People recording their clinical encounters
We searched Google, Google Scholar, and PubMed for research articles, blog posts, and news articles that discussed patients recording clinical encounters. We included any text that discussed patients recording clinical encounters, including, but not limited to, patients’ perspectives, physicians’ experiences, clinical trials, and medico-legal guidance. We excluded clinical trials during which clinical encounters were recorded for research purposes but patients did not receive a copy of the recording. Publication dates of included articles range from 1977 to 2020, reflecting the time period that research has been conducted in this field.
Peer Reviewed Empirical Research
Joshi A, Farberov M, Demissie S, Smith MC, Elwyn G. Attitudes of Physicians to Recording Clinical Encounters: Responses to an Online Survey. J Gen Intern Med. 2020 Mar;35(3):942-943. doi: 10.1007/s11606-019-05127-y.
A cross-sectional survey was conducted to assess physician attitudes towards patients recording clinical encounters. Half of physicians surveyed were opposed to patients recording clinical encounters; overall the idea of recording clinical encounters was met with hesitancy due to concerns that the recordings could be used inappropriately in the future.
Barr PJ, Bonasia K, Verma K, Dannenberg MD, Yi C, Andrews E, Palm M, Cavanaugh KL, Masel M, Durand MA. Audio-/Videorecording Clinic Visits for Patient's Personal Use in the United States: Cross-Sectional Survey. J Med Internet Res. 2018 Sep 12;20(9):e11308. doi: 10.2196/11308. PMID: 30209029; PMCID: PMC6231772.
Clinicians’ attitudes and the public’s attitudes towards recording clinical encounters, the prevalence of sharing audio recorded visits, and policies put in place by the health system to guide these practices were investigated. Cross-sectional surveys were administered in parallel to clinicians and the public in the United States. Researchers found that about twenty percent of patients recorded a visit in the past and two-thirds would consider doing it in the future. One-third of clinicians had recorded a visit for the patient’s personal use, and half of those who had not would consider doing so in the future. None of the health systems had a policy dedicated to sharing recordings of clinical encounters.
van Bruinessen IR, Leegwater B, van Dulmen S. When patients take the initiative to audio-record a clinical consultation. Patient Educ Couns. 2017 Aug;100(8):1552-1557. doi: 10.1016/j.pec.2017.03.001. Epub 2017 Mar 6. PMID: 28302340.
A survey was conducted to explore clinicians’ experiences with, and attitudes towards, patients recording in the oncology clinic. The majority of clinicians had experience with audio-recording; physicians who viewed it favorably embraced the patient-benefits of listening to the consultation, while those who opposed it believed recordings may be confusing for patients, and feared misuse and mistrust.
Tsulukidze M, Grande SW, Thompson R, Rudd K, Elwyn G. Patients covertly recording clinical encounters: threat or opportunity? A qualitative analysis of online texts. PLoS One. 2015 May 1;10(5):e0125824. doi: 10.1371/journal.pone.0125824. PMID: 25933002; PMCID: PMC4416897.
In a qualitative analysis of online articles, blogs, posts, and forums, researchers identified common themes such that patients and physicians acknowledge that patient-physician roles are shifting and there is little legal guidance governing covert recordings. While not viewed as negatively by patients, clinicians tended to have strong negative reactions to covert recording and often believed this signified a loss of trust.
Elwyn G, Barr PJ, Grande SW. Patients recording clinical encounters: a path to empowerment? Assessment by mixed methods. BMJ Open. 2015 Aug 11;5(8):e008566. doi: 10.1136/bmjopen-2015-008566. PMID: 26264274; PMCID: PMC4538278.
Patients were surveyed to examine their motivations for recording or not recording clinical encounters. The main motivations reported by patients were to be able to listen to the recording to aid memory and to share the recording with others. Not wanting to disrupt the encounter, some choose to covertly record.
Naeem K, Bhargava M, Porter R. Medico-Legal Implications of Video Recording Patient-Provider Communication. Neurosurgery. 2019 Aug 20;66(supplement_1). https://doi.org/10.1093/neuros/nyz310_104
During a ten-year period, physicians video recorded around 40,000 clinical encounters and uploaded the password-protected video to the internet where it could only be accessed by patients and healthcare personnel. These video recordings did not result in any malpractice suits. The authors recommend that physicians take recording into their own hands rather than patients covertly recording the encounters.
Bradshaw P. 91% of doctors want more guidance on patient’s recording consultations, MPS Survey Reveals. 2014 Dec 1.
A survey of over 500 doctors found that 19% of doctors experienced patients recording their consultations, 40% of which were not aware at that time. 97% did not know of any policies on recording consultations. 73% incorrectly believed they can decline a patient’s request to record, and 91% want more guidance on how to respond when a patient asks to record.
Hyatt A, Lipson-Smith R, Morkunas B, Krishnasamy M, Jefford M, Baxter K, Gough K, Murphy D, Drosdowsky A, Phipps-Nelson J, White F, White A, Serong L, McDonald G, Milne D. Testing Consultation Recordings in a Clinical Setting With the SecondEars Smartphone App: Mixed Methods Implementation Study. JMIR Mhealth Uhealth. 2020 Jan 21;8(1):e15593. doi: 10.2196/15593. PMID: 31961333; PMCID: PMC7001044.
This implementation study piloted the SecondEars app, which allows patients to record their oncology consultations. They assessed patient experience, acceptability, utility, and satisfaction with the app, as well as clinician perspectives on effective implementation of the app.
Lipson-Smith R, White F, White A, Serong L, Cooper G, Price-Bell G, Hyatt A. Co-Design of a Consultation Audio-Recording Mobile App for People With Cancer: The SecondEars App. JMIR Form Res. 2019 Mar 12;3(1):e11111. doi: 10.2196/11111. PMID: 30860487; PMCID: PMC6434400.
