Patients recording clinical encounters: a path to empowerment? Assessment by mixed methods.
OBJECTIVE
To examine the motivations of patients recording clinical encounters, covertly or otherwise, and why some do not wish to record encounters.


METHODS
Mixed-methods analysis of survey data and nested semistructured interviews.


METHODS
Survey to UK audience, using social media and radio broadcast.


METHODS
168 survey respondents, of whom 161 were 18 years of age or older (130 completions). Of the 56 participants who agreed to be contacted, we included data from 17 interviews.


RESULTS
19 (15%) respondents indicated having secretly recorded a clinical encounter and 14 (11%) were aware of someone who had secretly recorded a clinical encounter. 45 (35%) said they would consider recording secretly and 44 (34%) said they would record after asking permission. Totally, 69% of respondents indicated their desire to record clinical encounters, split equally between wanting to do so covertly or with permission. Thematic analysis of the interviews showed that most patients are motivated by the wish to replay, relisten and share the recording with others. Some are also motivated by the idea of owning a personal record, and its potential use as verification of a poor healthcare experience. The rationale for permission seeking was based on the wish to prioritise a trusting relationship with a health professional. Those who preferred to record covertly described a pre-existing lack of trust, a fear that recording would be denied, and a concern that an affronted clinician would deny them access to future care. There was a general wish that recording should be facilitated.


CONCLUSIONS
Patients' prime motivation for recording is to enhance their experience of care, and to share it with others. Patients know that recording challenges the 'ceremonial order of the clinic', and so some decide to act covertly. Patients wanted clearer, more permissive policies to be developed.
The Preference Laboratory, The Dartmouth Institute for Health Policy and Clinical Practice, Dartmouth College, Hanover, New Hampshire, USA.
Glyn
G
Elwyn
The Preference Laboratory, The Dartmouth Institute for Health Policy and Clinical Practice, Dartmouth College, Hanover, New Hampshire, USA.
Paul James
PJ
Barr
The Preference Laboratory, The Dartmouth Institute for Health Policy and Clinical Practice, Dartmouth College, Hanover, New Hampshire, USA.
Stuart W
SW
Grande
D000293:Adolescent; D000328:Adult; D040421:Cell Phone / Q000706:statistics & numerical data*; D003430:Cross-Sectional Studies; D004992:Ethics, Medical; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010817:Physician-Patient Relations / Q000941:ethics*; D036301:Qualitative Research; D035502:Trust; D006113:United Kingdom; D055815:Young Adult
MEDICAL ETHICS; MEDICAL LAW; QUALITATIVE RESEARCH