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Audio recording your consultation with NHS doctors

Discussion in 'General ME/CFS Discussion' started by golden, Mar 10, 2013.

  1. nolegion

    nolegion

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    Many thanks to golden for the write-up of the thread I started a few years ago and still kindly hosted by CAG (a UK, very large, 'non-profit' website covering a wide range of "consumer" issues).

    I think it would be tremendously useful if the initial interest in the topic shown here was taken forward and developed with particular reference to non-UK legal issues (which I am not qualified to explain). It can be hard work, but I have found it immensely rewarding, and have 'met' (at least electronically) a large number of people with considerable insight, and sometimes fascinating – and shocking - stories to tell, on the way.

    Never leave without a link: here's one I will be posting in the UK thread shortly:-
    http://www.speaksooner.org/why-every-patient-should-be-recording-appointments/

    There is no good reason why those who earn a living by advising should object to their advice being recorded by those they advise.

    With best wishes,
    nolegion
     
    MeSci, peggy-sue and golden like this.
  2. golden

    golden Senior Member

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    Hi Nolegion,

    If Id have thought about it - I wouldn't have just posted the thread reference but would have creditied your name too.. :)

    It was such an inspired, intelligent thread that is so relevant to M.E./C.F.S. community.
    As you may see.

    Thank you! :)
     
  3. golden

    golden Senior Member

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    I have only just seen this xks201,

    Thats so damaging. More so when younger I think.
    Its this sort of random mental health label that gets plucked out of thin air depending on the medics mood, thinking that scares me.
    n
    But physical testing isnt being done in lots of cases. And diet is rarely thought about.

    I have read a few accounts of the negative effects of dairy and remarkable health improvements.
    You were lucky in a way to find the true cause...
     
  4. golden

    golden Senior Member

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    I agree with the link.

    Personally though what is so difficult at a Doctors surgery ...

    is Everything !

    With a Neurological condition ,

    the travelling, the sitting at the surgery waiting , with nowhere to put feet up or lie down causing problems and POTS OI symptoms , the flourescent lights , probable chemical and sensory overload.

    One walks into the appointment after just battling through the jungle lol:)

    Then is the holding all the questions in my head whilst being rushed and interrupted by doctor.
    Taking a list of questions and symptoms is much better.

    In fact I have an idea !

    I will pre -record what I want to say to my G.P. -

    When I see him , I will just hit PLAY and watch as he tries to interrupt :)
    and insult it :)

    But at home or well rested to be honest I can take in difficult news or hard to hear diagnoses.

    I was reading a scientific study (NEnglJMed, 2012;367:1616-25) done by Researchers at the Dana-Farber Cancer Institute in Boston.

    To summarise the article in WDDTY, (August 2013 issue) , they discovered :

    "a major miscommunication issue between the oncologist and the patient when they interviewed 1,193 patients with metastatic lung or colorectal cancer....

    four out of five patients believed the chemotherapy would cure them even when they had discussed the trt with doc.
    Very few patients believed into the two more likely outcomes : that chemo might extend their lives or help with some of the symptoms ofthe cancer"

    My Mother did this too. She died of bladder cancer.

    That is a HUGE miscommunication. It could be as the article suggests.
    And if so , recordings should be standard and not 'radical'.

    :)
     
    peggy-sue likes this.
  5. xks201

    xks201 Senior Member

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    It's been a hell of a lot more complicated than just removing dairy.
     
  6. golden

    golden Senior Member

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    I bet it has.

    I vaguely recall alot of people chatting about the Cancer /dairy /china link ...
    And people who have successfully cured schizophrenia from a macrobiotic diet cutting out sugar etc.

    The thing is , finding what works for each of us, as individuals.
     
