Most Doctors Don't Think Patients Need Full Access To Med Records 659
Lucas123 writes "While electronic medical records (EMR) may contain your health information, most physicians think you should only be able to add information to them, not get access to all of the contents. A survey released this week of 3,700 physicians in eight countries found that only 31% of them believe patients should have full access to their medical record; 65% believe patients should have only limited access. Four percent said patients should have no access at all. The findings were consistent among doctors surveyed in eight countries: Australia, Canada, England, France, Germany, Singapore, Spain and the United States."
Conspiracy! (Score:5, Insightful)
What could possibly be in my medical records that they don't want me to know about?
Re:Conspiracy! (Score:5, Funny)
The price tag
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The price tag isn't part of your Medical Record. However you do get a lit of Procedures which you may be able to cross reference to see what the price of them are... However you normally get the price when they send you the EOB (Explanation of Benifits)
Re:Conspiracy! (Score:4, Interesting)
Re:Conspiracy! (Score:5, Funny)
That's not what the book says...
1) Quoting directly from the manual... "When Counseling and/or coordination of care dominates (more than 50%) the physician / patient... encounter, then time may be considered...
2) The actual code 99215 (level 5 existing patient office visit" reads "Physician's *typically* spend 40 minutes face-to-face". That statement only is applicable if #1 above applies. If not "...requires 2 of three key components". Typical doesn't mean every visit. Also I quoted the 5 minute visit for a level 4 visit. In a stable diabetic, treating a skin infection (for instance) may only take 5 minutes, which is enough time for a detailed history of the illness and the medical decision making which is of moderate complexity -- thus its a 99214 if all the physician does is write an antibiotic script.
Medicare alone has about 250 pages on how to code an E&M (office) visit, from two separate policy manuals, and most insurance companies (every one I've ever dealt with) use Medicare's definition. The CPT manuals I've looked at usually just barely touch the surface of the full regulations.
Patients (Score:3)
Most Patients think Doctors and Hospitals should charge less.
There are way more patients than doctors so if we are going to get into this bullshit of setting policy by taking fucking polls, then I think the Doctors will be fucked over well and good.
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You and your guild are deputized agents of the state granted the power to control consumer access to and provider competition in health care services, equipment, treatments, and drugs.
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Are you or are you not required to report any unexplained losses of consciousness to your local DMV?
Are you required to report any signs of suspected child abuse?
Deputized is an overstatement. But you are not just some schmo.
Re:Patients (Score:4, Insightful)
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Yea, It isn't like other countries have to pay Tax for their services. If the DR. is over charging their customers everyone pays for it.
Re:Conspiracy! (Score:5, Informative)
http://en.wikipedia.org/wiki/List_of_countries_by_total_health_expenditure_(PPP)_per_capita [wikipedia.org]
Re:Conspiracy! (Score:5, Interesting)
No, the reason why American health care is so expensive is a lack of preventative care and free riding. In other nations, because everybody is in the system, everybody pays into it. The only people who don't have no money and are a significant minority. The US, that minority has been about 40m people out of a population of about 310m and those people aren't opting out completely, either they wind up in Medicare eventually or they get their services through the ER at the local hospital.
Regulations are not a part of the problem to the extent that it's worth worrying about until we get those other things fixed. Then we might need to fix the regulatory environment.
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Price gouging...
Private hospital in tiny town: $18,000 for 36 hours in a womens health room with a straight saline drip, half of that bill was for the saline drip (billed as "IV therapy", it had no meds in it and was only there so they had a line open if needed)
Closest hospital equipped to deal with a 7 week preemie: $17,000 for 10 days stay total. Lifeflight, 3 days high risk pregnancy observation and blood pressure treatment, c-section, 7 days of recovery, and emergency hemorrhage treatment 2 days after t
Re:Conspiracy! (Score:5, Informative)
Price gouging... Private hospital in tiny town: $18,000 for 36 hours in a womens health room with a straight saline drip, half of that bill was for the saline drip (billed as "IV therapy", it had no meds in it and was only there so they had a line open if needed) Closest hospital equipped to deal with a 7 week preemie: $17,000 for 10 days stay total. Lifeflight, 3 days high risk pregnancy observation and blood pressure treatment, c-section, 7 days of recovery, and emergency hemorrhage treatment 2 days after the c-section
Even couple hour ER trips on the weekends where they just tell us "Sorry you're in blinding pain but I don't feel like doing anything, have some tylenol" result in multiple $5,000-10,000 bills from the hospital, doctor, nurses, oncall surgeon/anesthesia/radiology who wasn't even there and did noting.
I'm sorry, but [citation needed] here. I work in the health industry. A helicopter flight [wjhg.com] alone to a close hospital is on the order of $10,000. One figure quoted to me was that it costs $1,000 to wheel the bird out of the hanger (granted, likely a mark-up). ICU care [nih.gov] is on the order of $3,000-5,000 a day minimum, without major intervention. A c-section [healthcarebluebook.com] is going to be on the order of $10,000-30,000 itself. The OR [stanford.edu] is billed on the order of $30-100 per minute. Blood [nih.gov] is a couple hundred (~$500) per/unit. This doesn't even include the cost of medications or ancillary services.
