I have had patients try to snapchat their laceration repairs.  They have utilized FaceTime for discharge instructions with loved ones. I recently had a patient try to put their phone in selfie mode so they could see how their lumbar puncture was going in their back (my nurse quickly prompted them to get back into position and removed their phone).

Smartphones have changed everything.

By now many physicians know of the Bethesda, Maryland anesthesiologist who was successfully sued for hundreds of thousands of dollars by a patient who “accidentally” recorded conversations she was having while he was sedated.

My social media feeds were in overdrive when the final judgement was announced. Even though every physician I know felt the Anesthesiologist’s behavior was not appropriate, most were shocked at the massive amount of the judgement — $500,000. Most also felt it wasn’t appropriate for the patient to be recording the physician team without their knowledge. What if the team started talking about their next patient at the end of the case, and this patient was privy to all that information?

The patient most likely used the iPhone’s native Voice Memo app to record the conversation. The app enables you to record audio as long as you want or until your phone runs out of memory or battery life.

While the Anesthesiologist erred on an epic scale both professionally and with their medical charting — most felt it was still a gross invasion of privacy to do what the patient did. I was surprised by how many physician’s felt they somehow had a legal right to know if they were being recorded. That is definitely not the case.

Patient’s can legally record your interaction with them secretly in almost every state. Further, they can use that recording to sue you as well.

In my lectures on the interplay between social media and medicine, one of my themes is how physicians should expect their interactions with patients to be put in the public domain at any time. I tell my students how patients will be tweeting their doctor’s name if they aren’t happy with their care or uploading videos to Youtube showing how the patient visit went.  If you look at Google reviews of various hospitals, you already see this happening — specific doctors’ names being used and patient’s giving detailed descriptions of their medical record and what happened. What’s interesting is that when this happens for other services, the owner or manager is able to respond to specific complaints in order to give both sides. That’s impossible for hospitals to do due to privacy laws protecting patients.

In a great piece published by JAMA on this issue, the authors summed it up best with their following conclusion:

If physicians embrace this possibility, establish good relationships with their patients, provide compassionate and competent care, and communicate effectively and professionally, the motives of patients and families in recording visits will be irrelevant.

Expect it, embrace it, don’t complain about it.