One-quarter of oncologists uncomfortable with patients recording visits
Although most oncologists did not object to patients recording consultations, a quarter of those surveyed had reservations, with several indicating they decline some or all requests to record, according to study results published in Cancer.
The findings highlight disparities in access to recording and the need for policy solutions to create equity for patients who wish to record visits, researchers wrote.
“Nearly all oncologists are familiar with patients recording their visits and the vast majority are comfortable with this practice,” Rachel B. Jimenez, MD, associate program director of the Harvard Radiation Oncology Residency Program at Massachusetts General Hospital Cancer Center, told Healio.
“However, a quarter of oncologists express discomfort with recording and, in the absence of institutional policy, this could potentially translate into different practices for patients treated within the same health care institution,” Jimenez continued. “Therefore, institutional policies regarding the practice would be valuable to streamline care and optimize the alliance between oncologists and patients.”
The analysis included input of 360 oncologists (median age, 48 years; interquartile range, 42-57; 67% men; 75% white) from five U.S. cancer centers and community affiliates who had been surveyed about their experiences, beliefs and practices regarding patient-initiated recordings.
Physicians’ self-reported comfort with patient-recorded visits served as the outcome of primary interest. Researchers also examined physicians’ attitudes (positive or negative) regarding the impact of recording on the patient-physician relationship.
Results showed nearly all responding oncologists (93%) had experienced recording during a clinical visit. Among them, 85% reported one to five recordings per month, 11% less than one per month and 3% more than six per month. Researchers found that although 75% respondents were comfortable with recording, 25% were uncomfortable and 56% reported concerns ranging from less thorough discussions to legal liability. Additionally, 85% of oncologists responded that they always agree when patients ask to record, but 15% never or selectively allow recording.
Although nearly half of all respondents (48%) indicated that patients “usually” ask permission to record the visit, 57% reported having been recorded without permission.
“We were surprised by how pervasive recording was; nearly all oncologists in the survey relayed experience with the practice,” Jimenez told Healio. “We were also surprised that a sizable proportion of oncologists reported that they had been recorded without their consent even though the vast majority would have permitted the recording if they had been asked.”
About half (51%) of respondents described recording as positive for the patient-physician relationship, however, more than a quarter thought recording can lead to less detailed conversations (28%) or avoidance of difficult topics, including prognosis (33%). Nearly three-quarters (72%) desired institutional policies to govern guidelines about recordings.
An even larger proportion (85%) agreed that “patients have the right to record visits,” but 92% thought patients should not initiate recording without the physician’s consent and 70% felt it was acceptable for physicians to prohibit recording, researchers reported.
Jimenez and colleagues found no associations between recording and sex, race, years in practice, subspeciality or practice environment, but did report an association of older age with a greater likelihood of having been recorded (P = .0477).
“This research dovetails well with other studies evaluating the impact of providing patients ready access to their medical information via patient portals and open charts,” Jimenez said. “It will be valuable to see how these approaches will influence communication, education and trust between the clinician and the patient.”
For more information:
Rachel B. Jimenez, MD, can be reached at Clark Center for Radiation Oncology, Massachusetts General Hospital, 55 Fruit St., Boston, MA 02114-2606; email: rbjimenez@partners.org.
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