Your bill for a high risk pregnancy/premie treatment is more likely billed at $170,000, and in reality could reach $250,000. What you saw was probably a negotiated price from your health insurance, or mark-down from medicaid
I will agree that your community hospital bill was way out of line, but the upgrade in care, especially at a teaching hospital is going to be much higher.
Also a 7 week premie is non-viable. That is considered a spontaneous abortion. You probably meant to say a 32-week premie, which while serious, is a very survivable stage with modern care. (Premies are classified by length of gestation, not by the time remaining.) And FWIW, the current cut off (e.g. documentation of survival) is at about 25 weeks, it improves at 26 weeks where the mortality (chance of death) is about 50%
As an aside, I threw out those figures off the top of my head, and decided to verify and add the citations....I was pretty damn close (off on the ICU by about $1,000/day, but I was still in the ballpark). I'm either: that cynical or I've been at this too long....
Re:Conspiracy! (Score:5, Insightful)
Both of my two children were born around 31 weeks. The first was in a ICU for 3 weeks, and humidicrib for about 4 weeks.
My second was healthier (wife managed to get steriods to improve the baby's lungs before birth), but was still in hospital for around 5 weeks.
My wife was admitted to hospital during both pregnancies multiple times due to excessive vomiting.
We calculated the total cost to us for both pregnancies - it was around $200. Thankfully we live in Australia were there is a proper health care system.
Re:Conspiracy! (Score:5, Informative)
I'm saying expensive cancer drugs are banned because they would increase healthcare costs to US levels:
This is the key point. The American health care system is expensive because we demand expensive health care.
For those of us with insurance, we pick the best treatments, not the most economical. For those of us that can afford to choose what hospitals we get non-emergency treatment at, we pick the ones that have the experts, and the robot surgery facilities, and the fancy new MRI and PET scanners. Prices are set by contract with the insurance company, so why wouldn't we pick the one with the best marketing/facilities?
When we have bad outcomes, we sue the doctors, the hospital, the equipment manufacturers. We (via our lawyers) say things like, "they should have done more." This encourages them to practice medicine defensively: use the more expensive drugs, book more time on the expensive imaging devices, pay out settlements as a cost of doing business. And so, as time goes on, consumption of expensive health care rises as expensive health care options proliferate. In some ways this is good (sometimes the expensive options actually are better), but usually it's just wasteful.
It's easy to blame "free riders" and EMTLA, but this is a small fraction of healthcare expenses in the US.
EXTREME corruption (Score:3)
It is expensive because of extreme corruption. Here is a good summary: Bitter Pill: Why Medical Bills Are Killing Us. [time.com] As the article says, health care organizations often charge 10 or 100 times what things cost.
Re: (Score:3)
Try pointing your finger in the right direction, it's the fault of your severely litigious country, not the government. Malpractice insurance is very very expensive.
Re:Conspiracy! (Score:5, Informative)
Actually, malpractice insurance is around 2.4% of the overall cost.
http://www.hsph.harvard.edu/news/press-releases/medical-liability-costs-us/ [harvard.edu]
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Nope. Wrong again.
It is the problem you get when there is no market incentive to keep costs down. Which is what our for-profit insurance system creates.
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Around here one of our hospital systems is non-profit. So along with that gov regulation, they can NOT make profit. Now employees get paid, and i'm sure many of the suppliers are for profit, but the hospital it'self isn't making money for shareholders.
Of course with the cost of medical equipment, and the salaries medical pro's make, i'm not aware that it's actually any cheaper.
Just figured I'd share that they are not all for profit.
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I blame government bureaucracy spilling over into health care for most of that.
If you compare the overhead of Medicare, (in $ per claim) to pretty much any private insurance company, you will find out that they are doing just freaking awesome, actually.
Re:Conspiracy! (Score:4, Informative)
It's worth noting that Asian americans have a higher [worldlifeexpectancy.com] life expectancy than residents of japan.
Japanese Americans have a higher economic status than the median American, and higher than the median citizen of Japan: http://en.wikipedia.org/wiki/List_of_ethnic_groups_in_the_United_States_by_household_income [wikipedia.org]
Since race is strongly correlated with life expectancy, the mere fact of a more diverse population brings US numbers down, even if we handle every racial group better.
When we control for socioeconomic status [ssa.gov] the race correlation of life expectancy either is drastically reduced or else disappears entirely. You are trying to paint an economic problem the U.S. has (extreme disparity of wealth and serious poverty) which we could attempt to rectify as an inevitable genetic thing that no one can do anything about.
Life expectancy is a poor measure to star with, since it's not closely tied to medical care in particular.
Since it contradicts the considered option of the world medical community you need to at least try to post a link to substantiate such a radical claim.
In fact since 3/4 of the potential years of life lost in the U.S. before the age of 65 are due to medical conditions [google.com] your claim is nonsense. The link is very strong.*
Social factors are a major cause of premature deaths. Life expectancy at later ages may be more relevant, as medical conditions start taking over causes of death instead of accidents and violence.
The claim is false for those under 65, as well as for those over 65, which are acknowledging here.