The SecondEars app allows patients to record their encounters. When developing the app, there were certain requirements they deemed necessary for the app: patient-driven, secure, clear legal responsibilities, link to the patient’s medical record, and require minimal upfront and ongoing resources.
Ferguson BD, Angelos P. Ethical and Legal Considerations of Patients Audio Recording, Videotaping, and Broadcasting Physician Encounters. JAMA Surg. 2020 Oct 21. doi: 10.1001/jamasurg.2020.2968. Epub ahead of print. PMID: 33084856.
This viewpoint discusses three unique hypothetical instances of recording during clinical encounters, one of them being livestreaming to a social media network. The authors point out that even if a clinician consents to the recording, bystanders and others in the clinical settings may make it into the recording without giving their consent. The authors discuss the variable state laws for recording encounters, and how the laws for videorecording can even vary between different counties within the same state.
Elwyn G, Barr PJ, Piper S. Digital clinical encounters. BMJ. 2018 May 14;361:k2061. doi: 10.1136/bmj.k2061. Erratum in: BMJ. 2018 May 23;361:k2294. PMID: 29760149.
The authors discuss that alleviating the burden on healthcare professionals and providing evidence of what was said during the clinical encounters are potential benefits of recording and transcribing clinical encounters. They call for policies on how to collect, store, and analyze this data.
Adams MA. Covert Recording by Patients of Encounters With Gastroenterology Providers: Path to Empowerment or Breach of Trust? Clin Gastroenterol Hepatol. 2017 Jan;15(1):13-16. doi: 10.1016/j.cgh.2016.07.025. Epub 2016 Oct 20. PMID: 27771191.
Directed towards gastroenterologists, this article discusses the harms and benefits of patients recording, as well as the legality of doing so. The author recommends that clinicians embrace these situations as a way to enhance communications with patients, deliver patient-centered care, and encourage shared decision making.
Rimmer A. My patient wants to record our appointment, what should I do? BMJ. 2019 Mar 19;364:l1101. doi: 10.1136/bmj.l1101. PMID: 30890537.
In this article, the author argues that while a patient requesting to record may leave the physician uneasy, it is not a sign of mistrust. Recording can help patients process complex information, especially if they have underlying anxieties surrounding the visit and/or pain levels.
Combeer EL, Iqbal RK. Smile for the camera: audio-visual recording of doctor-patient interactions. Anaesthesia. 2019 Sep;74(9):1079-1082. doi: 10.1111/anae.14698. Epub 2019 May 23. PMID: 31124132.
In this article, the authors discuss the benefits, concerns, and issues with patients recording anaesthetists.
Rodriguez M, Morrow J, Seifi A. Ethical implications of patients and families secretly recording conversations with physicians. JAMA. 2015 Apr 28;313(16):1615-6. doi: 10.1001/jama.2015.2424. PMID: 25763514.
The authors discuss the benefits, harms, and uses of recordings when patients record a clinical encounter. The authors suggest that to prevent the negative effects of serendipitous recording, clinicians should embrace the possibility of recording and establish good relationships with patients, ensuring effective, appropriate, and compassionate delivery of sensitive information.
Elwyn G, Buckman L. Should doctors encourage patients to record consultations? BMJ. 2015 Jan 8;350:g7645. doi: 10.1136/bmj.g7645. PMID: 25569249.
This article discusses two conflicting viewpoints regarding whether doctors should encourage their patients to record consultations. The reasons listed in favor of encouraging patients to record were an improvement in care, increase in shared decision making, and increase in trust and transparency. The reasons listed against encouraging patients to record were concerns that doing so may elicit changes to professional behavior, interfere with the doctor-patient relationship, and that the recordings may be misused.
Elwyn G. "Patientgate"--digital recordings change everything. BMJ. 2014 Mar 11;348:g2078. doi: 10.1136/bmj.g2078. PMID: 24620357.
This article discusses an online forum which elicited strong reactions from patients and clinicians regarding recording clinical encounters. Audio recordings have the potential to improve delivery of care and shared decision making but may also undermine relationships if the covert recording is discovered.
Elwyn G. Recording consultations--an inevitable future which could improve healthcare. BMJ Opinion. 2020 Mar 12.
The author discusses changes since the 2014 “Patientgate”--digital recordings change everything article. Specifically, organizations have begun embracing patients recording their clinical visits and companies have been created to make recording easier for patients. Clinicians still remain concerned about the recording, and hospitals have begun to implement policies encouraging or banning patient recording.
Mercer E. Recording Doctor Visits Is Just Another Step Toward Patients Taking Ownership over Their Own Care. Doximity Op-Med. 2019 Aug 6.
In this article, the author discusses how smartphone applications, such as Medcorder, Abridge, and SecondEars, are being developed to aid people in recording clinical encounters. The author also discusses how HIPAA does not apply to these recordings, and that wiretap laws determine if a physician in the United States can refuse the recording.
Ross C. More patients are taking home recordings of their doctor visits. But who else could listen? STAT. 2018 May 18.
This news article discusses implications for recording clinical encounters, specifically with regards to artificial intelligence with concerns of data storage and inappropriate usage by third-party vendors.
Lahey T, Elwyn G. Go ahead and hit ‘record’ in the doctor’s office. STAT. 2017 Jul 10.
This article describes a time when a physician was caught off guard when a patient asked for permission to use her smartphone to record their conversation about treatment options. Ultimately, the physician agreed to let the patient record the conversation, which she shared with her daughter to help reach a treatment decision. The authors further discuss the risks and benefits of patients recording their clinical visits.
