I think the whole liability thing is why it's hard to get hospitals/docs to take pics/video. - Spidra Webster

Yeah, that's my guess as well. Maybe it should be mandated or something. I feel like I should have the right to have all of my interactions with the "system" be recorded. - Paul Buchheit

Not to mention privacy issues ... - LANjackal

What privacy issues? If I want to be recorded I should have that right. (if people don't want it, that's fine too) - Paul Buchheit

What privacy issues? I want HD video of my own medical procedures, not anyone else's. - Tudor Bosman

You can usually get your Lasik surgery recorded. - Kevin Fox

When I got my cholescystectomy, I asked for pictures. The first surgeon said no. He also wanted me to do a 23 hr outpatient procedure that would cost me more than staying overnight at the hospital. I got a 2nd opinion. 2nd doc was much nicer, worked w my insurance needs, and gave me polaroids of the gallbladder. I have no video of any of my procedures that I've had, but I've asked for copies of film or pics to be taken ever since 2000. I figure I'm paying a buttload of $ for this stuff. It's the least they could do. - Spidra Webster

23 hours? Geez. Was this before laparoscopic procedures became commonplace, or were there a medical reason that a laparoscopic procedure wouldn't work for you? Jeanette was in and out in less than 6 hours when she had her gallbladder removed. - Tudor Bosman

I had laparoscopic. However, my insurance was such that it was cheaper for me to have an overnight stay than not. And I actually needed it. I was NOT ready in 23 hrs. In fact, I fainted just when trying to go to the bathroom. Since I lived alone and no friends were willing to help, I needed to be someplace staffed. - Spidra Webster

"it would be useful" in the sense that you would like to sue the doctor later on? - t toring

No, that would be 'sueful'. But seriously, wouldn't this protect both parties? With video evidence you could better sue a doctor who actually made a mistake, and defend a doctor who didn't. Evidence should protect the parties that need protecting. - Kevin Fox

*adds webcams to the list of things she will be called in to replace in the OR on nights and weekends* just kidding...actually, I may not be (well, surely they'd want to use high-quality recording devices...) - MiniMage, enterRUPPted

doctors are humans.. they can nick something in a routine procedure.. who will make the call from the video that it was a mistake that a human can make or it should be classified as carelessness. - t toring

As lawsuits go, video would probably help whoever was in the right, but it's the hospital that gets to decide whether to allow it, so they need to figure out whether it would help them more than it would hurt. - Seth

Imagining some doctor who likes how he looks striking a pose or wanting to get his good side. - MiniMage, enterRUPPted

Heh. I wish I had been able to stay in the hospital for my gall bladder removal. My surgery was at 8AM and they kicked me out by 11AM. No surprise I ended up in the ER the next day. - Rochelle

:( Rochelle - MiniMage, enterRUPPted

>>video would probably help whoever was in the right.... why do you think so? there is an industry out there with the sole purpose of suing doctors to make money - t toring

If they were suing for malpractice, and no negligence could be seen in the video, wouldn't it help the doctor? - MiniMage, enterRUPPted

is missing a nodule in one breast scan out of 1000s of breast scan a radiologist read malpractice or negligence? the high sue rate is why there is a shortage of radiologists who want to read mamos - t toring

Some old school OBs won't allow video of births because they don't want the video to come back and bite them if something bad happens to the baby and the parents sued. Nowadays, most OBs will allow video, but many still won't allow their face to be shown. - Rochelle

From some of the stories I've heard from a resident, even just recording the audio would be sufficient to increase the professional conduct of some surgeons. - Simon

! - t toring

It's probably highly dependent on what the lawyers at the hospital and the malpractice carriers of everyone involved think. During residency, we actually videotaped pretty much every delivery that required resuscitation, for teaching purposes. But apparently there have been instances where the physician was totally willing to record, but their malpractice carrier actually told them that they shouldn't. - Victor Ganata