The definition of live birth as actually calculated differs from country to country [nationalcenter.org] and this has a large impact on numbers [bmj.com]. As a way of avoiding those differences in counting live births, I suggest perinatal mortality instead. And, go figure, the US is better [who.int] than some of the countries that regular infant mortality would suggest would surpass it. The UK (25th) for instance goes from being 2 better than us to 1 worse on rates. It's funny, but the numbers on that wiki link do not correspond to sorty by any of the actual infant mortality numbers. I believe perinatal has it's own landmines, but the time frame immediately surrounding birth is more connected to medical system than from birth to 1.
We do better true, but we are still 24th on the list.
*There is a claim that has been bouncing in the right wing megaphone echo chamber for four years asserting that if you control of accidents and violence U.S. life expectancy jumps to number one. The claim is false and traces to a single miscaptioned table in a report by conservative think tank economists Robert L. Ohsfeldt and John E. Schneider. The table shows that the U.S. would lead in life expectancy if U.S. life expectancy tracked the life vs GDP trendline of the OECD. In fact it does not, it does far worse - which is exactly the problem that needs to be solved.
Re:Conspiracy! (Score:5, Insightful)
The mistakes
Re:Conspiracy! (Score:5, Insightful)
Notes.
For example:
"Patient responds well to placebos"
"Patient is a looney hypochondriac, but has lots of money. Recommend all possible expensive tests."
"Patient is an addict, faking symptoms in order to get painkillers."
etc.
Re:Conspiracy! (Score:5, Funny)
Or,
"I'm not going to do test X because the lab I own doesn't sell that service, but I'll send him for an extra MRI because I've got a boat payment to make".
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"Patient is an addict, faking symptoms in order to get painkillers."
This one actually happened to an old friend of mine. He had in the past had issues with substance abuse and it had made its way into his medical records. Fast forward a couple of years and shows up at the ER with a pretty nasty injury after chopping wood and they outright refuse to give him any painkillers except ibuprofen...
Took 24+ hours before he and several others were able to convince the doctors that he needed real pain relief.
Re:Conspiracy! (Score:5, Interesting)
"Patient is an addict, faking symptoms in order to get painkillers."
This one actually happened to an old friend of mine. He had in the past had issues with substance abuse and it had made its way into his medical records. Fast forward a couple of years and shows up at the ER with a pretty nasty injury after chopping wood and they outright refuse to give him any painkillers except ibuprofen...
Took 24+ hours before he and several others were able to convince the doctors that he needed real pain relief.
A number of states now have databases of patients that doctors label as such for other doctors and pharmacies to watch out for.
Unfortunately, doctors are generally woefully unequipped to treat pain, particularly long-term pain. Plenty of addicts are made by the medical profession, something they don't like to admit.
Re:Conspiracy! (Score:5, Insightful)
Unfortunately, doctors are generally woefully unequipped to treat pain, particularly long-term pain. Plenty of addicts are made by the medical profession, something they don't like to admit.
Posting as AC for obvious reasons but... Yes I would agree that a lot of addicts get their drugs directly from a doctor. It just takes one injury that causes chronic pain and you're often left with two choices in the end: Try and live with the pain, or become an addict. I don't necessarily mean mental addiction, but there is no way to avoid the physical addiction. I was hurt, and was on narcotics for years. They finally were able to perform a procedure that didn't remove the pain, but got it down to the bearable level it was at when I was medicated. I was virtually pain free, even at the lowest dose of my medication. I asked the doctor to take me off completely and we spent months and months weening me off. Within 3 days of taking that last dose, I thought I was dying. It was the most miserable experience in the world. At least, I thought so at the time. It's been almost a year since I've touched the stuff, but the first few weeks were the only time in my life where I ever thought I needed a drug to live. I had to flush my stockpile of medication down the toilet for fear that I would, in my weakness, use it.
Unfortunately for me, the procedure was only a temporary fix. It will help me for 6-24 months. I've also discovered that I still have bad days. Days where I can't get out of bed in the morning due to pain. So, now I find that I am going to have to ask my doctor for a limited supply of meds anyway, just to deal with this occasional issue. I could have gone on long term disability years ago, but I prefer to work. I can't keep a job if I can't get out of bed, however. It's a terrible situation to be in, and I would never wish it upon my greatest enemy. I wouldn't even subject the man who did this to me to this kind of life.
Re:Conspiracy! (Score:4, Insightful)
Look at the millions each year they are exposed to narcotics alone in a hospital that never become addicts, if it were really the medical professions fault then every single one of them would become an addict but that isnt the case. They make themselves addicts because they have an addictice personality which has nothing to do with the medical industry.
This is, sadly, the attitude of many physicians. A tendency to get addicted to narcotics is a moral failure on the part of the patient, whereas, e.g., an allergy to penicillin is a legitimate, organic, condition that should be addressed in considering treatment.
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Disclosure: I'm married to a doctor. A pain doctor, no less.
Doctors go to jail for prescribing painkillers that are later abused, so they err on the side of caution. Your friend is a victim of the drug war. My wife has "fired" many a patient - most of them quite deservedly. But people are very good at saying what they need to say, so she has to be over-cautious.
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Not really, this would be more like not giving an alcoholic cough syrup because of the alcohol content.
