To the Editor: Burns and Belton1 are to be commended for their reminder that informed consent is required before taking patient photographs. They warn that many clinicians are unaware of copyright issues, fail to meet required hospital standards for clinical photographs and/or store images in unacceptable ways. These are important messages.
Interestingly, their article did not mention the core reason for medical photography. They state that the best-case scenarios for use of medical photographs are in teaching or telemedicine. Discussion about medical photography should begin from the premise that clinical photographs are often an important part of the clinical record. Capturing an image and storing it with the patient file is part of appropriately documenting the physical signs at that presentation. There may be reasons for not taking photographs, but the basic tenet of keeping accurate medical records remains fundamental to good medical practice. I see patients where photographs taken by a clinician at a previous consultation are in the patient file. Having this record can make my assessment more certain and, in some cases, allows initiation of treatment which otherwise would be delayed for some weeks.
It is important that we address the concerns that Burns and Belton raise about secondary uses of medical photographs. At the same time, we should consider how technological advances in photography are increasing opportunities for medical images to routinely be part of the patient record.
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