Physician's Scathing Remarks Humiliate Patient, Cost Hospital

In the wake of an astonishing case of unprofessional behavior, health systems and medical practices are scrambling to review their recording policies—rules that aren't as straightforward as one might think—and their damage-control readiness.

While sitting in a hospital waiting room last week I could hear an escalating argument taking place in an exam room down the hall. Later, after I'd been called in for my appointment, I asked the nurse what had been going on. She said a patient wanted to record their appointment on their phone and the doctor wouldn't allow it.

The nurse wasn't sure if this particular patient was inspired by the news story about the $500,000 payment awarded to the Bethesda, MD, patient who sued his anesthesiologist for remarks said during his colonoscopy—which he happened to record on his cell phone.

But she thought it was likely. A lot of patients had been talking about it, she said.

Damage Control Lacking
Once I got home, I did some digging into how Aisthesis, the practice that had employed anesthesiologist Tiffany M. Ingham, MD, and was mentioned in nearly every national article about the trial, was handling damage control. In short: they weren't.

The only public acknowledgement I can find is a statement published in the Washington Post article that broke the story:

We apologize to this patient and regret the distress and suffering that this most unfortunate incident caused," a spokesperson told the paper. "The anesthesiologist involved is no longer with our practice. Once we learned of this incident we assured that every anesthesia staff member reviewed and reiterated their pledge to abide by our professional organization's code of ethics.

It's not bad as far as statements go—at least they apologize for their former employee's transgression and explain steps they're taking to make sure it doesn't happen again—but it's certainly not enough to repair their reputation.

It doesn't help that the practice's website makes no mention of the lawsuit [read the complaint here], its Facebook page hasn't been updated since 2013, and its Twitter account has been quiet since 2012. This social silence is not the best approach, especially since the scathing Washington Post article is the sixth result when you Google "Aisthesis Bethesda MD."

Lessons for Hospitals
While the practice directly implicated in the suit isn't doing much to help itself, the ripple effect is now being felt at other hospitals and medical practices and many are scrambling to review their recording policies—rules that aren't as straightforward as one might think.

Take my aforementioned hospital visit for example: A patient wanted to record their appointment on his or her phone, was told no, and an argument ensued, which could be overheard by several patients. It wasn't a positive patient experience for anyone involved, which makes me question if a black-and-white "no recording" policy is the right approach.

In fact, the first matter to consider whether state law permits recording and under what conditions.

Then of course, there are a number of HIPAA concerns—especially with video recordings—as well as infection-control issues, but there's transparency to consider, too. Outright denying a patient the right to record their visit will likely make them wary and do nothing to address any anxiety they may have. And there's the matter of fairness—if patients can record their baby being born why can't they record other types of visits?   

At the very least, clinicians should be instructed to ask patients looking to video or audio record a visit what they are hoping to get out of it. Perhaps they are worried about remembering the doctor's instructions, or maybe they aren't comfortable with English and are concerned about understanding everything the physician says. In both instances, staff could then take steps to allay the patient's fears, either by reviewing instructions or arranging for a medical interpreter.

And, in the rare instance that a patient wants to record a doctor in an attempt to gather evidence, a patient advocate and other support staff should be brought in to address any grievances.
While it's easy to bemoan modern technology and increasingly demanding patients, reviewing your organization's video and audio recording policy is ultimately an opportunity to address potential patient satisfaction concerns. Cell phones and other recording devices are ubiquitous and they're going to keep getting smaller and easier to conceal. So having an open dialogue with patients will likely yield better results than slapping "no recording" signs on the walls.