And it's a very real concern, despite what some of the pro-drug folks around here seem to think. Just because it's for medicinal use doesn't mean that the body knows that.
Re:Conspiracy! (Score:5, Informative)
I worked in the medical industry, handling medical data. This is exactly what they don't want you to see.
Patient records are riddled with notes intended only for internal use. To a doctor, it's nothing special that you suffered explosive diarrhea in the middle of the hospital elevator - that happens once a week, and it could be medically important. To a patient, that's a terribly embarrassing episode that shouldn't be in records, and even considering storing such a thing is grounds for a lawsuit. That lawsuit would be argued in front of people outside a hospital setting, who would be biased in favor of the patient. In front of a hospital ethics board, tthe incident is just another bad day for the janitor.
To use the traditional car analogy, hospitals are much like body shops. You really don't need to know every point that was inspected, every noise source that was considered, or the internal notes from the mechanic about how you question every repair so he should make sure to only finish work on days the manager's available. Most of the information is obvious to someone knowledgable, useless to someone who knows nothing, and ammunition for someone who knows just enough to be dangerous.
On the other hand, what does the patient need to see? Doctors know that old records are unreliable, so history beyond a few years old doesn't really matter if it's slightly inaccurate. Current treatment is usually handled by a single primary doctor, who knows what makes sense for a particular patient, so inaccuracies there don't matter either.
Sure, it's information about the patient, but giving out all the details just causes more trouble than good.
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To use the traditional car analogy, hospitals are much like body shops. You really don't need to know every point that was inspected, every noise source that was considered, or the internal notes from the mechanic about how you question every repair so he should make sure to only finish work on days the manager's available.
True, but I'd expect to get that information if I ask for it. Same with medical records.
Re:Conspiracy! (Score:5, Insightful)
I observe every single thing done to my car. I am there in the shop as they do them; not in the waiting room. I have seen belts put on backwards, i have seen a mechanic raise my hood into the ceiling. I also come out with a full understanding of what needed to be done on my vehicle and why. Healthcare is the same. You should have full access to YOUR records.
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Sure, it's information about the patient, but giving out all the details just causes more trouble than good.
You miss the point... it's ALL discoverable in a lawsuit. And not just the patient's internal records - everything the hospital did anywhere near the case. Emails, internal mail, policies, meeting notes, texts, call records... you name it. Discovery alone can cost the hospital a small fortune. People in general - not just doctors - are under the impression that secrecy prevents problems, but making a patient feel like there are secrets to be discovered only leads to more trouble. Even if the hospital makes
Re:Conspiracy! (Score:5, Interesting)
In a lawsuit, the trouble's already arrived, and the records can do more good than harm.
The real problem isn't really patients knowing their records, but rather patients taking their records out of context, without understanding what each note means. Ten minutes on the Internet, and patients get a huge list of questions about every trivial detail in their records, and they'll be sure to waste the doctor's time with them at the next appointment. They'll think that a noted tiny chance of a problem is a major issue, They'll see every mistake is a gamble with their life.
Not every patient, of course... but just enough to make medicine even harder than it is.
An interesting anecdote: About two decades ago, my father developed cancer. He had surgery, which went well and led to a complete recovery. At one of his follow-up appointments, his doctor told him something from his record, that he'd kept secret. As it turns out, my father had actually died on the table. He's always known he was allergic to all seafood (and that was noted in the record), but it's actually a particular iodine compound that's the culprit. That compound was used in the normal surgical antiseptic, and was never before thought to be an allergen. During surgery, he had a severe reaction and had a severe heart attack.
The surgeons of course noticed immediately, treated the heart attack, then finished the cancer surgery, then the doctors included treatment afterward to clean up the mess. It was all detailed in the record, and any inquiry (or future surgical plans) would have clearly seen it, but it wasn't something my father needed to know in the months after surgery. After such an ordeal, the extra stress of knowlege would have only hindered recovery. Ignorance can indeed be bliss.
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Patient records are riddled with notes intended only for internal use...could be medically important.
Not all of those notes are. Friend of mine got access to her medical records. One of the notes was, "pleasant young female."
Wtf?
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I've read notes on me that said the same, but I'm also in a health profession, so I read the importance a little differently.
"Pleasant" indicates that the patient is not showing undue signs of stress, depression, altered mentation, or hostility. A "pleasant" person is more likely to follow medical advice (i.e. comply), and therefor more likely to actually get the treatment as prescribed by the doctor. Depression, altered mentation, or hostility indicate more care needs to be taken, or might indicate pain,
Re:Conspiracy! (Score:4, Insightful)
If someone is sueing a hospital because their medical records contain an episode of explosive diarreha in a hospital elevator and winning, you should maybe find a lawyer worth a lick of salt.
So let's suppose the patient sees the note about the incident, and takes offense. They sue the hospital for libel, claiming that the incident was recorded for the amusement of doctors at the patient's expense. One defense would be to show a medical reason making the note necessary - but if it was isolated with no known cause, that may not be possible. Another defense is to point out how common messy incidents are in a hospital, but that'll skewer the PR department's campaign saying how clean the hospital is (which it was again an hour after the incident). Regardless of how skilled the hospital's lawyers are, an offended patient with a grudge will be expensive to deal with.