Span P. The appointment ends. Now the patient is listening. The New York Times. 2017 Aug 18.
In this New York Times article, doctors give their perspective for wanting to record the clinical encounter and offer the recordings to patients as a tool to aid patients’ memory.
Ramachandran D. When patients secretly record their doctor visit. KevinMD. 2014 May 5.
In this post, the author, a physician, shares his experience of patients secretly recording their visit. The author then discusses potential benefits for patients to have access to a recording, giving an example of improved patient-satisfaction scores and decreased 30-day readmission rates when patients were given a recording of the instructions they were given during discharge.
Kirby R. Welcome to the world of digital audio recordings of your consultation. BJU International. 2014 Mar 27.
In this blog post, a physician reflects on a time when a patient wanted to record a clinical encounter with him and reflects on a blog post he read about a physician who was taken aback when a patient wanted to record the conversation. The author recommends that physicians respect patients’ wishes to record and proceed with the visit in a respectful manner.
Patients Given Recordings of their Encounters by Physicians
Dommershuijsen LJ, Dedding CWM, Van Bruchem-Visser RL. Consultation Recording: What Is the Added Value for Patients Aged 50 Years and Over? A Systematic Review. Health Commun. 2019 Sep 26:1-11. doi: 10.1080/10410236.2019.1669270. Epub ahead of print. PMID: 31556750.
This systematic review explores the affective cognitive outcomes, behavioral outcomes, and health outcomes of consultation recordings for patients 50 years and older. Recordings were found to improve patient satisfaction, recall, decision-making, and fulfillment of informational needs.
Rieger KL, Hack TF, Beaver K, Schofield P. Should consultation recording use be a practice standard? A systematic review of the effectiveness and implementation of consultation recordings. Psychooncology. 2018 Apr;27(4):1121-1128. doi: 10.1002/pon.4592. Epub 2017 Dec 19. PMID: 29178602.
In this systematic review exploring the effectiveness of consultation recordings and barriers and facilitators of routine implementation, the authors found that patients generally described recordings as beneficial, citing benefits in knowledge, perception of being informed, informed recall, factors for decision-making, anxiety, and depression. Facilitators to implementation included comfort with being recorded, having a clinical champion, legal strategies, efficient recording procedures, and positive experiences with recording consultations. Barriers to implementation included strength of evidence concerns, patient distress, impact the recording has on the quality of the consultation, clinic procedures, medico-legal issues, and the cost of needed resources.
Sharma S, McCrary H, Romero E, Kim A, Chang E, Le CH. A prospective, randomized, single-blinded trial for improving health outcomes in rhinology by the use of personalized video recordings. Int Forum Allergy Rhinol. 2018 Dec;8(12):1406-1411. doi: 10.1002/alr.22145. Epub 2018 Sep 17. PMID: 30221851.
This single-blinded prospective study investigated the effects of providing patients with a video-recorded summary of their visit on patient recall and satisfaction. While there were not any significant differences in recall or satisfaction between patients who did and did not receive the video, half of those who received the video watched it and 90% who did not receive the video would have liked to have access to the recording.
Hyatt A, Lipson-Smith R, Gough K, Butow P, Jefford M, Hack TF, Hale S, Zucchi E, White S, Ozolins U, Schofield P. Culturally and linguistically diverse oncology patients' perspectives of consultation audio-recordings and question prompt lists. Psychooncology. 2018 Sep;27(9):2180-2188. doi: 10.1002/pon.4789. Epub 2018 Jul 12. PMID: 29893041.
This study tested a communication intervention package (consisting of audio-recordings of consultations and question prompt lists) for cancer patients with low English-proficiency in Australia. Low-English speaking patients perceived audio-recordings as a tool to not only aid memory recall, but also to help participate in shared decision making, think of questions to ask their clinicians, and mediate language communication barriers. Patients expressed that they felt audio-recording the encounter improved the quality of the encounter, and reported that audio-recordings may be useful in most contexts.
Wolderslund M, Kofoed PE, Holst R, Axboe M, Ammentorp J. Digital audio recordings improve the outcomes of patient consultations: A randomised cluster trial. Patient Educ Couns. 2017 Feb;100(2):242-249. doi: 10.1016/j.pec.2016.08.029. Epub 2016 Aug 29. PMID: 27593087.
This study investigates the effect of providing patients with a digital audio recording of the consultation and a question prompt list on patient outcomes in routine practice. Patients who received an audio recording, either on its own or with the question prompts, reported being better informed, and had improved recall and understanding after replaying the audio recording. Researchers also found that providing patients with an audio recording positively influenced the participants’ confidence in their relationship with the clinician, satisfaction with the consultation, and involvement in decision making.
Moloczij N, Krishnasamy M, Butow P, Hack TF, Stafford L, Jefford M, Schofield P. Barriers and facilitators to the implementation of audio-recordings and question prompt lists in cancer care consultations: A qualitative study. Patient Educ Couns. 2017 Jun;100(6):1083-1091. doi: 10.1016/j.pec.2017.01.005. Epub 2017 Jan 16. PMID: 28117193.
In this thematic analysis of interviews conducted with clinicians and hospital administrators, researchers explored attitudes towards consultation audio-recordings and question prompt lists. While both question prompt lists and audio recordings are already being initiated by patients, people had concerns with medico-legal issues, uncensored sharing, storage of audio recordings, and successful implementation requiring minimal burden to clinical environments.
Meeusen AJ, Porter R. Patient-Reported Use of Personalized Video Recordings to Improve Neurosurgical Patient-Provider Communication. Cureus. 2015 Jun 2;7(6):e273. doi: 10.7759/cureus.273. PMID: 26180697; PMCID: PMC4494565.
