Patients covertly recording clinical encounters: threat or opportunity? A qualitative analysis of online texts.
BACKGROUND
The phenomenon of patients covertly recording clinical encounters has generated controversial media reports. This study aims to examine the phenomenon and analyze the underlying issues.


RESULTS
We conducted a qualitative analysis of online posts, articles, blogs, and forums (texts) discussing patients covertly recording clinical encounters. Using Google and Google Blog search engines, we identified and analyzed 62 eligible texts published in multiple countries between 2006 and 2013. Thematic analysis revealed four key themes: 1) a new behavior that elicits strong reactions, both positive and negative, 2) an erosion of trust, 3) shifting patient-clinician roles and relationships, and 4) the existence of confused and conflicting responses. When patients covertly record clinical encounters - a behavior made possible by various digital recording technologies - strong reactions are evoked among a range of stakeholders. The behavior represents one consequence of an erosion of trust between patients and clinicians, and when discovered, leads to further deterioration of trust. Confused and conflicting responses to the phenomenon by patients and clinicians highlight the need for policy guidance.


CONCLUSIONS
This study describes strong reactions, both positive and negative, to the phenomenon of patients covertly recording clinical encounters. The availability of smartphones capable of digital recording, and shifting attitudes to patient-clinician relationships, seems to have led to this behavior, mostly viewed as a threat by clinicians but as a welcome and helpful innovation by some patients, possibly indicating a perception of subordination and a lack of empowerment. Further examination of this tension and its implications is needed.
The Dartmouth Center for Health Care Delivery Science, Hanover, New Hampshire, United States of America.
Maka
M
Tsulukidze
The Dartmouth Center for Health Care Delivery Science, Hanover, New Hampshire, United States of America.
Stuart W
SW
Grande
The Dartmouth Institute for Health Policy and Clinical Practice, Lebanon, New Hampshire, United States of America.
Rachel
R
Thompson
The Dartmouth Center for Health Care Delivery Science, Hanover, New Hampshire, United States of America.
Kenneth
K
Rudd
The Dartmouth Center for Health Care Delivery Science, Hanover, New Hampshire, United States of America; The Dartmouth Institute for Health Policy and Clinical Practice, Lebanon, New Hampshire, United States of America; The Scientific Institute for Quality Improvement, Radboud University Medical Center, Nijmegen, The Netherlands.
Glyn
G
Elwyn
D057218:Blogging; D006301:Health Services Needs and Demand; D006801:Humans; D016247:Information Storage and Retrieval; D020407:Internet; D010344:Patient Advocacy; D010820:Physicians