So treat it more like flight data recorders: Put the video/audio in escrow and only allow it to be viewed by either party if a suit is filed. A deposition as to the nature of the pain etc prior to viewing the video will inhibit the patient from searching for a questionable bit in the video and faking the corresponding symptoms. - Kevin Fox

i would love to code while having a "manager" watch my screen.. somehow i think i will produce beautiful stuff - t toring

toring, I don't think that's what anyone is saying, but if you were writing code in an environment where writing the wrong thing could kill me, I wouldn't feel so bad about having someone watching your work. - Kevin Fox

Toring: If there is a bug, do you permit anyone else to look at the code and revision history log so that they can identify the exact cause of the problem? - Simon

It depends how scared your Doctor is. Some Doctors allow it, but many don't due to liability worries mentioned. It's stupid, I know, but if they have the monopoly on your business there's not much you can do (yet another problem with our Healthcare system). - Jesse Stay

Funny how no one ever has any problems with continuous surveillance as long as it's not happening to them ;) - Victor Ganata

Who is this "no one" you're talking about? - LANjackal from IM

I haven't seen a thread where anyone has proclaimed: "I have no problems at all with having a camera trained on me continuously during my work day" but maybe I haven't been observant enough. Actually, though, I don't have any problems with recording per se, but if my malpractice carrier told me they'd drop me or raise my premiums if I did, I might not be so cavalier about it. - Victor Ganata

I think it depends in part on how performance-oriented your profession is. Football players seem to be ok with the cameras, for example. - Paul Buchheit

If your malpractice carrier told you they'd lower your premiums if you recorded your procedures, would you? A lot of people are getting lower auto insurance rates in exchange for installing a GPS black box in their car. Bus drivers have always-on cameras recording them *and* their passengers. People who are in jobs where their actions have a reasonably high chance of killing other people should understand the need to have a secondary source of information, *especially* when the patient is unconscious and unable to be aware themselves. - Kevin Fox

simon, its not the act of being watched.. i would actually like to be watched by a fellow coder who could give me valid input.. if i understood it correctly the intention of recording the operation is that if something goes wrong then the patient (and his lawyer) will be able to go through the video to find stuff they can sue for.. the intention is not a peer review to improve a surgeon - t toring

Football players can't get sued for dropping a pass, though. (Or can they? o_O) - Victor Ganata

toring: If something goes wrong the patient (and yes, their lawyer) *should* be able to go through the evidence and find out what happened, and that an impartial judge/jury could, if needed, make the same decision. Rampant malpractice suits don't mean that actual malpractice doesn't happen. Information is a good thing. - Kevin Fox

Like I said, I don't have any objections to recording surgeries and patient encounters, and I would totally do it if malpractice carriers agreed to lower premiums, but, frankly, that's not what the environment is like these days. I think the hospital where I trained got a lot of benefit from recording and reviewing neonatal resuscitations in terms of improvement of quality of care--but the sad fact is that lawyers, risk management teams, and malpractice carriers have a vested interested in not allowing it. - Victor Ganata

I was just discussing this in a meeting this morning. Some doctors want everything recorded, while others don't want anything recorded. The arguments against it are that for any non-trivial procedure you'll be able to find something that somebody did wrong, and that it takes up enormous resources. The arguments for it are the ability to review (like game films) and defend against lawsuits where the surgeon didn't do anything wrong. - Gabe

