Patient recorded me

[jacoavlu]

It's not obvious to me that mere recording is a HIPAA violation. It would only be clear violation if the recording was shared with someone who isn't legally allowed to access protected health information.

What if the doc uses the same line as the patient "Oh, I'm just recording this so I can review it later when I write my note..."

I wouldn't be surprised if there is something HIPAA that prevents a doc from doing this. I just don't know what it is. But I'd be surprised if there wasn't something.

yeah I don’t know

is the recording stored on a secured device? Is the recording app approved? Is there a BAA in place? Is it a personal device or work device? Is there cloud backup? The rabbit hole is deep.

[Tim]

Well, big brother is watching surgeons in South Korea.

https://www.zmescience.com/science/south-korea-fits-big-brother-in-operating-rooms-to-stop-rampant-ghost-surgeries/amp/

Sounded like a pretty good reason.

[K82]

Would it be possible for them to edit the recording to make it sound like you said something that you didn't?

[Golfing Doc]

I don’t mind patients recording and actually encourage it. We have complex conversations and it’s almost always for a family or for the patient to play for themselves later on.

Even if said not to record, they could extremely easily do so without me knowing

[Zaphod]

Well, big brother is watching surgeons in South Korea.

https://www.zmescience.com/science/south-korea-fits-big-brother-in-operating-rooms-to-stop-rampant-ghost-surgeries/amp/

Sounded like a pretty good reason.

I love that they said spinal surgeries were simple and easy so thats why theyre delegated to nurses and techs, lol. No big deal, just your spine.

[mamaham]

All my doctor offices have signs up saying no photos or recording allowed. Especially my OB office where it is almost comical the amount of signs.

[Gamma Knives]

All my doctor offices have signs up saying no photos or recording allowed. Especially my OB office where it is almost comical the amount of signs.

I wonder if these signs increase or decrease rates of recording. It almost seems like what are they hiding - maybe I'd better record.

Obligatory not a lawyer - I don't think these signs would protect you if someone was using a recording in a lawsuit in a one party consent state. You could potentially use the policy as a rationale for immediate terminate of the patient for violating practice policy if you caught them. However, your office policy would not make recording illegal in a one party state. With the technology easily avalible I just assume any patient may be recording me.

[mamaham]

I wonder if these signs increase or decrease rates of recording. It almost seems like what are they hiding - maybe I'd better record.

Obligatory not a lawyer - I don't think these signs would protect you if someone was using a recording in a lawsuit in a one party consent state. You could potentially use the policy as a rationale for immediate terminate of the patient for violating practice policy if you caught them. However, your office policy would not make recording illegal in a one party state. With the technology easily avalible I just assume any patient may be recording me.

Sorry I should have noted that I am not a physician. But the doctor offices that I go to have these signs. But I agree they are not legally binding. I would assume that doctors don’t want to be recorded not because they are hiding something, but rather for hippa etc.

[VagabondMD]

As a radiologist, we are accustomed to every single word that we say being recorded and transcribed and available for all to read. Even though the context in the OP is somewhat different, perhaps it is why this does not bother me all that much, except the threats, of course. Why would I say something that I would not want the patient's spouse, child, primary care physician, or lawyer to listen to later?

[AR]

As a radiologist, we are accustomed to every single word that we say being recorded and transcribed and available for all to read.

That's not actually true, is it? If you had an unusual case you could show it to some colleagues and have a bit of a discussion and the only thing that ends up recorded is what you finally dictate.

And I'm assuming if you do interventional stuff, your entire discussion with the patient, including obtaining consent and answering their questions and such is not recorded either.

Everything other clinicians dictate into chart notes are transcribed and available for all to read also. That's not any different than a dictated radiology report.

I definitely agree with your conclusion, but there is nothing unique about radiology that gets you there.

[Lordosis]

With modern day software it is easy to edit video and audio to show whatever you want.

Even if it is simply just omitting important parts.

[VagabondMD]

That's not actually true, is it? If you had an unusual case you could show it to some colleagues and have a bit of a discussion and the only thing that ends up recorded is what you finally dictate.

And I'm assuming if you do interventional stuff, your entire discussion with the patient, including obtaining consent and answering their questions and such is not recorded either.

Everything other clinicians dictate into chart notes are transcribed and available for all to read also. That's not any different than a dictated radiology report.

I definitely agree with your conclusion, but there is nothing unique about radiology that gets you there.

Of course, it's not exactly true, but the mindset that just about everything you say about the patient is in medical record, including grammar and syntax errors and other malapropisms and gaffes, perhaps gives you the mindset that just about everything you say ends up being on-record.

[medicoFIRE]

The problem I see with this is that you’d be naïve to think that patients wouldn’t pull short audio clips out of context while conveniently losing the context portions of the audio. Perhaps a fringe case, but imagine a malicious patient purposefully provoking and antagonizing you then posting your response on youtube in edited form and reframing it how they want to. Even reasonable physicians could be made to look deranged and unhinged with the right provocative maneuvers by the patient. In the OP case, the best bet is to be overly nice in such an encounter and then subsequently ban that patient from your practice a few weeks after the encounter. Otherwise you could keep them on and reward their behavior. If enough patients think it is ok then it becomes the norm. If it does become the norm, then physicians will have to also record every encounter in a hipaa compliant manner just to protect themselves.

[jacoavlu]

That's not actually true, is it? If you had an unusual case you could show it to some colleagues and have a bit of a discussion and the only thing that ends up recorded is what you finally dictate.

And I'm assuming if you do interventional stuff, your entire discussion with the patient, including obtaining consent and answering their questions and such is not recorded either.

Everything other clinicians dictate into chart notes are transcribed and available for all to read also. That's not any different than a dictated radiology report.

I definitely agree with your conclusion, but there is nothing unique about radiology that gets you there.

the different part about (diagnostic) radiology is that the images are forever. a physical exam, an unrecorded conversation, a procedure or surgery, those don't exist the way radiology images do.

did the cardiologist miss a murmur? did the FP miss a breast lump on physical exam?

when a mammogram can be magnified and put up in front of a jury with the negative mammogram report, and then the subsequent mammograms that show the subtle architectural distortion that was there on the original blossomed into an obvious mass on the next mammogram, is unique about radiology

[AR]

the different part about (diagnostic) radiology is that the images are forever. a physical exam, an unrecorded conversation, a procedure or surgery, those don't exist the way radiology images do.

did the cardiologist miss a murmur? did the FP miss a breast lump on physical exam?

when a mammogram can be magnified and put up in front of a jury with the negative mammogram report, and then the subsequent mammograms that show the subtle architectural distortion that was there on the original blossomed into an obvious mass on the next mammogram, is unique about radiology

I agree, but that difference is not due to the recording part. It's due to the fact that the image remains forever, as you point out.

And it's not entirely unique to radiology. Pathologists have a very similar problem.