Docs not pleased when patients record procedures

SASKATOON – According to a new study by Dr. James Stempien (pictured) and three colleagues, more people are asking to record their own emergency procedures, a self-documentary trend that’s creating controversy among medical staff.

Dr. Stempien is provincial head of emergency medicine in the Saskatchewan Health Authority. The other authors included Taofiq Oyedokun, Andrew Donauer and Shari McKay.

The study found that most patients (62 percent) believed they should be allowed to video record their emergency procedures, versus 28 percent of emergency department (ED) doctors and nurses.

“Contrary to patients’ views, clinicians were not in favour of allowing audio or video recordings in the ED,” they reported in the Canadian Journal of Emergency Medicine.

Doctors had concerns around consent, staff and patient privacy, and covert recordings and legal issues. They worried that patients might use the video against them if they were unhappy with their care. (The recording could be considered part of the medical record.)

Some worried about performance anxiety, though the researchers looked for, but couldn’t find, research as to whether doctors perform worse if they know they’re being recorded.

“Outright objections included the possibility of recording the faces of staff and patients as well as audio recordings of other patients,” the researchers wrote.

Public policy on video recording procedures is governed by provincial legislation and varies across Canada at each hospital or emergency department.

With no clear ED recording policy in the new Saskatchewan Health Authority, the team set out to examine patients’ motivations, and doctors’ and nurses’ attitudes about taping visits.

In all, a total of 110 people aged 17 and older who arrived in three urban Saskatoon emergency rooms with at least one laceration requiring stitches, and 156 staff, responded to a short survey.

Of the doctors, more than 80 percent said that they had a patient request to video record a procedure in the past. About half had allowed the patient to record.

About a third of patients said they had contemplated taking a video of the procedure on the day of the survey.

When asked why, and what they would do with the video, people mostly said they wanted it as a memento to share with friends and family.

Of the doctors who said they would allow people to video, most were in support of a person’s right to video their own body or have a record of care.

“Of those who were not in favour of allowing patient videos, some simply found it inappropriate,” the researchers wrote. Others worried about potential legal action, where the video might get posted, and “lack of control over distribution.”

Given that a complete ban wouldn’t be feasible, the authors suggested allowing smartphone recordings in private spaces only, where “no faces or genitals or confidential personal health information are shown (or heard),” the video focuses solely on the procedure and all parties present have verbally consented.

“I think most of the patients were saying, ‘I find it interesting, I want to show my mother, I’m going to show my girlfriend,’” Dr. Stempien said.

“And I think some of the hesitancy among the healthcare staff was: what are they going to do with it? Are they going to post it on Facebook? Are they going to put it on social media? Are they going to use it as some form of complaint if they were unhappy?”

Dr. Stempien has agreed to recordings on occasion. He has also declined. There are few rooms in the emergency department with doors that close. It’s mainly curtained space.

“In a busy space with lots of other patients around, you would have to get consent from everybody in that zone that you could either see or hear, and that wasn’t a possibility,” Stempien said.

Some patients take out their phone and record anyway.

What’s not addressed in the study is that smartphones are also reservoirs of bacteria. Researchers have cultured staphylococcus aureus, E. coli and other species from mobile phones.

Still, privacy concerns work both ways: Across Canada, doctors are using their own personal mobile phones to text and share images of patients to help with diagnosis, monitor the course of an illness and assist in teaching. Doctors first have to obtain consent from the patient.

However, when plastic surgeons in Alberta surveyed colleagues throughout the country, they discovered that almost three quarters keep patient photos next to vacation snaps, pet pictures and other personal images on their phones.

And a quarter have accidentally shown the patient shots to friends or family.