  7. nolegion

    nolegion

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    It has been kindly suggested to me that people might find more links on this subject helpful. Truly, I am spoilt for choice, but here's a selection from the past 18 months or so:-

    Summary from a Scottish medical defence union. Legally, it's nearly accurate:
    http://www.mddus.com/mddus/news-and-media/media-centre/may-2012/covert-recording-risks.aspx

    Ivy Robinson's case (warning, distressing):
    http://www.theguardian.com/society/video/2012/aug/29/ivy-robinson-abuse-oakfoss-video

    Dr Robinson's case. I don't think the complainant in this one earned many new friends, but it is important as a demonstration of the principle that the General Medical Council can and will strike doctors off the register on the basis of a covert audio-recording:
    http://www.dailymail.co.uk/news/article-2101313/Doctor-secretly-taped-enjoying-sex-sessions-female-patient-struck-off.html

    Beware of bears:
    http://www.mirror.co.uk/news/uk-news/christine-anne-mayor-mum-puts-2023206
    &
    http://www.cbc.ca/whitecoat/blog/2012/12/19/big-brother-is-watching-secret-recordings-of-mds/

    CBT…or common sense:
    http://www.babcp.com/cafe/index.php?topic=3207.0

    Common sense, oncology USA:
    http://blogs.webmd.com/cancer/2012/03/your-new-best-friend-an-audio-recorder.html
     
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  8. overtrain

    overtrain Medical Mafia needs to die via this virus.

    I wouldn't think of going to a doctor's office without turning on the recorder right before I walk through the door. My "medical care" was so poor in Iowa City, U.S. that at my final appt. I referred to the fact I was recording our visit right in the middle of it, & pointed to my cell phone placed between us. I said I wanted it on record I came in with these symptoms on this date and asked for help. He got a whole lot nicer right away. Demeanor, tone, everything. But bottom line? No help. I even record any dealings with my landlord now. If someone isn't doing anything wrong, they should have no fear of exposure. Used to be a college teacher. Couldn't care less when students asked if they could record occasionally. Only those who act badly have fear. That tells you something in itself. Hello, transparency? Also, it totally changes the dynamic if you bring a witness. And if you're female? Studies have shown you'll get better care if you're accompanied by a male, not a female. For a while I recruited various male friends in my life to go to the ER with me. I got taken more seriously than when I went alone or with a female. Turn the tables on these doctors; they work for you, not you them. :D
     
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  9. nolegion

    nolegion

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    Although there is some overlap between this link and previous ones posted here, it is well worth persevering with it in my opinion:-
    http://helphealthcare.wordpress.com/2012/12/11/too-expert-to-ask-why-we-distrust-medical-professionals/

    Above all there is the podcast link to a CBC discussion of patients who record (which as indicated starts at 18:28 - and finishes at 28:12).

    Like the blogger, I found myself increasing irritated with the alleged 'expert' who gets most of the air time. Sitting on the fence until it requires surgical removal helps nobody.

    I much prefer the relaxed pragmatism of the doctor first asked to comment:-

    "… because there is no way to stop it, I think hospitals will have to figure out a way to embrace it."

    When I first heard that, it reminded me of a commentator in England over 3 years ago. See 'Seth Fyl's' final remark in an annotation at the foot of an online article back in May 2010:-

    "At the risk of earning an MA in the bleedin’ obvious: if we don’t ‘embrace’ this aspect of ‘patient-power’ we will get “0££!!!17$ffRF*ed by it."
    ( http://editorsblog.gponline.com/2010/05/11/should-patients-post-consultations-on-youtube-facebook-and-twitter/#ixzz2cQLnBrig )
     
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  10. golden

    golden Senior Member

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    http://www.bmj.com/content/348/bmj.g2078

    Nice to see the stream of sanity flowing far and wide :)

    BMJ article 'patientgate' acknowledges Nolegions thread on The Consumer Action Group...

    :) Thanks again Nolegion!
    This was an important topic to me.
     
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  11. Esther12

    Esther12 Senior Member

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    Nice to see. Thanks.
     
  12. nolegion

    nolegion

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    Hello again.