I was to be treated for cardiac disease. The deal was $2600 for a three hour operation. Well, long story short, the procedure took much less than three hours, yet the surgeon still wanted the full $2600. I said to the guy, "Look, we agreed on $2600 for the full three hours, not for 15 minutes." He said that wasn't the deal; that it was $2600 for the job and not per hour. "What do I look like -- a fast food worker?" he said smart-assily. He also said it was actually 2 hours he worked, but I know for a fact that could not be possible, as I went in at 3:00, the operation began at approximately 4:15, and we were done by 5:00. I know this because I watched the 5:00 news on channel 6. Anyway, the point of my story is that if this operation had been filmed in HD, I would have known exactly how long the operation lasted, and my case would be much stronger. - tabbr

tabbr: I don't know what country you're in, but I'm sure that if it were in the US the case record would have the incision start and stop times. However, I wouldn't argue with the guy. If he thought it would be a 3-hour case and it ended up being much shorter, you should consider yourself lucky. Besides, just because he only spent 15 minutes standing over you doesn't mean he didn't spend 3 hours on the case -- he still had to have consultations, review test results, make dictations, etc. And even if he didn't, he scheduled 3 hours for your case, meaning that he couldn't make up the revenue by doing other cases after yours. Would you prefer that he schedule other cases later and then rush yours if it ran late? - Gabe

BTW, the meeting I had this morning was about retention policies. One of our clients retains video for only 30 days unless somebody asks for it because their dedicated NAS only holds 4 TB. They don't even have HD cameras and can't record more than one video stream per OR. A typical hospital with 16 ORs and HD cameras could probably use 5 TB per week. - Gabe

If patients ask for a copy, do they provide one Gabe? - Paul Buchheit

I sense OperationFeed coming.... - Jemm

Paul: I doubt any patient has ever asked for a copy, but I don't see why they wouldn't be able to get one. The real problem would be doing something with the video. It's not like most patients would be able to do anything useful with an 8 hour video file. - Gabe

It would just be fun to have. I'd upload it to youtube :) - Paul Buchheit

I've seen some intraoperative video. I must say, they're rather boring... That said, if you know you want a video, just let the surgeon know ahead of time to record it. If he refuses, find another surgeon. - Gabe

Good to know Gabe. I didn't even realize that the hospitals were equipped for this kind of thing. Do you get a good view of the inside of the body? - Paul Buchheit

Honestly, I don't know how many hospitals are equipped for recording video of typical surgeries because I only deal with hospitals that have or are installing the capability. Of course any laparoscopic case can be recorded because they all use video and anybody spending $50k on a scope can pop for a few $100 for a VCR. - Gabe

The view of inside a body from a laparoscope is not very interesting. It's a pretty narrow angle of view and mostly you look like steak inside. - Gabe

Do you get the OR audio as well? - Paul Buchheit

Most ORs probably don't have microphones. If they have a microphone, it probably gets recorded with the video. - Gabe

there must be enough data out there to know if this is a good idea or not - john schneider

The War Lady was offered operating room video of her recent knee replacement. We declined but it seems common here in MN to record operations and routinely make it available to patient. As for surgeon who spent less time then estimated, in my varied experience time in OR time varies wildly based mostly on what they find when they unzip you, don't kvetch about the price be happy he got you back upright - WarLord

An old anesthesiology joke: knocking you out is free, it's getting you back and making sure you're still alive that costs big bucks. - Victor Ganata

tabor: I have the feeling that if there was a complication and the operation took 6 hours, you would resist a request to pay him $5200. - Kevin Fox

They probably record everything coming in through a scope at teaching hospitals. I would imagine reviewing recordings is clinically useful, since then you can look at things leisurely without worrying that the patient might code right under your nose. - Victor Ganata

Victor: Generally they only record cases that they expect to be notable for some reason or another. There's little point to recording thousands of hours of routine cases every year. - Gabe

When I tried to take photos of my wife's ultrasound the doctor stopped me, said it was for liability reasons that they don't allow photos or video. - Robert Scoble

Gabe: to be honest, all I know about what goes on in an ORs is from 3rd year med school, but I still imagine they probably do more recording at a teaching hospital than at a non-teaching hospital, more for the sake of the residents' learning than anything else. - Victor Ganata

gary my preference as I stated to anesthesia doc was "silly and stupid" even for minor surgery being on the table is too umm real for me I guess I'd prefer to skip it thank you very much - WarLord