Researchers investigated patient and provider experiences being video recorded with a handheld camera during neurosurgery consultations. Patients had the ability to choose whether or not they wanted to be recorded and receive the recording. Those who chose to be recorded self-reported improved memory after watching their video and decreased anxiety about their medical condition. Almost all of the patients would recommend that future visits be recorded.
Wolderslund M, Kofoed PE, Holst R, Ammentorp J. Patients' use of digital audio recordings in four different outpatient clinics. Int J Qual Health Care. 2015 Dec;27(6):466-72. doi: 10.1093/intqhc/mzv069. Epub 2015 Sep 23. PMID: 26403974.
In this randomized controlled trial, the researchers investigated patients’ use of digital audio recordings following pediatric, orthopedic, internal medicine, and urology consultations. Thirty-one percent of patients replayed the recording within the first 90 days following their consultation, with pediatric playback being significantly lower than the three adult clinics. Difficulty remembering or understanding information from the consultation and desire to share the consultation with relatives were cited as the most common reasons for replaying the recording.
Tsulukidze M, Durand MA, Barr PJ, Mead T, Elwyn G. Providing recording of clinical consultation to patients - a highly valued but underutilized intervention: a scoping review. Patient Educ Couns. 2014 Jun;95(3):297-304. doi: 10.1016/j.pec.2014.02.007. Epub 2014 Mar 3. PMID: 24630697.
This scoping review aimed to summarize the literature regarding patients receiving an audio recording of their consultation. In reviewing the literature, researchers identified common themes among patients receiving audio recordings, including: high levels of patients listening to and sharing the recordings, improved recall from the consultation, increased understanding of information discussed during the consultation, and favorable receptions of the recording.
Koh TH. Smartphones improve communication with parents in NICU. Lancet. 2013 Feb 16;381(9866):535-6. doi: 10.1016/S0140-6736(13)60279-2. PMID: 23415302.
One of the mothers in the neonatal intensive care unit suggested using her smartphone to record the encounter, which then became practice in that NICU. The author discusses the favorableness of using smartphones instead of their typical recording devices that require batteries and a cassette tape, but recommends that clinicians make a recording on their smartphone as well to have their own copy as a precaution.
Hack TF, Ruether JD, Weir LM, Grenier D, Degner LF. Promoting consultation recording practice in oncology: identification of critical implementation factors and determination of patient benefit.Psychooncology. 2013 Jun;22(6):1273-82. doi: 10.1002/pon.3135. Epub 2012 Jul 23. PMID: 22821445.
This implementation study looked at barriers and facilitators to the uptake of the use of recordings in breast and prostate oncology consultations and patient-reported benefits of listening to the recording. The recordings were rated highly favorable by patients, and patients reported benefits in information retention, informed decision making, communication with family members, and anxiety reduction.
Uitdehaag MJ, van der Velden LA, de Boer MF, Spaander MC, Steyerberg EW, Kuipers EJ, Siersema PD, Pruijn JF. Recordings of consultations are beneficial in the transition from curative to palliative cancer care: a pilot-study in patients with oesophageal or head and neck cancer. Eur J Oncol Nurs. 2012 Apr;16(2):109-14. doi: 10.1016/j.ejon.2011.04.006. Epub 2011 May 19. PMID: 21600848.
In this pilot study, researchers explored the feasibility and utility of providing audio recording CDs of their consultations to oncology patients diagnosed with incurable cancer. Generating these CDs did not create any procedural problems in the clinic. While those who received the CD reported being more open to discussing cancer-related issues, they also reported poorer qualities or life.
Mishra PK, Mathias H, Millar K, Nagrajan K, Murday A. A randomized controlled trial to assess the effect of audiotaped consultations on the quality of informed consent in cardiac surgery. Arch Surg. 2010 Apr;145(4):383-8. doi: 10.1001/archsurg.2010.45. PMID: 20404290.
Researchers investigated the effect of providing patients with an audiotape of their consultation before cardiac surgery. Patients who received a recording of their consultation reported significantly higher mean knowledge scores, perceived having more control over their health, and experienced less depression and anxiety compared to control patients who did not receive the tape.
Watson PW, McKinstry B. A systematic review of interventions to improve recall of medical advice in healthcare consultations. J R Soc Med. 2009 Jun;102(6):235-43. doi: 10.1258/jrsm.2009.090013. PMID: 19531618; PMCID: PMC2697041.
In this systematic review, ten studies were identified as meeting the criteria for investigating the use of audio-recordings as a tool to aid patient recall. Half of the studies, all of which were from an oncology setting, found that providing patients with audio recordings after their consultation improved recall from the consultation at a later date. The other half of studies did not find significant differences in recall of consultation information between patients who received an audio-recording and those who did not.
Stephens MR, Gaskell AL, Gent C, Pellard S, Day-Thompson R, Blackshaw GR, Lewis WG. Prospective randomised clinical trial of providing patients with audiotape recordings of their esophagogastric cancer consultations. Patient Educ Couns. 2008 Aug;72(2):218-22. doi: 10.1016/j.pec.2008.04.004. Epub 2008 May 29. PMID: 18513915.
The researchers investigated the impact of providing patients with a recording of the consultation where they were given a new diagnosis of esophageal or gastric cancer. Patients who received a recording of their consultation reported significantly better memory retention. There were not any adverse psychological outcomes associated with receiving the tape.
Pitkethly M, Macgillivray S, Ryan R. Recordings or summaries of consultations for people with cancer. Cochrane Database Syst Rev. 2008 Jul 16;(3):CD001539. doi: 10.1002/14651858.CD001539.pub2. PMID: 18646075.
