If a patient is old and forgetful, or the family members are not able to make the appointment, what if they, with permission, request to have their doctor's visit video and audio recorded and a link to watch sent home with them.
Obviously we don't facilitate it in medicine — by installing cameras and making it one click. God forbid, if there was a video recording of the doctor's visit, someone might be able to fact check the doctor's physical exam.
I've had patients ask me to audio record visits, and I've always said yes. But I've never known a hospital system to facilitate it/ make it easy. And certainly not video.
(What about concerns of privacy around the exam? For the sake of argument, I'm stipulating the patient wants it recorded nonetheless. Also it is rare these days for doctors to actually have the patient put the gown on, etc)
Enter the new battle
Do patients have a right to the audiotape recording if a doctor is using AI to generate a note (and if the recording is saved?)
Before I give you my answer. Let's think about body camera's worn by police officers. There are a number of studies, including some randomized trials. Researchers find that the use of body cameras reduces citizen complaints. It's unclear if it reduces police aggression. The footage has been useful in anecdotal cases. It is costly to collect. There are additional questions that are not fully answered because the sample size of the studies and scope is limited. Probably the vast majority of footage is not looked at.
With this in mind, medicine should embrace randomization when it comes to more accurate recordings and encounters. It is plausible that allowing patients to opt into a video taped encounter with a link provided to family to review later, will improve medication compliance, satisfaction, family member involvement, etc. It may even result in a reduction in level 5 billing, as doctors more accurately document their physical.
Just as citizen complaints go down, patient complaints may go down. Doctors may be less likely to sound impatient or be hurried or dismissive— the universal characteristics that annoy patients.
Malpractice is a disaster. Many doctors are sued who shouldn't be, and many cases of malpractice aren't brought. The patient may not even know something was done incorrectly.
It's not clear to me why investigating malpractice with the doctor's note is superior to having the raw audio tape of the encounter. Just like in cases of police shootings, everyone is interested in the body cam footage even if grainy and limited.
But just like body cams, we need to consider the broader effects of the policy. These effects may dwarf malpractice concerns.
The AMA filed an amicus brief to keep the AI recordings private and some companies auto delete them. If you are a patient tell me… why are you consenting to AI recording your encounter? What is in it for you?
I suspect there will be more court rulings and eventually patients will have a right to the raw audio just like they are free to review the raw radiology film and not just the note written by the radiologist. To combat this, more companies will discard the audio.
Eventually, someone may study the impact of audio and video recordings on patient satisfaction. Some have even been done.
Just remember. Survey data will be near useless (sorry Dartmouth). Single center studies will be useless. You really need multi-center, cluster randomization with adequate power to draw any real conclusions or to land up like a lot of the body cam studies.
In the meantime: audio recording is to AI note what radiology imaging is to radiologist note. I suspect legally it will be owned by the patient, and eventually hospitals may not be able to discard it.
My grandfather is old and doesn’t have a great memory, he asks every doctor if he can record their encounter and always sends me the recording after to review and help him understand. Several times it’s helped us clear confusion on what was said in a visit.
I think the only people scared of this are bad doctors who think they will be exposed doing something wrong or inadequate.
The last couple of appointments I’ve had in a doctors office they asked if I mind if they record - I always agree. Utilizing AI for their recorded notes has been an improvement in returning to actual conversations between caregiver & patient compared to recent years when the doctors sat at a keyboard looking back & forth between a screen & the patient while they frantically typed every possible detail. It was like having an appointment with a court reporter or if they had the budget (usually only specialists) they brought their court reporter into the room & you were having a private conversation with a third party sitting there. If I agree to my appointment being recorded then I should have full access to that recording as well. I agree with you that this would cut down on complaints about the doctors - not increase lawsuits as the AMA assumes. Case in point, my 88 yo aunt went to a convenient care for a rash that came on suddenly. She complained to me that the nurse did not tell her anything but merely handed her a script to fill for hydrocortisone. When she filled it the directions said it was to treat unicateria. She looked it up & found out that meant hives but maintains the nurse said nothing to her. So she’s telling me that she had an almost silent appointment with the nurse? I question my aunts recall about this & a recording that she could have access to would have taken care of it.