Because of this, we wouldn't leave a remark like "Patient questions everything, be sure to only see patient when management is available" because that sounds absurd, and yeah if that comes out during a case where say, the patient wasn't seen quickly in an emergency situation resulting in injury or death, well, too bad.
One comment I saw in actual records: "Patient has dementia and insists on seeing Dr. Johnson, who retired in 1985. Dr. Williams looks similar enough that he can tell her that whoever's on call is 'a good doctor'."
Sure, it's sneaky and underhanded, and a skilled lawyer can turn it into a case where the hospital was intentionally deceiving a patient to mislead them into trusting someone... but it's ultimately what's necessary to get anything done.
Inacuracies dont matter? I'd love to know where you work, so I can avoid whatever idiots you work with.
I worked with data from one of the largest hospital networks in the United States. Good luck avoiding them. The problem is that they've switched record systems a half-dozen times in the last two decades, and some records are known to be wrong. Whe processing their data, I was explicitly told to ignore anything older than 6 years, because anything prior to that was from the last system, and would likely have invalid data. I did still encounter some things like an ingrown toenail on someone's face (wrong ICD9 codes), a patient over 200 years old (invalid dates being sent by a third-party system), and one patient with a hundred different names (but the same social security number: 000-00-0000).
I think a patient has a right to understand everything regarding their treatment. Just dumping raw medical records on them won't do that, though.
Re:Conspiracy! (Score:5, Informative)
My knee-jerk reaction to this is of course "there's NO good reason to withhold my medical information from me!", which was only made worse by the surprising statistics of doctors that wanted to keep it hidden from my view. But you raise some very good points.
Perhaps what's needed here is a two-section medical record. Things that should be shared with the patient, (which should be the default behavior) and things that should NOT be shared with them, for their own benefit. The patient should not be able to determine if the "not to share" section contains information or not.
But as for the 2nd of your examples, yes a hidden feature is abusable. But this is your DOCTOR we're talking about. They are in a position of trust. If you don't trust your doctor, you need to find a new one. If you're a doctor and you've proven yourself untrustworthy, you need to be delicensed. It should be safe to assume you can trust your doctor. Given that, they should be allowed to selectively hide information from you for your benefit.
Like the old saying goes, there are two people in life you should never lie to: your doctor, and your lawyer. Because it's their exclusive job to represent and protect your best interest. And you need to be able to completely trust them both, because your health and your freedom are on the line, and they're the ones you're relying on to protect that.
Re:Conspiracy! (Score:5, Informative)
Re:Conspiracy! (Score:5, Interesting)
Well... what they did :-)
I guess doctors make wrong or let's say suboptimal decisions all the time, it's just that rarely people get so bad or die because of it so you actually get into malpraxis discussions. They want no patient oversight of what they are doing because a 5 minutes google search might convince you they are not doing a stellar job after all.
In Romania we have a law, that they "forget" to change every year, stating that the dead guy (and only him) must personally ask in writing for the medical records. In case someone dies from malpraxis no-one has access to that anymore so basically you can't argue malpraxis for people who died (therefore we have a statistically excellent medical system).
So yes, I'd go with conspiracy.
5 min on google 10 years medical training (Score:3, Insightful)
I guess doctors make wrong or let's say suboptimal decisions all the time, it's just that rarely people get so bad or die because of it so you actually get into malpraxis discussions.
Doctors do make mistakes just like any human. The human body is a complicated thing and doctors are nearly always working with incomplete information. Mistakes are unfortunate but also inevitable. The most you can and should ask for is that the doctor treated you with the appropriate standard of care [wikipedia.org].
They want no patient oversight of what they are doing because a 5 minutes google search might convince you they are not doing a stellar job after all.
It is terrifying that some people think that 5 minutes on google somehow will make them more informed than 10 years of medical training plus years of actual medical practice. Self diagnosis via google is a
Re:5 min on google 10 years medical training (Score:5, Informative)
5 minutes on google will tell me that the self-protecting asshole doctor prescribed a relative of mine a drug containing paracetamol, which google helped me learn was a synonym for acetaminophen.
What's the big deal? Well the relative had knee replacement surgery, so painkillers were necessary. The asshole doctor ignored the fact that he was explicitly told not to administer anything containing acetaminophen because the patient had liver disease and explicitly stated such on multiple occassions. The doctor didn't want to go through the hassle/overhead of dealing with a schedule 2 drug, and just prescribed the drug containing acetaminophen.
Even after explaining to him that 'No, this person really needs to not take acetaminophen/paracetamol/tylenol/etc' we still discovered that they kept 'resetting' and going back to giving him the drug.
So you will have to forgive me for not trusting 10+ years of experience vs google when the asshole kept giving tylenol to a guy with liver disease.
Mistakes and anecdotes (Score:4, Insightful)
So you will have to forgive me for not trusting 10+ years of experience vs google when the asshole kept giving tylenol to a guy with liver disease.
It's appropriate to check on what is being prescribed and be involved in your care when you have the ability. Even well intentioned doctors (and pharmacists) make mistakes. Odds are that there was a problem with communication and that it was an honest mistake. Doctor's that would intentionally or negligently harm a patient are quite rare.
