Many years ago, I organised the British Lingual Orthodontic Society annual conference. It was called “Did video kill the radio star” with the aim of discussing the advances in technology. Would these advances in the CAD CAM world kill the traditional methods of appliance fabrication, a bit like video killing the radio star.
The recent Dentinal Tubules Study Club on the subject of consent made me wonder about the title again, especially when it comes to consent. Will video kill the current traditional way?
We know a signed consent sheet holds little weight in the legal world. The barristers like to see the word ‘discussion’ in the clinical notes. But how can we prove that the discussion occurred.? Thats where recording the consultation can be helpful and, this has become a lot easier with the likes of Digital Audio Notes.
However, one of the comments that stood out from the Dentinal Tubules event was about the patients body language. “It’s clear from her body language that she is not giving consent” or words to that effect, were mentioned. Which made me think. If operations in NHS hospital theatre are videoed and the recording used when the procedure goes wrong, then why don’t we just get on with it and install video cameras as well? After all, CCTV cameras are almost everywhere these days.
Personally, CCTV in the practice (although not in the surgery) has helped me in the past. A patient stealing from the bathroom (yup, the Moulton Brown Soap, disposable tooth brushes and toothpaste samples every time she came to have her brace adjusted) and a builder, who’s company flatly denied that he stole some of the staff belongings as he had been an exemplary employee for twenty years. I just said “I m watching the CCTV recording of him doing it”. End of argument.
So, if we have nothing to hide then why don’t we install video recording equipment in the surgery? At least then we can prove we discussed all the options, the advantages / disadvantages. We can use ‘teach back’ to prove the patient had an understanding. At least this way we would have all the evidence we needed to prove we had ‘informed consent’ …..and even the body language agrees !
ps. If you think this is a little too much, I m certain within the next coupe of years we will all have a ‘co-pilot’….. a device recording…. transcribing…and prompting us on what investigations/procedures you need to do. And soon after this, it will be able of absorbing the data from the intra oral scans… the radiographs… and may be even the glasses your wearing to give you a treatment plan. It is coming…. Like it or not !