    That 'patientgate' article by Prof. Elwyn may disappear behind the BMJ's usual paywall shortly, so, just in case, here's a further route to it that doesn't involve tangling with the, now voluminous, thread I started a few years ago at CAG:-

    http://thehealthcareblog.com/blog/2014/03/13/patientgate-digital-recordings-change-everything/#comments

    Some weeks prior to that, in what is frankly a complete volte-face by the insurer concerned, the MDU went into print warning doctors not to try to 'ban' patients solely on the ground that a patient wants to take an audio-recording of a consultation home:-

    http://www.themdu.com/guidance-and-advice/latest-updates-and-advice/what-should-you-do-if-a-patient-wants-to-record-a-consultation

    This is, obviously, all very helpful indeed. But I think we should also bear in mind the fact that in the online poll the BMJ has just closed, nearly 40% of the vote was still against the right of patients to record at all(!).

    Damn the dinosaur doctors, and get recording, I say - perhaps with copies of the above articles in your pocket.

    Best of luck to all patients here, especially recording ones, of course; and if you have a 'recording story' – good or bad, 'overt' or 'covert' – please do put it online one way or another, so we can all learn from it.
     
    Last edited: Mar 18, 2014
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  13. Esther12

    Esther12 Senior Member

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    Thanks nolegion.

    re the BMJ poll: currently in the UK doctors have a lot of power and little accountability, and it's not in their interest to change that - I expect that change will have to be pushed upon them.

    Before I fell ill, I had no idea how much a 1950s mentality continued to reign within medicine. It's has not been a pleasent surprise!
     
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  14. nolegion

    nolegion

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    For anyone here still keeping an eye on this subject, there was a World Service 'Health Check' broadcast about it a few days ago, which you can access here:-
    http://www.bbc.co.uk/programmes/p020r2y5

    I now understand the topic is also likely to be covered in an edition of Radio 4's programme 'Inside Health' coming up next month: specifically, for diaries:-
    Tuesday 8th July at 9:00 pm - repeated at 3:30pm on Wednesday 9th July. (Or you will be able to listen again from here for a short while if you miss it:-
    http://www.bbc.co.uk/programmes/b019dl1b)

    Both the patient who used two recorders and Prof. Elwyn, who wrote the 'patientgate article', feature in the earlier broadcast, and may well do so in the next, I believe.

    Meanwhile, the Prof. has been conducting a major 3 day conference (Dartmouth Institute) in the USA - ended yesterday - about 'shared decision-making' ( = fundamental part of 'patient empowerment', in my book). He has indicated before that recording by patients would be on the agenda there.

    I am hoping the forthcoming UK broadcast on R4 will tell us a bit about how that conference went.

    Regards to all here.
     
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  15. Esther12

    Esther12 Senior Member

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    Thanks for posting the updates for us.
     
  16. golden

    golden Senior Member

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    Havent visited this thread for a while.

    This case is against a G.P. in Huyton, Liverpool. 65 year old Dr ARUN SINGHAL.

    Patient feels suicidal, had told him her anti depressant meds not working - after first consultation she thinks she hears her G.P. tell her:

    'You should go home and kill yourself'.


    So she books in again and records the session.

    On suicide the Doc says agsin:

    'You can go and jolly well do it now'

    'If you dont know how to do it, its on the internet'


    G.P. also tells patient she was a 'disgrace' And added a false entry on her records claiming she had threatened to kill him.

    He also failed to note in her records an expression of suicidal intent.

    The hearing will last 5 days in the absence of the G.P. as he didnt want to take part.

    http://www.dailymail.co.uk/news/art...tml?ITO=1490&ns_mchannel=rss&ns_campaign=1490
     
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  17. nolegion

    nolegion

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    And the verdict last Thursday was:

    'MPTS panel chair Eileen Carr said while Dr Singhal's medical treatment of Patient A had not been called into question his comments to a patient with a history of mental health concerns were "totally unacceptable and inappropriate".
    She said: "The panel finds his conduct fell well below the standards expected of a medical practitioner and is satisfied that his behaviour amounts to serious misconduct." '

    http://www.bbc.co.uk/news/uk-england-merseyside-29254609

    While this is in one sense yet a further instance of the triumph of evidence recorded by a patient - because who can doubt that what was actually said behind closed doors would, in the absence of such recording, simply have been denied - the disciplinary consequences for the wretched doctor concerned seem woefully inadequate.