That said, if you felt the patient was being intentionally mis-treated or incompetently treated then one has to ask why you continued to let this doctor treat the patient? If this guy was such an "asshole" then you can and should demand a different doctor be involved. You always have that right and you should exercise it if needed. What you are describing is grounds for a lawsuit. Did you bring one or are you just trying to bash doctors in general based on one anecdote?
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That said, if you felt the patient was being intentionally mis-treated or incompetently treated then one has to ask why you continued to let this doctor treat the patient? If this guy was such an "asshole" then you can and should demand a different doctor be involved. You always have that right and you should exercise it if needed. What you are describing is grounds for a lawsuit. Did you bring one or are you just trying to bash doctors in general based on one anecdote?
It was the non-surgical doctors/staff
Doctors are still better than patients at rare (Score:4, Interesting)
if a doctor comes across someone who genuinely has a rare condition they're almost certain to misdiagnose it.
And a patient is even more likely to do so. A doctor is supposed to look to the highest probability diagnosis first. Rare diagnosis are hard and it's pretty rare for doctors to have perfect information. Almost every diagnosis is an educated guess and some percentage WILL be wrong. In fact sometimes getting a percentage wrong is considered appropriate care. Doctors are expected to take out a small percentage of appendixes that are not actually wrong. There is no way to know with 100% certainty whether it needs to come out until they actually do the operation and some symptoms can be mimicked by other conditions.
doctors are often too sure they have a deeper understanding than they really do.
This does happen but having a doctor that not confident is rather useless. It's a fine line to tread and most do it reasonably well.
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Admittedly, it's bad when some looney googles a list of every single illness that initially presents with "headache, fever, sore throat" and insists they have meningitis or chlorine poisoning when they obviously just have a cold. There's also the flip side, though, that if a doctor isn't very good, they're going to be easy to catch out with
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(speaking as a programmer now, regardless of my medical-industry history)
Every time someone tells me they "need" to double-check my highly-specialized knowledge to have confidence in my work, I tell them (usually politely) to fuck off. It's Invariably, those that do their own investigations come back with questions that I don't want to try to answer, and they'll never accept "I felt like it" as a valid reason. No, I don't really have an objective reason to prefer Perl over Python for this menial little cron
Re: (Score:3)
This line of reasoning demonstrates the fallacy of mis-applying statistics to an individual case.
Who the hell cares whether the bad doctor is identified and dealt with after he screws up a statistically significant number of times? What is important is whether he has screwed up in MY case.
I favor completely open medical records. There are plenty of laws on the books to protect doctors and other health care professionals from the consequences of their honest mistakes--- that's what "best practice" training
Re: (Score:3, Insightful)
Agreed. Whatever their reasoning is, you can bet that it isn't for your benefit.
Doctors are human beings just like the rest of us, and driven by self-interest just like the rest of us. I've always found it strage that people are so willing to put their undivided trust in doctors -- when those doctors are ultimately driven by self-interest and theferore should be regarded as no more or less trustworthy than any other human being.
In fact, I've noticed that doctors are every bit as susceptible to "material dri
Comment removed (Score:5, Interesting)
Re: (Score:3)
Re: (Score:3)
I type medical transcription. Doctors can and do insert personal opinion into their notes, make mistakes, misstate facts, and other things that might lead to malpractice suits and other legal problems. This is called ass coverage.
But no mention of why (Score:5, Insightful)
I was surprised that in the article and in the linked survey article there was no mention of WHY a doc would want to restrict information.
Re:But no mention of why. (Score:3, Funny)
Because you don't need it; now stop acting like a 3 year old with all this 'why' nonsense!
Re:But no mention of why (Score:4, Interesting)
In fact, if you think about it for two seconds, you realize that a system where doctors are people who are selling a service is the worst possible way to set up the system: the incentive for doctors is to get people to come to them and get them to perform expensive tests. All of the financial incentives, then, are to inflate the actual cost of medical treatment, to claim medical treatments are necessary when they really aren't, and to provide treatments that don't actually fix the problem so that the people come back again later.
Fortunately, most doctors are neither cruel nor narcissistic enough to engage in this knowingly, but even the most virtuous of doctor is going to be rather disinclined to realize they are wrong when they are profiting from being wrong. The result of this is high medical costs and crappy medical treatment. Nations that do not structure their medical system like a market have much better outcomes and much lower costs.
Office-only comment section (Score:3)
So have a little comment section for the medical records. Those comments are for that office only. Those comments do not get transferred to another doctor. Only the official diagnoses and medical records get transferred to other offices. If a doctor wants to write down details for himself and suspects that you have mental instability, that's fine. That's for their eyes only. But if they want to communicate that to other doctors, they should use proper terminology, they should explain why they think that the
I develop an EHR (Score:4, Interesting)
We had to take out a feature that let patients update their medical history online (which is a great feature because then the patient isn't be forced to memorydump in the clinic, there's a reason they tell you to write all this down and bring it a notebook when you see the doctor) because they were trying to removing items from the medical history in order to get claims paid that were rejecting for pre-existing conditions.