This systematic review of trials for oncology patients found that patients viewed receiving audio recordings or written summaries as favorable, and particularly useful for personal reminders, sharing information with loved ones, and sharing information with general practitioners.
Hack TF, Pickles T, Bultz BD, Ruether JD, Degner LF. Impact of providing audiotapes of primary treatment consultations to men with prostate cancer: a multi-site, randomized, controlled trial. Psychooncology. 2007 Jun;16(6):543-52. doi: 10.1002/pon.1094. PMID: 16991107.
This randomized controlled trial investigated the impact of providing audiotapes of treatment consultations to men with prostate cancer. While there were no significant differences in quality of life, patient satisfaction with communication, or mood state, patients who received the consultation recording reported having significantly more information regarding treatments, treatment side effects, and treatment alternatives.
Koh TH, Butow PN, Coory M, Budge D, Collie LA, Whitehall J, Tattersall MH. Provision of taped conversations with neonatologists to mothers of babies in intensive care: randomised controlled trial. BMJ. 2007 Jan 6;334(7583):28. doi: 10.1136/bmj.39017.675648.BE. Epub 2006 Dec 1. PMID: 17142256; PMCID: PMC1764090.
The researchers investigated the effect of providing mothers of babies in the neonatal intensive care unit with audiotapes of conversations with the neonatologist. Providing them with audiotapes improved recall of information for up to four months, but did not have an impact on the mothers’ satisfaction with the neonatologist or their wellbeing.
Hack TF, Whelan T, Olivotto IA, Weir L, Bultz BD, Magwood B, Ashbury F, Brady J. Standardized audiotape versus recorded consultation to enhance informed consent to a clinical trial in breast oncology.Psychooncology. 2007 Apr;16(4):371-6. doi: 10.1002/pon.1070. PMID: 16906625.
Researchers compared giving oncology patients an audiotape of their consultation, a standardized audiotape about the clinical trial, or both. Patients preferred to receive a recording of their own consultation instead of the standardized recording.
Leahy M, Douglass J, Barley V, Jarman M, Cooper G. Audiotaping the heart surgery consultation: qualitative study of patients' experiences. Heart. 2005 Nov;91(11):1469-70. doi: 10.1136/hrt.2004.048769. PMID: 16230447; PMCID: PMC1769188.
This qualitative analysis explored patient perspectives on having a recording of their heart surgery consultation. Most patients who received a recording of the consultation found it to be valuable, while those who did not receive the tape felt it would have improved their information experience. The authors concluded that the results suggest providing patients with audiotapes of their consultations can help improve the quality of information patients receive before their heart surgery.
Santo A, Laizner AM, Shohet L. Exploring the value of audiotapes for health literacy: a systematic review. Patient Educ Couns. 2005 Sep;58(3):235-43. doi: 10.1016/j.pec.2004.07.001. PMID: 16054796.
This systematic review found that providing patients with audiotapes of their encounters can provide many advantages for patients, including increased shareability of information with others, increased family communication, decreased amount of information that is forgotten or misunderstood, and increased ability to review information before follow-up appointments.
Koh TH, Budge D, Butow P, Renison B, Woodgate P. Audio recordings of consultations with doctors for parents of critically sick babies. Cochrane Database Syst Rev. 2005 Jan 25;(1):CD004502. doi: 10.1002/14651858.CD004502.pub2. PMID: 15674950.
This systematic review aimed to include randomized or quasi-randomized trials to assess the utility of providing parents of babies in the NICU with audio recordings of their consultations with neonatologists. No research trials met the eligibility criteria.
Liddell C, Rae G, Brown TR, Johnston D, Coates V, Mallett J. Giving patients an audiotape of their GP consultation: a randomised controlled trial. Br J Gen Pract. 2004 Sep;54(506):667-72. PMID: 15353052; PMCID: PMC1326067.
In this randomized controlled trial, sixty-one percent of patients randomized to receive an audio recording of their routine general practitioner consultation listened to the recording. While over half of listeners found the tape to be useful or very useful, there were no significant differences in anxiety or adherence with the general practitioner’s advice at the one week follow-up.
Hack TF, Pickles T, Bultz BD, Ruether JD, Weir LM, Degner LF, Mackey JR. Impact of providing audiotapes of primary adjuvant treatment consultations to women with breast cancer: a multisite, randomized, controlled trial. J Clin Oncol. 2003 Nov 15;21(22):4138-44. doi: 10.1200/JCO.2003.12.155. PMID: 14615442.
This randomized controlled trial investigated the impact of providing audio recordings of treatment consultations to women with newly diagnosed breast cancer. Patients who received the audiotape reported improved recall of treatment side effects. Patients who received the audiotape did not report significant differences in satisfaction with communication, mood state, or quality of life twelve weeks after the consultation.
Cope CD, Lyons AC, Donovan V, Rylance M, Kilby MD. Providing letters and audiotapes to supplement a prenatal diagnostic consultation: effects on later distress and recall. Prenat Diagn. 2003 Dec 30;23(13):1060-7. doi: 10.1002/pd.747. PMID: 14691993.
This randomized controlled trial investigated the effects of providing patients with a non-technical letter, audiotape of the consultation, or a non-technical letter plus an audiotape of the consultation compared to standard information given at a consultation; the study also aimed to explore any interactions that diagnosis severity had with the type of information provided in affecting recall, anxiety, or depression in patients. Women who received an audio recording of the consultation reported less anxiety than those in the standard control group. There were no significant effects on depression or information recall.
