Recording patient/doctor encounters: A modest proposal

This is a guest post by Dr. Drake Ramoray (A pseudonym. He is not affiliated with the actor, character, the show “Days of Our Lives,” or NBC.)

I have been assured by a very knowing American of my acquaintance in London, that a young healthy child well nursed is at a year old a most delicious, nourishing, and wholesome food, whether stewed, roasted, baked, or boiled ...—Jonathan Swift

I have A Modest Proposal. I suggest we just videotape all patient/physician encounters. Why rely on a possibly low quality audio recording where exterior noises or interruptions could interfere with the quality? Furthermore, perhaps my comment that may or not be taken out of context will make more sense if one can see my body language. Even better, lets just transmit the videos directly to CMS and your insurance carrier so we can add additional layers of bureaucracy and non-medical personnel to the mix whose pay has to come out of physician charges, taxes, or patients' premiums.

The physician claims he did a level 5 review of systems and physical examination? Hey lets just review the tape and see what he did. Don't believe your doctor spent over 40 minutes on your case with over 50% face-to-face time and the rest coordinating your care? Might as well just get the doctor to wear the camera all day at the office. Who wouldn't want to watch me getting a prior authorization with United Healthcare for 20 minutes? In fact, if I'm rude on the phone then the corporate hospital that I have been forced to work for can accuse me of being "disruptive" when my physician peer-to-peer is not approved.

Female patient feels a little uncomfortable during a breast or pelvic exam, doesn't want a chaperone? Who needs a chaperone? We can record that too.

The TSA already gets to look at your genitals. Why not CMS? We need to stamp out waste, fraud, and abuse!

Not sure that your doc is overtired or getting 8 hours of sleep? He claims he doesn't have a substance abuse problem or drink alcohol. Let’s just imbed the camera in his head and monitor him 24/7. In fact let’s just make it public. I mean quality metrics are going to be made public. Oh, Dr. Ramoray had a Texas Tonion and Chocolate Stampede at Longhorn with his wife last night. Did you see him eat that whole dessert? We think he only had one glass of wine, but there are certain parts of the footage that are obscured during parts of the meal. Watching the video one thing is for certain, Dr. Ramoray married up.

Why trust doctors with anything? I have an uncontrollable yet subconscious urge to prescribe Crestor for my next patient whether they need it or not. What!? I didn't eat the greasy food from Olive Garden today. I had to go see a patient at the hospital. Review the tape! (Bonus points to the Crestor rep for bringing Chicken Alfredo and lasagna to an endocrinologist’s office to push a cholesterol medication.)

PS: Actually, now that I think about it, I'm not sure at all which medication to prescribe. My pen has run out of ink.