Now that obamacare is putting an end to the pre-existing condition thing, we may put it back, we'll see if the docs want it though. I believe the 65 percent is right though. On the other extreme, my boss believes that the patient should own their own medical record as a file they carry with them everywhere on a thumbdrive, I see that as a recipe for lost records and forgotten passwords. The alternative to having it on your person being Microsoft HealthVault still doesn't exactly make me tremble with joy.
Re:I develop an EHR (Score:5, Insightful)
Re:I develop an EHR (Score:4, Funny)
Like most things, it would benefit from being managed by Git :-)
Obvious reason (Score:5, Interesting)
You see a simple folder full of your medical history.
Your doctor sees it as a book of half-truths that can be twisted to create liability in a multitude of ways.
Remove the liability here, and these results would change.
Re: (Score:2)
Yes. Remove the liabllity.
Improve professional standards.
If doctors think they are vulnerable to malpractice suits then clearly they are aware that their house needs to be cleaned. You can either put up with the dirty house (tort reform), or you can actually clean house and improve medical standards.
Of course doctors don't want their misdeeds and incompetence on display for all to see.
Re:Obvious reason (Score:4, Insightful)
John Edwards and his kind are the reason. Many malpractice suits don't have any scientific basis, it's just a matter of running a sympathetic "victim" in front of a jury.
http://www.washingtontimes.com/news/2004/aug/16/20040816-011234-1949r/?page=all [washingtontimes.com]
Information != Knowledge (Score:5, Interesting)
Information != Knowledge. It's already a big problem for doctors that patients come in demanding this or that treatment that they've read about on the internet, often with no real understanding of whether it's appropriate for them, or whether it's actually an effective treatment at all. I would imaging this is what is behind the doctors attitude in this study; full access to medical records will probably only increase that trend, with people trying to interpret their own records, and saying why did I not get such and such a treatment that I found on Google. That's not to say I agree with the doctors stance, but I can see where they're coming from.
Re:Information != Knowledge (Score:5, Interesting)
Doctors don't know everything. They're trained to spot the most common problems, but it's really, really easy to stump a doctor. My GF has been having dizzy spells. She went to her GP, who sent her to an ENT, who sent her to an audiologist. None had any ideas.
So she spends some time on Google, and finds out that dizziness can be a side effect of gall bladder attacks(through over stimulation of the vagus nerve which causes a sudden drop of blood pressure). And she had seen the same GP a year earlier about her gall bladder problems. Why didn't the GP pick this up?
No, patients should be encouraged to do as much research as they can. You as a patient care more about your issue than anyone else. You know more about your body than anyone else. You should be a partner with your doctor in your own health care.
Individualized medicine requires empowerment (Score:3)
Why didn't the GP pick this up?
Probably because (a) he has more than one patient to manage and may have forgotten about the gall bladder incident (especially if it was a single acute incident that went away, as opposed to something needing surgery), (b) he may not have had time to review her chart for the past year, given the number of patients he had to see, how far his office was backed up, etc., and (c) the actual number of patients who manifest dizziness as a symptom as a result of a gall bladder attack may well be very small.
I doubt that you expected an actual answer, but these seem to be most likely. None of these, by the way, are unexpected or unusual or even get close to a notion of malpractice. In the end, you are correct in your last statement.
That is why we have computers and AI. Doctors don't have to pick everything up. Patients should be able to pick certain things up on their own to make a doctors life easier. Also with big data and the ability to analyze it, a lot of doctors will be able to take advantage of technology to empower themselves to deal with the big data problem and so should patients. Personalized or individualized medicine requires the patient to be empowered and involved.
Re:Information != Knowledge (Score:5, Informative)
With my ex-wife, we only managed to get a (now-multiply-confirrmed) diagnosis of her inherent genetic condition after 30 years of misdiagnosis by dozens of doctors. With the help of Google. Yes, I'm sure lots of people waste their time and it's a haven for hypochondriacs but it's also an invaluable resource when doctors are as overworked/lazy as they are.
Her condition is JHS - joint hypermobility syndrome (also called HMS) that can come from over-extending joints (e.g. ballet dancers, gymnasts) or - in her case - from a genetic predisposition to a collagen deficiency. It was almost unheard of until a decade of so ago (and I've since seen another diagnosis of it in the school I work for) and there is little research on it - it's one UK doctor's pet research project, but by all accounts he's a bit of an arsehole.
It's misdiagnosed by most doctors as arthritis because the chronic joint pain associated with it is easier to write off as that than anything else (even in 20-30 year olds). In fact, it's the exact opposite - sufferers can do the splits and bend over backwards to rival the best contortionists but have chronic pain, whereas arthritis LIMITS joints movement and have chronic pain.
There's a simple ten-point test that's taken as official diagnosis, one point if you can place your hands flat on the floor without bending your knees, for example. Everyone in the world scores about 2-3. Flexible people can score 3-5. JHS sufferers score 8-10. My ex- scored 10 and always will, even when she's 80. It's the prime diagnostic for it, as they don't even have isolated genetic tests for it yet.