Knox R, Butow PN, Devine R, Tattersall MH. Audiotapes of oncology consultations: only for the first consultation? Ann Oncol. 2002 Apr;13(4):622-7. doi: 10.1093/annonc/mdf055. PMID: 12056714.
In this prospective study, oncology patients were offered to have their consultation recorded. Most patients accepted, and over 75% reported they found it useful. Patients who were receiving bad news and patients who were married were more likely to want the recording of their consultation.
Lobb E, Butow P, Meiser B, Barratt A, Kirk J, Gattas M, Haan E, Tucker K. The use of audiotapes in consultations with women from high risk breast cancer families: a randomised trial. J Med Genet. 2002 Sep;39(9):697-703. doi: 10.1136/jmg.39.9.697. PMID: 12205117; PMCID: PMC1735239.
In this randomized controlled trial, half of the women who were randomized to receive an audiotape of their genetic consultation listened to it. Most participants reported high satisfaction with receiving the tape. Women who had breast cancer, had less knowledge about breast cancer genetics, and who were more depressed and anxious were more likely to listen to the recording.
Scott JT, Entwistle VA, Sowden AJ, Watt I. Giving tape recordings or written summaries of consultations to people with cancer: a systematic review. Health Expect. 2001 Sep;4(3):162-9. doi: 10.1046/j.1369-6513.2001.00127.x. PMID: 11493322; PMCID: PMC5060066.
In this systematic review examining the effects of providing cancer patients with recordings or written summaries of their consultations, between eighty-three and ninety-six percent of patients found recordings or written summaries to be helpful. Receiving a recording or summary did not have significant effects on depression or anxiety, but improved recall in four out of the seven studies that examined patient recall.
Krackow KA, Buyea CM. Use of audiotapes for patient education, medical record documentation, and informed consent in lower extremity reconstruction. Orthopedics. 2001 Jul;24(7):683-5. PMID: 11478555.
Clinicians recorded every consultation and offered the recordings to patients. Almost all patients viewed receiving the recording as positive, and there was not an increase in malpractice or exposure.
Ong LM, Visser MR, Lammes FB, van Der Velden J, Kuenen BC, de Haes JC. Effect of providing cancer patients with the audiotaped initial consultation on satisfaction, recall, and quality of life: a randomized, double-blind study. J Clin Oncol. 2000 Aug;18(16):3052-60. doi: 10.1200/JCO.2000.18.16.3052. PMID: 10944140.
In this double-blind study, cancer patients referred to a gynecology or medical oncology outpatient clinic in Amsterdam were randomized to receive or not receive a tape recording of their initial consultation. Three-quarters of patients who received the recording listened to it, most of whom listened with others. Those who received the tape reported greater satisfaction and greater recall of diagnostic information compared to those who did not receive the tape. There was an interaction effect, where younger patients with access to the tape reported greater satisfaction and older patients who had access to the tape had enhanced recall of diagnostic information.
Hack TF, Pickles T, Bultz BD, Degner L, Katz A, Davison BJ. Feasibility of an Audiotape Intervention for Patients with Cancer: A Multicenter, Randomized, Controlled Pilot Study. Journal of Psychosocial Oncology. 2008 Oct 12;17(2):1-15. Doi: 10.1300/J077v17n02_01
This randomized controlled trial investigated the impact of giving breast cancer and prostate cancer patients the choice of receiving an audiotape of their primary treatment consultation. They specifically measured patients’ decisional role preference, recall of information, satisfaction, anxiety, and perceptions of oncologists’ expertise and likability before the consultation, after the consultation, and six weeks later. At the six-week follow-up, patients that chose to receive the audio recording reported significantly greater recall. Patients who recalled the most information reported the highest satisfaction with physician-patient communication, suggesting that providing patients with an audio recording is an effective tool to enhance communication, facilitate information recall, and encourage patient satisfaction.
McClement SE, Hack TF. Audio-taping the oncology treatment consultation: a literature review. Patient Educ Couns. 1999 Mar;36(3):229-38. Doi: 10.1016/s0738-3991(98)00095-0. PMID: 14528558.
In this literature review, the authors evaluate the effects of recording oncology consultations. The authors conclude that having a taped recording of their consultation benefits the majority of patients, but more research needs to be conducted on the usefulness of audio recording as a way to improve patient-physician communication.
Bruera E, Pituskin E, Calder K, Neumann CM, Hanson J. The addition of an audiocassette recording of a consultation to written recommendations for patients with advanced cancer: A randomized, controlled trial. Cancer. 1999 Dec 1;86(11):2420-5. PMID: 10590386.
The researchers investigated the impact that providing advanced-cancer patients with an audiocassette recording of their consultation in addition to their written recommendations had on patients’ recall and satisfaction with their consultation. The addition of the audiocassette significantly improved patient recall of information from the consultation and patient satisfaction. Patients reported being highly satisfied with the audiocassette, with patients and family members listening to the cassette a median of two times.
Watson M, Duvivier V, Wade Walsh M, Ashley S, Davidson J, Papaikonomou M, Murday V, Sacks N, Eeles R. Family history of breast cancer: what do women understand and recall about their genetic risk? J Med Genet. 1998 Sep;35(9):731-8. doi: 10.1136/jmg.35.9.731. PMID: 9733031; PMCID: PMC1051425.
In this prospective randomized trial, the researchers investigated the impact of providing patients audio-recordings of their breast cancer genetic consultations. Women who received the audiotape reported less cancer worry than those who did not, but audiotapes did not impact recall of genetic risk or overall risk perception.
Ah-Fat FG, Sharma MC, Damato BE. Taping outpatient consultations: a survey of attitudes and responses of adult patients with ocular malignancy. Eye (Lond). 1998;12 (Pt 5):789-91. doi: 10.1038/eye.1998.204. PMID: 10070510.
