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CAMHS won't see you now

No, I’m not ready for my close-up

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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

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Readers' comments (36)

  • How can there be trust, if the other person is at worst, looking for ways to f*ck you over, at best, heaping more pressure on you not to make a mistake?
    I agree, if allowing covert recording is a must, then we should also be allowed to record covertly, 'as long as we don't show it to a 3rd party', but to have just in case of any nonsense

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  • Anything that transpires during a medical consultation is part of the medical record.We have every right to ask the patient for a copy of the recording to be included in the records.

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  • andrew Field

    Welcome Zoe. I'm with you. No doubt if you took most of my typical and sometimes frantic consultations squeezed into that 10 minute slot with time left for typing they would fall well below par of many objective assessors. And these are the snapshots we will potentially be judged on - out of context, taken in isolation, low quality records of the episodes when things didn't go at all well. Personally, I can't wait to go viral.

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  • Can I help it if the builder installed strong electromagnets into the door frames of the Consultation Rooms.

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  • Anonymous | 29 July 2015 12:36pm

    The fact of the matter is that covert recording comes from a breakdown in the doctor patient relationship as well as further contributes to it.

    If I do not feel I have the confidence of a patient I would ask them to see another GP or leave the practice.

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  • Great article.

    I agree GP's should have equal rights, we are asked for our opinions. There are two peoples confidentiality here.

    If this becomes widespread, then all consults will become recorded, consults longer and far fewer consults. Glad I'm not involved anymore

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  • This is modern slavery!!! No rights for doctors.

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  • A tricky one here.

    One must explore why the patient wants to record the consultation. If they have genuine reasons, then sobeit. Who are we to deny a deaf or blind person that they cannot record the consultation so they can review what was said? Or somebody with learning difficulties who wants to show their parents to make sure they got all their points across?

    Having said that recording (audio or visual) should be a 2-way conversation and agreement between patient (and any advocates in the room) and the GP. If either side is not happy, then in my view the consultation should not be recorded. If the GP declines but the patient insists then unless it is an emergency offer them an appointment with another GP who may agree to it.

    Covert recording is a very different thing. This implies mistrust, deceit and is just plain rude and unacceptable in my eyes. Although it may be that the patient is too timid/scared to ask for permission,
    ultimately to me it suggests nefarious and deceitful intent and is likely to be used for complaints or compensation seeking behaviour (the country being the way it is), and if I discovered it I would refuse to see the patient again and explain the relationship has irrefutably broken down.

    Why not have automatic recording set up so that all consultations are recorded and stored securely so that GPs have a comeback against spurious and deceitful complaints? Oh yes, because patient rights trump everything.

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  • anonymous at 07:29 am
    I completely agree with you.

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  • As a patient I would never dream of videoing a consultation for two reasons; first, my loss of confidentiality and second, I feel it would have a seriously adverse effect on my relationship with my GP.

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