In reply: We are grateful for the interest in our article on medical photography. We plan to publish a more comprehensive article on our research results shortly, to provide a better understanding of the issue in one Australian tertiary hospital.
Medical photographs aid diagnosis by becoming part of the patient file, providing a highly useful visual record for case management. Among 167 clinicians surveyed in our research, 70 out of 80 took photographs for the patients’ medical record.1 The eight main reasons for photography were documenting cases, tracking transient symptoms, tracking wounds, education, publication, telehealth, personal record, and at the patient’s request.2
Image use in wound surveillance is multifaceted. In addition to aiding diagnosis, a photograph can reduce unnecessary, expensive dressing changes and associated physical and psychological discomfort.3 We also suspect progress images can be used to counsel patients undergoing long-term wound healing, improving treatment compliance and resulting in better health outcomes.
However, our study identified the major issue of lack of compliance with hospital policy. Research ethics compliance is mandatory, and Tomlinson et al’s 2012 study of hand surgery patients’ attitudes to the use of camera phone images will no doubt enshrine best practice. In our research, most clinicians who were unaware of guidelines did not meet the mandatory requirements set out by hospital policy or state legislation, thus opening up the possibility for legal recourse and questionable ethical practices. Patients may accept the benefits of using mobile phone technology to aid diagnosis in hand surgery, but context is very important. We suspect that if genital areas were photographed on a mobile phone, the perceptions and reactions of patients may be different.
We believe that soon the use of picture-taking handheld devices to aid diagnosis and management will become a norm. This is why a warning and discussion about the pitfalls of consent and incorrect or unethical image capture, use, storage and retention is timely, relevant and critical.
- 1. Burns K, Belton S. “Click first, care second” photography. Med J Aust 2012; 197: 265. <MJA full text>
- 2. Burns KR. Examining issues and compliance with hospital policy when clinicians take medical photographs [honours thesis]. Melbourne: RMIT University, 2011.
- 3. Lam TK, Preketes A, Gates R. Mobile phone photo messaging assisted communication in the assessment of hand trauma. ANZ J Surg 2004; 74: 598-602. <MJA full text>
Publication of your online response is subject to the Medical Journal of Australia's editorial discretion. You will be notified by email within five working days should your response be accepted.