Privacy and confidentiality laws (HIPAA) were enacted with the aim to protect patients and their health information from being used, abused, showcased or made a spectacle of in the name of research, teaching, meta-analyses, and other endeavors.[1]  As a result, healthcare providers are educated extensively as to how, under what circumstances, and with what means patient information will be used, and ultimately how and when the information will be destroyed – all with the ultimate goal to protect the dignity and privacy of the patient.   It is not irrational or absurd to assume, then, that there must be similar protections in place to safeguard the healthcare provider from certain acts perpetrated upon them by unscrupulous patients, such as the clandestine recording of office visits or treatment plan discussions and recommendations (without first asking if or apprising the healthcare provider that a recording of the clinician-patient encounter will be made). Why? You have no control as to how the taped product will be used. The recording may be edited, taking your comments and genuine concern for the patient and manipulating these into seemingly questionable, suggestible and negligent sound bytes that may construct the foundation of a claim against you.   Since there are no such protections for healthcare providers, how can you shield yourself from these situations? The proliferation of cell phones with their huge capabilities and diminutive size make it far too easy to record any kind of event, including consultations with healthcare professionals. Ponder this: how many people recorded the destruction of the Twin Towers in New York or the watery landing of a jet on the Hudson River?  Might yours be the patient encounter that finds its airing on YouTube or another website?      Depending upon the nature of your services and the set-up of your practice/office, consider the following:   Use your printed materials that describe your practice and your services to patients to address the issue of audio and/or video taping by patients, patient support members, etc.  If you have a practice website, make your position regarding taping of office visits, telephone discussions, etc. very clear and obvious on the web page so there is no dispute about your stance with regard to this practice before it occurs.  Informed consent discussions and informed consent forms should articulate your practice’s position with regard to audio and video taping of sessions.  Describe under what circumstances taping may be permitted and outline the steps to be followed in order to make the session being taped as useful to the patient as is possible.  As is practical, require patients to leave their personal belongings, such as handbags, loose fitting outer garments, and any other materials in which recording equipment may be retained with a family member, or place in a secure patient-belongings storage area.   Ask the patient to produce his/her cell phone and turn it off for the duration of the office visit.  Don’t continue the visit until you are assured this has been done. Create a consent form for this purpose that must be completed by the patient and signed by you before any such taping is permitted.  The consent should specify the reason for the taping request and what will be done with it.  Consider making your own tape of this session so you have an original copy.  It’s not beyond the realm of reason to suspect that any recording, once it leaves your office, can be tampered with, altered, etc, and turn any innocent discussion, recommendation, etc. into something malicious and “proof” of negligence or professional incompetence. Not all patients should be viewed as harboring unscrupulous intentions where recording of office visits is concerned. There may be perfectly acceptable conditions under which a patient may want to record the visit for good reason. How often have you encountered a patient who wants to record the discussion about a diagnosis or proposed treatment, fearing that s/he may forget important details once the visit has concluded? Consider encouraging the patient to invite a spouse, partner or family member to be present for the office visit. Alternatively, dictating your progress notes in the patient’s presence to capture the essence of the visit, discussion of diagnosis, treatment and patient questions or providing a visit summary for the patient to have in order to remember details, recommendations, and the like are viable alternatives to recording the visit.   The lesson here is a familiar and sensible one: the best defense is a good offense. Discourage recordings if the intent appears to be something other than recording information to share with the patient’s family. Or, at the very least, attempt to control the circumstances under which the recording will be permitted. Document in the patient’s medical record the request and the rationale for the taping and your understanding as to how the tape will be used by the patient. Consider the use of an Authorization or Consent Form both you and the patient will sign before any recording begins. Remind returning patients periodically as well as new patients about your “no recording” policy. And make your own recording of the encounter using your own equipment if the patient insists on taping the encounter.   If a patient is determined to make a recording without your knowledge or consent, chances are s/he will find a way. But, you can minimize the chances for a recording to be made without your prior knowledge and consent by considering some of these steps.     [1] These laws are designed to protect the patient in a relationship that historically has imbued the physician with a kind of paternalistic power due to his/her medical knowledge, training and experience.  The patient, on the other hand, is ignorant, by and large, of medical issues and is forced to place his or her trust into the hands of a professional.  Laws help to moderate this “imbalance” by placing responsibility on providers to treat patient information with the highest degree of respect and confidentiality as is achievable.