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The BMJ Today: Patient recordings, gestational diabetes, and smoking cessation in pregnancy

12 Mar, 14 | by BMJ

We’ve grown so used to the words, “your call may be monitored or recorded,” when dealing with our bank, phone company, or even dentist over the phone that it no longer even registers.

But did you know that patients have the right to record medical consultations, even covertly, as it is regarded as a legal form of notetaking? Patientgate—digital recordings change everything on bmj.com today, illustrates this, to some alarming, reality through an example based on an online discussion thread.

The thread was begun by a patient made furious after her family doctor “Dr Byte” refused to have their consultation recorded on a smartphone. More patients weighed in: what did doctors have to hide? The doctors who posted were mostly indignant that these confidential conversations could be recorded for wider consumption. As the online comments mounted, Dr Byte reflected. What did he have to fear, as long as he was confident about his advice and treatment options? Now even the GMC has, like Dr Byte, shifted its view, and allows recordings as admissible evidence in professional practice hearings.

Patient recordings “changes almost everything,” admits the article’s author Glyn Elwyn. But for the good.  “We have never really been able to verify the content of clinical practice, never before been able to analyze what is said, what is claimed, and what is actually done.”

What do you think? Do vote in this week’s bmj.com poll, Should patients have the right to record consultations? The poll runs until early next week but the “yes” currently have it.

Back to the consulting room and to the question, are recently proposed, diagnostic criteria for gestational diabetes a good thing for pregnant women? In an analysis paper just posted, Tim Cundy and colleagues argue not. These criteria, based on an observational study and using a test that has poor reproducibility, may triple the prevalence of gestational diabetes. Furthermore, there is no evidence of any treatment benefit from interventional studies. Another example for the BMJ’s campaign Too Much Medicine?

And finally, but still on pregnancy, a new randomised, double blind, controlled trial from France looks at whether nicotine patches help pregnant smokers to quit, and concludes it doesn’t. Fortunately, despite these disappointing results and a slim evidence base for drug treatment, there is good evidence that behaviour support works, finds a linked editorial.

Rebecca Coombes is magazine editor, BMJ.

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