This site is intended for health professionals only

At the heart of general practice since 1960

pulse june2020 80x101px
Read the latest issue online

GPs go forth

No, I’m not ready for my close-up

  • Print
  • 36
  • Rate
  • Save

I am sure you know the searing pain of paying your indemnity fees. After handing over £8,000, you may be surprised to hear that two of the biggest companies are advising that we have no rights to refuse if a patient wants to record a consultation.

Not only can we not refuse if they ask outright, but if they record us covertly, that is also allowed as long as they don’t show it to a third party. Apparently the issue is this: we can’t decline to assess them in case they are seriously ill, and the confidentiality being breached is theirs, not ours. As long as they don’t care, we don’t have a leg to stand on.

I am genuinely open-mouthed at this. I can’t imagine a greater breakdown in the doctor-patient relationship than covertly recording a consultation.

Also, it implies that we are lesser beings than those we treat. We are not allowed to be ill. We are not allowed to ‘clock off’ like other professions. We are not allowed to express dissatisfaction or humour at the behaviour of patients. We are not allowed to protest about workload because our massive pay negates that right. We are routinely expected to tolerate abuse from patients and relatives if we don’t accede to their demands. We are the whipping boys of the NHS.

I have about seven minutes to consult and examine, then a frantic three minutes to type, refer or deal rapidly with any extra problems raised. Do I now have to cope with a smartphone being pressed into my face as I examine that rash on your snotty child’s thigh?

If a patient wants to record me consulting with them, they should do so at that mythical time when I can put my full MRCGP hat on. When I have 30-40 minutes to explore their ideas, concerns and expectations; to deal with the seven-item list they have brought, to do a textbook examination of every possible system involved, and to come to a wholly acceptable shared management plan with full counselling regarding the pros and cons of any treatments proposed or otherwise.

While we are at it, why not just install cameras in all our consulting rooms? When patients arrive we can offer a complementary hair and make-up service with reception, then wardrobe service with the practice nurse, and after their consultation with the GP a gift-wrapped souvenir CD recording? In between, we can live-stream footage to waiting patients of me in my room stuffing down a packet of Jaffa Cakes in lieu of lunch.

Now, tell me, where do I sign up?

Dr Zoe Norris is a GP in Hull

• Ed’s note: Welcome to our new columnist Dr Zoe Norris, who is temporarily taking over Peverley’s slot in the magazine while he has some well-deserved time off

Rate this blog  (4.4 average user rating)

Click to rate

  • 1 star out of 5
  • 2 stars out of 5
  • 3 stars out of 5
  • 4 stars out of 5
  • 5 stars out of 5

0 out of 5 stars

Readers' comments (36)

  • Can the patients have the right to video record the consultation or do they only have right to audio record the consultation?

    Also what is the guarantee that the patient will not give the recorded consultation to a third party.

    Unsuitable or offensive? Report this comment

  • Vinci Ho

    The shared understanding and shared decision making in Pendleton's model will cease to exist if one party unilaterally decides to break the trust and confidentiality .

    Unsuitable or offensive? Report this comment

  • Doctors make notes about patients and patients have no recourse to correct mistakes.

    A recording of a consultation allows a patient to have an accurate record of what happened in a consultation - not a subjective record, subject to doctors' biases and prejudices.

    Unsuitable or offensive? Report this comment

  • I am not against a patient video recording during a consultation, but GPs should also be allowed to do this.

    What I am not sure about is whether patients or GPs need to get each other's permission or whether a patient or a GP can do do this without the other's permission

    Unsuitable or offensive? Report this comment

  • I am actually not sure I agree with this column.

    I would hope that a patient wanting to record our consultation would ask (never been recorded to my knowledge), but I wouldn't refuse without a specific reason.

    And while it isn't pleasant to be recorded covertly, look how many scandals have been brought to light through covert recording of medical situations. Would you really want a legal ban so that such scandals could not be uncovered?

    Covert recording has saved lives. Personally, I will consider any offended pride - my own or another GP's - to be a price worth paying for patient safety.

    Unsuitable or offensive? Report this comment

  • Vinci Ho

    There is a difference between covert investigation and shared decision/understanding in a consultation .
    The former is a mean to identify serious faults in any close door conversations and latter is a prerequisite of healthy outcomes in a doctor-patient relationship .
    Video recording of the consultation , in fact , is a shared decision by its nature.

    Unsuitable or offensive? Report this comment

  • Id be delighted to be able to record video consultations as a GP. It would immediately slash the idiotic patient complaints system where anyone is allowed to complain about anything - even the colour of my clothes, apparently. It would also show up the massively idiotic and demanding requests we have to put up with day in and day out. If they can record, then we should be allowed to do the same, to defend ourselves. Such is the state of medicine in the UK, but thats why Im getting the hell out at the first opportunity that presents to work in a country that doesnt have this crap.

    Unsuitable or offensive? Report this comment

  • Anonymous | 29 July 2015 2:43pm
    Absolutely right - it's all one way traffic. GPs have rights too - and the right to defend themselves against vicarious accusations should be at the top of the list!

    Unsuitable or offensive? Report this comment

  • My colleagues,

    Talk as less as possible in consultations. A patient coming for the 3rd time for a problem, refer to hospital specialist. First consultation, follow up, third; I will refer to the hospital.

    Unsuitable or offensive? Report this comment

  • Very contentious issue. If I had been recorded in some of my more 'fiery' consults with patients then I'm sure I may end up a little red faced, a little embarrassed that I let myself lose my rag, but it's only because I care about doing the right thing!
    I would never refused, if asked. If I'm not asked, so be it. The patient better not push my buttons and start being unreasonable with multiple requests and a shed load of self limiting, Internet searched, benign issues. They would be able to hear me loud and clear, "look, I am very happy to sit here and sort all of your problems out for you, remember you came in a few minutes late, the next patient will come in even later. If you do t mind holding them up, we can continue...I'm here til late tonight!"
    You know one patient actually just ignored me, shrugged her shoulders, and went on!
    There is a distinct lack of awareness in the general public as how best to use and access healthcare. If we don't start standing up for ourselves and try to defend ourselves from this endless flow of pointless trivial nonsense that we are offered up on a daily basis then we will sink.

    Unsuitable or offensive? Report this comment

View results 10 results per page20 results per page50 results per page

Have your say

  • Print
  • 36
  • Rate
  • Save