    A mere 3 months suspension from practice?!
    ,
    I suppose one should wait until the full case report is available at the MPTS website (in a day or two) to see the full statement of facts as found and the reasoning behond the decision; but it's difficult at this stage to imagine how such leniency could be construed as anything but insulting to the patient concerned - and, by extension, to all patients.
     
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  18. golden

    golden Senior Member

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    I am going to wait because this is all too jolly for words.

    "The panel was disappointed it had not heard from Dr Singhal during its proceedings, with no evidence of an apology, insight or remediation"

    This is particularly disturbing. Strike Doctors off automatically for not bothering to turn up to the hearing.

    It was not a moment of frustration from this G.P. as he said it on two seperate occasions. I cant think of a worst thing to say.

    This vulnerable patient has been put through unecessary trauma. She had to take the iniative herself, record her G.P. abusing her and go through the hearing - hopefully righting her notes.

    How can this be deemed as NOT medical treatment? And have it seperated? It occurred in the Doctors office during consultation time. He committed fraud on her medical records all which could have resulted in her being locked up in a psychiactric ward, future poor care from Doctors who may believe her medical notes and think she threatened a Doctor.

    The lack of accurately recording her symptoms and addressing the fact she needed a sick note and her medication wasnt working. How can it be deemed as satisfactory medical treatment.

    A three month holiday and work as usual then.

    But I hold hope that further
    insight and understanding will
    come with more information.

    Edit: A compulsory Full Time, year long refresher course for Doctors who are so out of touch, if they want to continue to practice. Paid out of pocket - £20,000 - 30,000. To make sure its good quality.


    And an aside link :)
    http://www.worldmedicaltimes.org/dr-david-jarman-ducking-the-gmc-prosecution/ on.
     
    Last edited: Sep 21, 2014
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  19. Esther12

    Esther12 Senior Member

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    I don't really like commenting too much on an individual case without knowing a lot about it, but am also aware that this caution can easily let those in positions of authority get away with a lot. Self-regulation seems to end up allowing abuses of power wherever it occurs. At least with politicians there is a degree of democratic accountability - for other powerful professions that should be genuinely independent disciplinary processes.
     
  20. nolegion

    nolegion

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    The full case report on Singhal was not published online until today. I think the MPTS leaned over backwards to provide excuses for a doctor who couldn't even be bothered to turn up to the hearing, and to minimise any adverse consequences for him.

    As regards the evidence against him the audio-recording taken on the patient's mobile phone was clearly absolutely vital. Even then, however, because the recording ended 'abruptly' (it's called an off-switch), the panel decided that the patient 'might' herself have made a homicidal threat, which 'might' therefore be accurately 'recorded' in the doctor's notes, which 'might' mean that the doctor was not actually being deceitful in the compilation of the record - although, those notes were indeed found to be 'misleading' in places.

    The legal test to be applied at these hearings nowadays is 'the balance of probabilites' - not whether a panel can be completely satisfied that something did or did not take place. Just how much benefit of the doubt can a supposedly impartial tribunal manufacture on behalf of someone who wasn't there to allege what the panel concluded in the first place?

    One practical moral is keep on recording until you are out of the building. I have to say that is something I always do; and I 'sign off' in the same way as I start: with an 'announcement' to my gadet of date, time, place and clinician concerned.

    in any event, a couple of months from now this GP will most likely just send in a bunch of glowing 'testimonials' from some cronies, and he will back in practice.

    I would be interested in what anyone else thinks:-

    http://www.mpts-uk.org/static/documents/content/Arun_Kumar_Singhal.pdf

    The baffling - I would say absurd - distinction between what Singhal said and his 'medical' treatment of the patient is to be found at numbered paragraph 8, on page 11.
     
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