chart or records to support the recollection of the patient interview. Likewise, any individual who has knowledge about the recording should prepare a written summary of the interview. The summaries should include detailed observations, specific questions, and verbatim answers. The observations should include whether the patient appeared sedated, irrational, or competent to make a recording."

 

Oh, for goodness sake! 'The recording incident..' Lol! You would think this is a wind-up, but it's written in complete earnest. It reminds me of the police in 'Alice's Restaurant ':-

 

"They was taking plaster tire tracks, footprints, dog-smelling prints, and they took twenty-seven eight-by-ten coloured glossy photographs with circles and arrows and a paragraph on the back of each one explaining what each one was to be used as evidence against us. Took pictures of the approach, the getaway, the northwest corner the southwest corner and that's not to mention the aerial photography…"

 

Ref:

http://www.manteselaw.com/files/ct-2015-01-mantese-kubik.pdf

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Whatever happened to that court case where a patient in Virginia left his recorder on during a colonoscopy and later found he was being insulted by the doctors. I can't find anything on Google. Perhaps it was settled out of court?

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Good point, My Turn.

 

I see the case is still being discussed on the net, e.g.:-

 

http://www.medscape.com/viewarticle/844251

 

but I can't find a report of the outcome of any litigation. At one stage it was scheduled to go to trial in January of this year. By now, I think it reasonable to assume that it settled out of court for a sum even more eye-watering than the procedure – but with a confidentiality clause in the settlement agreement.

 

Meanwhile, there are moves in the States to provide patients with the option of a recording whenever they are under anaesthetic:-

 

http://www.firstcoastnews.com/story/news/local/florida/2015/05/21/group-wants-black-box-recording-device-used-in-surgery/27755539/

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BTW, My Turn, I recently came across an article posted online last year which centres on your experience. I know I have reported Trisha Torrey in this thread before, but, unless my memory is playing tricks on me, this would appear to be a very fiery 'upgrade' of her previous comments:-

 

" So - in this case I'll say that while I see that the doctor's first reaction - his shouting, berating and belittling - were in response to his assumption that the patient was trying to do something nefarious by recording the session - I'm sorry - but I don't give the doctor any sort of understanding or pass for believing that. What an arrogant jerk." (!)

 

http://patients.about.com/b/2014/03/24/blistered-eyeballs-make-me-suggest-why-not-record-your-doctor-visit.htm

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Here's an extraordinary story, courtesy of the Mirror and a justly aggrieved Mr Michael Valentine:-

 

"Man left 'terrified' after 'paranoid' doctor locked him in room over fears he was recording conversation"

 

http://www.mirror.co.uk/news/uk-news/man-left-terrified-after-paranoid-5733989

 

I hope this account 'has legs', as some say, and we get to learn the name of the doctor in due course. He should have an idiocy prize named after him. (The Derriford Dork will have to do for now.)

 

In all seriousness, though, when medics display such ignorance and arrogance, it is no wonder that so many choose to record their consultations covertly.

 

I think Mr Valentine is being very forgiving in merely asking for a donation to charity.

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I found a full version of the JAMA article mentioned recently in this thread. "Ethical Implications of Patients and Families Secretly Recording Conversations With Physicians". It is an interesting read.

 

I also found the following article and I am not sure if it has been mentioned here already. Apologies if it has. "Patients Covertly Recording Clinical Encounters: Threat or Opportunity? A Qualitative Analysis of Online Texts". This too is very interesting and has many good links at the end. What a pity they didn't mention this thread because I am sure they would have come across it in their research.

 

 

My Turn

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Many thanks for those links, My Turn. I am very pleased that there may be lasting access here to that JAMA article. It's slow to load on my PC and I have to turn up the font size in my browser to be able to read it – but it is all there.

 

As I have confessed before, in my ignorance I entirely failed to predict how extensively and seriously it would be received by the medical profession in the USA. But extensive and serious the reaction has indeed been, and maybe, just maybe, we will be able to look back on it in a year or two and say that its publication really marked the turn of the tide across the pond – which could only be helpful as regards attitudes over here

.

I had spotted the 'plosone' article your other link leads to (back at #979, and yes this thread did get a mention), but I am also glad that others find it interesting. As I post, I see from the 'metrics' published alongside it, so far it has attracted less than 600 views and only one reader's comment. This seems to me a meagre response to a piece of research which must have taken no small amount of effort.

 

I wonder if viewers here would like to change that.

 

Couple of further links, for good measure:-

 

This one's to a blog where I have commented myself before. I particularly like the conclusion of the third commenter this time round: "If it [recording] offends your doctor , then you need a new doctor."

http://www.speaksooner.org/to-record-or-not-to-record-that-is-the-question/

 

And this one speaks for itself:-

 

"Surgeon entrepreneur develops video replay for specialist appointments to boost patient education"

 

http://medcitynews.com/2015/05/video-replay-patient-education/

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As is my wont, I put "patients" & "recording" & "consultations" into a search engine beginning with G, this morning, and confined the results to the last few days.

 

Somewhat teasingly the results it returned included this one:

 

" Using mobile devices for teaching and learning in clinical ...

ep.bmj.com/content/early/2015/06/01/archdischild-2014-306620.full

20 hours ago - The alternate application could however see patients recording interactions with ... and the covert recording of consultations is deemed to be within the law.12..."

 

which relates to an article published online yesterday, part of which you can read here:-

 

http://ep.bmj.com/content/early/2015/06/01/archdischild-2014-306620.extract

 

It seems, however, that my BMJ subscription does not extend to this paediatric specialist publication and so I cannot read\report the full paragraph concerned. I don't suppose there is anyone out there who could …?

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I asked my advocate if I could use recording in a Scottish court - she said no despite what I've read here, is she right?

 

m

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mikv,

 

1. Audio-recordings as evidence. Under English law recordings are classed as 'hearsay' and arguments can be made against their admissibility as evidence before a court in some circumstances. However, in civil actions, courts\tribunals etc have a wide discretion to admit such evidence, and it is established law that where a recording is genuinely relevant to matters of contested fact, that discretion should be exercised in favour of recordings being admitted for consideration as the general rule.

 

Unfortunately, I have no idea how much of the foregoing applies under Scottish law, which can be significantly different from ours in England.

 

2. A secondary consideration. I wasn't quite clear from your post as to whether you might in fact be referring to the audio-recording of legal proceedings themselves. This is not usually permitted in England (unless the court itself specifically directs and authorises it) and unauthorised recording is a form of contempt of court which can land – and indeed has landed - people in jail. I don't know for sure, but I would make a guess that Scottish law would be the same or similar on this point.

 

Regrets, not being able to offer more assistance.

  • Confused 1

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