Patients in an ocular oncology clinic were given an audiotape of their initial consultation. Almost all patients listened to the tape at least once, often sharing the tape with relatives. Of those who listened to the tape, almost all found it to be very or quite useful to help them understand their condition, understand their treatment and associated side-effects, reduce anxiety and fear, and adjust emotionally and psychologically to their illness.
Davison BJ, Degner LF. Empowerment of men newly diagnosed with prostate cancer. Cancer Nurs. 1997 Jun;20(3):187-96. doi: 10.1097/00002820-199706000-00004. PMID: 9190093.
In this study investigating the effect of empowering men with prostate cancer to get involved in their care, patients randomized to the intervention arm were encouraged to record their consultation as a way to help them remember what was discussed at the treatment consultation. The majority of men in the intervention group recorded their initial treatment consultation, and at the six-week follow-up, fifty percent reported using the audiotape to listen back to information they were given and to share information with their family.
Ford S, Fallowfield L, Hall A, Lewis S. The influence of audiotapes on patient participation in the cancer consultation. Eur J Cancer. 1995 Dec;31A(13-14):2264-9. doi: 10.1016/0959-8049(95)00336-3. PMID: 8652254.
Investigating the effect that providing patients with an audio recording of their clinical consultation has on subsequent consultations, the authors found that providing patients with recordings facilitated clarification of information given during the initial encounter at the next visit.
McHugh P, Lewis S, Ford S, Newlands E, Rustin G, Coombes C, Smith D, O'Reilly S, Fallowfield L. The efficacy of audiotapes in promoting psychological well-being in cancer patients: a randomised, controlled trial. Br J Cancer. 1995 Feb;71(2):388-92. doi: 10.1038/bjc.1995.79. PMID: 7841058; PMCID: PMC2033600.
In this randomized controlled trial, oncology patients were randomized to receive or not receive an audiotape of the clinical encounter where they were given bad news. All consultations were recorded, and physicians were blinded to which patients received the tapes. At a six month follow-up, patients who received the tape reported significantly improved recall of information pertaining to their illness compared to controls, and viewed the tapes favorably. However, patients who received the audiotape and had a poor prognosis showed less improvement in psychological distress than control patients who did not receive the audiotape.
Ong LM, de Haes JC, Kruyver IP, de Reijke TM, Lammes FB. Het meegeven van een geluidsopname van het poliklinisch oncologisch consult aan de patiënt; ervaringen van patiënten en artsen Providing patients with an audio recording of the outpatient oncological consultation; experiences of patients and physicians. Ned Tijdschr Geneeskd. 1995 Jan 14;139(2):77-80. Dutch. PMID: 7838223.
Patients referred to a gynecology, urology, or medical oncology outpatient clinic received an audio recording of their initial consultation where they were given their diagnosis and discussed treatment options. Almost all patients listened to the recording, most of whom listened with relatives. Patients found the tapes contained information that they forgot and reassuring information. All physicians reported that optimal information transmission is an advantage of recordings, and most did not see any logistical difficulties. Three physicians were concerned about misinterpretation of the information on the audio recording.
Tattersall MH, Butow PN, Griffin AM, Dunn SM. The take-home message: patients prefer consultation audiotapes to summary letters. J Clin Oncol. 1994 Jun;12(6):1305-11. doi: 10.1200/JCO.1922.214.171.1245. PMID: 8201393.
In this randomized trial, patients received, in differing orders, both an audiotape of their consultation and a letter summarizing the points from the consultation that their physician deemed most important. The order of intervention receival did not cause significant differences in patient recall. Patients reported that the tape was more effective than the letter for reminding them what the doctor said during the consultation. Patients who wanted noninvolvement in decision-making or minimal news found the tape to be less useful.
Dunn SM, Butow PN, Tattersall MH, Jones QJ, Sheldon JS, Taylor JJ, Sumich MD. General information tapes inhibit recall of the cancer consultation. J Clin Oncol. 1993 Nov;11(11):2279-85. doi: 10.1200/JCO.19126.96.36.1999. PMID: 8229143.
Cancer patients were randomized to receive a recording of their consultation, a recording describing cancer in general terms, or no recording. Patients who received a recording of their consultation reported being the most satisfied with their consultation, while patients who did not receive any recording reported being the least satisfied with their consultation. There was no improvement in recall scores for patients receiving the consultation recording compared to the no tape control, but patients receiving a general recording had decreased recall.
Stockler M, Butow PN, Tattersall MH. The take-home message: doctors' views on letters and tapes after a cancer consultation. Ann Oncol. 1993 Aug;4(7):549-52. doi: 10.1093/oxfordjournals.annonc.a058586. PMID: 8363987.
Physicians were mailed a questionnaire to garner their views on the use of audio recording the initial cancer consultation and the use of individualized letters as a means to improve doctor-patient communication. The majority of doctors were supportive of both methods. However, compared to general practitioners, specialists were more concerned with the risks of audio recording and less supportive of the recording of consultations.
North N, Cornbleet MA, Knowles G, Leonard RC. Information giving in oncology: a preliminary study of tape-recorder use. Br J Clin Psychol. 1992 Sep;31(3):357-9. doi: 10.1111/j.2044-8260.1992.tb01005.x. PMID: 1393167.
The researchers investigated the effects of providing patients who have advanced carcinomas with a recording of their consultation. Patients who received the recording had a significant reduction in anxiety one week after the consultation compared to those who did not receive a recording. Furthermore, at the one-week follow-up, those who received the tape were able to recall significantly more information regarding their diagnosis, prognosis, treatment options and implications, and how the illness arose. On average, patients listened to the recording four times during the week following the consultation.
