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Should Doctors Share Notes with Patients?



What would happen if physicians' notes about patients were actually read by patients? Would it cause extra work for physicians? Could those notes motivate patients to take action in their own care?



3 comments on "Should Doctors Share Notes with Patients?"
william hay, md (2/26/2012 at 12:11 AM)

I find increasingly because of medical legal issues I'm writing notes as if they will be read in court or viewed by the nation. It's resulted in my being more and more politically correct and less and less a physician. I am also aware of just how ignorant judges are of science and how others don't understand clinical note taking the way doctors do. I believe that patients want to watch their own brain surgery and would be very enthusiatic about it but in truth would not contribute to the process. If medicine is entertainment then this is a fine direction. American Idol the clinician. I will not record the material in a way that is useful to me years hence if I've someone watching over my shoulder. I will also not communicate to another doctor in one of the most advanced medical scientific communications that doctors share if I have to translate this down to the level of judges no matter how self important those individuals can be. Admittedly I'm Canadian and we still have some modicum of freedom of speech left to physicians. It's a double edged sword.
Dawn Faulk (1/3/2012 at 2:28 PM)

Interestingly enough, I have recently been dealing with the same issues in your article. Both my parents have been relatively healthy until this year. At 74 y/o they both began to have major health problems. My mother went to see her PCP. She presented with 9 s/s written down on piece of paper of heart attack. She was forced to see the Nurse practioner who sent her next door to get a heart moniter & home. She ended up in the ER the next evening & in the cath lab, where she was misdiagnosed & treated for an MI. She was in & out of the hospital for the next 3 weeks with again, poor mgmt, incorrect txs. when we finally convinced her to discharge & go to St. Lukes for a second opinion. She was finally correctly diagnosed & treated for Takosubo syndrome & has not had to return since. When I asked for copies of the records from the PCP, all I got was her lab reports, & any other test results, not the drs. office notes. I am an RN with 15 years experience & a documentation specialist for a hospital. Unfortunately I am 2 hrs. away from my parents & am often not able to be there with them for office visits/problems to help them navigate through a difficult healthcare system. I felt like I was the doctor & the only one who was on top of my mothers care. We asked for consults several time, & was told that he doesn't like to do that, it is too confusing when too many people are involved. (Red Flag!) I had to call the Dr. to tell him my mother had a DVT floating around in her leg, & what was his plan? He was shocked that I had those results before he did. If the technician had not warned my mother, she might have died, because she did the test at noon, & he didn't know till 8:00 pm when I called him on his cell. The technician got in trouble, which I think is absurd. If anyone knows anything about potential harm that could come to a person, it is there obligation to share that information without any kind of repercussions. I am on every HIPPA form for my parents & I still have so many problems trying to receive info re: my parents health & care. For my Dad it is a prostate issue where he has not been able to void due to enlargement. He has been in & out of the ER in the middle of the night to be cathed at least 5 times over a 2 mth period. He has had an indwelling catheter for the last 2 mths. The Dr. finally decided to scope him and he did a procedure like a TURP, but it is where they just remove the inside of the gland & leave the prostrate. An obs./24 hr. procedure, the next am, they pulled the cath, he drank lots of fluids, tried to discharge him & he could not void. He was in so much pain & agony, we had to beg the LVN to please call the Dr. & get an order to cath him. When I called to find out how many cc's of urine he had & what the color consistency was, I was told they couldn't share that with me, even though I was on the HIPPA forms. I expressed my concern for a return trip to the ER in the middle of the night, & blood clots possibly clogging up the catheter. Spoke to charge nurse who assured me that if it wasn't safe to discharge him, the dr. wouldn't have done so. I let her know, that I understand that ins. only pays for so many hrs/days for certain diagnosis/procedures & that the dr. didn't know the results that I was asking for as he had just given order to cath him, but that he should want to know that info as well before discharging him. Needless to say, after dealing with the same problem for over 2 mths & not getting any better, my Dad was finally ready to get a 2nd opinion. The new Dr. has he scheduled for sx in 2 days & when my Dad called the old Dr. to get his records, he was told that he was no longer welcome there as a pt. if he was going to let another Dr. do sx. on him. I was appalled. My gut says that the old dr. knew he should have taken the whole prostrate out & is concerned that the new dr. will know that as well. Another way to pad his pockets with medicare. I am in healthcare & I see things done everyday, that are not in the pts. best interest. Pts. need advocates like myself, to help them navigate safely through their illness. When we were at St. Lukes, I never once had to ask for any reports, results, etc. Everything was offered up freely upfront. This makes you feel that your physician has nothing to hide. But when physicians/hospitals do not want to share your healthcare information, it makes you feel as if there is something to hide. And I can personally say from my own experience, their usually is. Drs have to see more pts. to make the same amt of money they used to make seeing only a few. That means, they are overworked, tired, & burnt out. Why would you not want an extra set of eyes/ears to help you not miss something. It would only benefit everyone involved. Less lawsuits, less liability, improve their scores, etc. I have found this to be moreso with our older generation of physicians, vs new docs. Teaching hospitals are much better as sharing info as they have to since their is so many people involved in the pts. care, making it less likely for mistakes to happen. I hope my sharing can help others to know their rights & to avoid some of the unneccessary frustration & that it will keep them healthy & safe.
smlarch14 (12/31/2011 at 8:22 AM)

Sharing notes with patients is a great idea. My mom (a Medicine benficiary) told me about her first experience with one of her doctors doing this. She shared that at first it seemed uncomfortable - she wondered why the doctor did things this way but at the end she said she really liked it! A new speciality explained that he was going to type while they discussed her family and medical history and that when he was finished, they would go through it together. Which is exactly what they did and she found a small mistake in his note and they got it corrected right there! He then examined her and entered his findings and printed it out and they went through that portion together. When she left, she had all the information she needed. I thought that the doctor had found a great way to integrate the patient into his new medical records exam workflow! Win/win