Deutsch G. Improving communication with oncology patients: taping the consultation. Clin Oncol (R Coll Radiol). 1992 Jan;4(1):46-7. doi: 10.1016/s0936-6555(05)80774-5. PMID: 1736980.
Consultations where difficult conversations were anticipated to occur were recorded for one hundred cancer patients. Patients were then given the recording to take home and invited to complete a questionnaire after they listened to the tape. Over three quarters of patients returned the questionnaire. Almost all patients listened to the tapes, with patients playing their tape an average of four times. All patients reported that the recording was worthwhile.
Rylance G. Should audio recordings of outpatient consultations be presented to patients? Arch Dis Child. 1992 May;67(5):622-4. doi: 10.1136/adc.67.5.622. PMID: 1599301; PMCID: PMC1793710.
In this study, parents were given tape recordings of their child’s pediatric outpatient visit. The tapes were viewed positively, providing benefits of refreshing memory of those in attendance and facilitating understanding for those who were not at the appointment.
Johnson IA, Adelstein DJ. The use of recorded interviews to enhance physician-patient communication. J Cancer Educ. 1991;6(2):99-102. doi: 10.1080/08858199109528098. PMID: 1911176.
Cancer patients were given a recording of the consultation describing their diagnosis and treatment planning. In follow-up questionnaires, patients reported frequently reviewing the tape, often with loved ones. While patients initially reported understanding the diagnosis and treatment plan, they reported that listening to the tape provided new information and clarified their understanding of their care.
Hogbin B, Fallowfield L. Getting it taped: the 'bad news' consultation with cancer patients. Br J Hosp Med. 1989 Apr;41(4):330-3. PMID: 2720274.
In this study, forty-six cancer patients were given audio recordings to take home with them from consultations where they received bad news. The results of a follow-up questionnaire indicated that patients and their families greatly benefited from the ability to relisten to details of their diagnosis and treatment plan.
Reynolds PM, Sanson-Fisher RW, Poole AD, Harker J, Byrne MJ. Cancer and communication: information-giving in an oncology clinic. Br Med J (Clin Res Ed). 1981 May 2;282(6274):1449-51. doi: 10.1136/bmj.282.6274.1449. PMID: 6784861; PMCID: PMC1505182.
In this randomized controlled trial, oncology patients who were given a tape-recording of their consultation in addition to a handout from their visit did not have enhanced recall compared to patients who received a handout only. However, in follow-up interviews, patients who received the audiotape reported finding it to be valuable. There were no significant differences in satisfaction between either intervention group and the control group.
Butt HR. A method for better physician-patient communication. Ann Intern Med. 1977 Apr;86(4):478-80. doi: 10.7326/0003-4819-86-4-478. PMID: 848814.
Patients seen at the outpatient facility of Mayo Clinic were given a recording of their consultation. Patients listened to the recording an average of 3.5 times. Ninety-one percent of patients thought the recording helped or significantly helped aid their understanding of their discussion with the physician, and eighty-six percent of patients reported that the recording improved their healthcare.
Yentis SM, Shinde S, Bogod D, Flatt N, Hartley H, Keats P, Leifer S, Pappachan J, Parfitt E, Pooni J, Rowland A. Audio/visual recording of doctors in hospitals: Guideline from the Association of Anaesthetists.Anaesthesia. 2020 Aug;75(8):1082-1085. doi: 10.1111/anae.15010. Epub 2020 Mar 2. PMID: 32124425.
This article provides a summary of the legal framework regarding recording of doctors in UK hospitals and recommends guidelines for how physicians should approach situations where a patient asks to record. There are no legal grounds for a clinician to refuse recording, so the authors recommend that local policies be created to address these situations.
Patients Recording Consultations. MDU Good Practice. 2014 Jun; 1(5).
A medico-legal advisor recognizes that while physicians may see recording as a threat to the doctor-patient relationship, recordings can be beneficial for patients (help aid their memory and help them understand the risks and benefits of treatment options) and to doctors. The advisor suggests that a more pragmatic approach for physicians to take is to invite a patient to record the consultation and then ask them for a copy to add to the patient’s medical record.
O'Hara N, Walkergp L, Singh K. Setting the record straight: patient recordings of consultations. Clin Med (Lond). 2017 Apr;17(2):188. doi: 10.7861/clinmedicine.17-2-188. PMID: 28365637; PMCID: PMC6297609.
This scientific letter discusses the legality of patients recording their visits in the UK. Recognizing that recording is not illegal and is likely to become more common, the authors recommend clinicians and patients discuss the patient’s reasoning for wanting to record and the clinician’s reasoning for being uncomfortable recording.
Elwyn G, Barr PJ, Castaldo M. Can Patients Make Recordings of Medical Encounters?: What Does the Law Say? JAMA. 2017 Aug 8;318(6):513-514. doi: 10.1001/jama.2017.7511. PMID: 28692707.
This article discusses the laws in the US governing a patient’s ability to audio record clinical encounters and share these recordings with others.
Turley, Dan & Metcalfe, Neil. Patients recording their clinical consultations: A new challenge for medical ethics. InnovAiT: Education and inspiration for general practice. 2020 Mar 1;13(5):306-310. doi: 10.1177/1755738020907358.
Physicians are aware of professional guidelines for physician-initiated recordings, but most wrongfully assume they have the right to refuse a patient-initiated recording. Recording consultations can have benefits for patients (recall, understanding, ability to share with others), but covert recordings can threaten the doctor-patient relationship. People are not aware of the legislation, and physicians want more guidance. New apps are being developed for this field (e.g. SecondEars).