The process to find out what the condition was (from just 30 years of constant arthritis diagnoses and treatments to help loosen joints, etc.) was:
a) I had to explain to her that normal people AREN'T in pain 24 hours a day (when you live with it all day, every day, you just assume everyone else does but keeps quiet and soldiers on) and that your shoulder/hip shouldn't just "fall out of the socket" once a week or so (I became expert at putting them back in).
b) I collected her symptoms, went on Google, found this (rare, genetic) condition that matched. There was precisely one doctor actively researching it, but it was in all the medical textbooks. Arthritis wasn't even close to matching the symptoms, but it was listed under the arthritis departments and diagnoses every time because it's SO often mis-diagnosed (which makes you wonder how 20+ doctors missed it).
For instance, one of the symptoms is a reduced effectiveness of anaesthetics, and my ex- had a chronic fear of dentists because - even when anaesthetised - it hurt her too much. That's too simple to be a diagnostic on its own, but after 20+ such odd foibles of her health explained within 10 minutes of reading, things started to click (and not just her joints!).
c) We took it to our doctor. He was overjoyed and keen. He had a diagnosis that he'd never seen before, it fitted the symptoms he had recorded in her notes perfectly, it was commonly mistaken for the arthritis that doctors before him had diagnosed. He was able to say that 20+ doctors before him were wrong, that "he'd" spotted the problem, and prove it. He ran off, researched it himself, and said he thought we were right.
d) He sent us to a specialist (ironically, an arthritis consultant). They confirmed the diagnosis in seconds, and said they would have been able to in seconds for the previous few decades as it was well-known to them even if there was little they (or anyone else) could do to treat it.
e) She received treatment (physio, painkillers, etc.), an official diagnosis, found support groups, was made aware of the chances of passing it on to our daughter (who has a much milder form, that isn't pain-associated, which probably means she'll be good at ballet and gymnastics and not suffer like her mother, but she'll still carry the gene and needs to know that when she gets older), got on with her life, and hasn't been back to a doctor for anyth
Re: (Score:3)
If you ask doctors if patients NEED access, they should say no. If you ask doctors if patients have a right to access their records you'll get a different answer.
I think there's really three different questions here:
Do patients need access to their medical records?
Should patients have access to their medical records?
Should patients be reading their medical records?
I suspect that the answers to these questions are not all the same.
Not really surprising (Score:5, Insightful)
Some doctors will argue that by allowing the patient full access to the notes in the system, a doctor may be less frank about the mental condition of the patient or be reluctant to place information in the record which reflects poorly on the patient's demeanor, such as cooperativeness, a tenancy toward hypochondria, or just plan belligerence. In their defense, this honesty could lead to lawsuits (in the worst cases). Even in the instance where it's a simple difference of opinion, some patients are going to be fairly vocal about having the records changed or modified to suit their version of reality (correctly or not), resulting in more time spent by the doctor and administrative staff on uncompensated work.
Now, the best way to combat this is to allow comments on the records by patients. It will keep some of the sillyness out of records (http://www.smithsonianmag.com/arts-culture/The-Last-Page-UBI-in-the-Knife-and-Gun-Club.html) and will allow legitimate differences of opinions. A chart which is riddled with patient comments contradicting past providers will be just as valuable to a future provider as a note that the patient is difficult or uncooperative in treatment decisions.
Another item of concern is from the insurer's side. There will be people who attempt to expunge their records of items which decrease their insurability or increase their rates (and this will only get worse with mandatory insurance without cost caps or guaranteed rates). The way the questions were worded wasn't mentioned in the fine article, so if write/erase access was included in "full access," then continuity of care may be jeopardized by those seeking to minimize the impact of previous conditions on current health care rates - or simple embarrassment.
Re: (Score:3)
Some doctors will argue that by allowing the patient full access to the notes in the system, a doctor may be less frank about the mental condition of the patient or be reluctant to place information in the record which reflects poorly on the patient's demeanor, such as cooperativeness, a tenancy toward hypochondria, or just plan belligerence. In their defense, this honesty could lead to lawsuits (in the worst cases).
If they are less frank, then doctors are adding opinions and personal biases, not facts.
Arrogance (Score:3, Interesting)
I'm an attorney, so I know a little bit about arrogance, but we're patzers compared with doctors. Many truly have, if not God, then Emperor complexes, with their wisdom received without question by their subjects.
But that's probably not the real reason they don't want patients to have access to their complete medical records. It's all about avoiding medical malpractice claims (and annoying phone calls from patients asking questions).
So blame the lawyers.
Seen them (Score:3)
I have seen my entire medical records. Everything that a doctor has access to about myself. They were handed to me while I was at my doctors once and left alone in the room for several minutes while they arranged something. This was pre-computerisation, and they were my damn records, so I sat and read through them all.
Most of them were boring. Most of them related to childhood reports that were ultimately no-diagnosis because it was a cold or sniffles or whatever. One of them relating to my birth describes sub-conjuctival haemorrhaging (bleeding behind the eye) - today my birth would have resulted in compensation and investigations as they damaged my eyes pulling me out.
Apart from that, it was not interesting. Hell, they didn't even have my blood type, because they don't test for it unless they need to. And I haven't been to the doctors in YEARS except to register with a new one. I'm in the UK so there's no "cost" involved in treating me that I shouldn't know, as such.
That said, why would you not want me to see them. If I have a condition, can you really hide it from myself? Seems like nothing more than an arse-covering exercise and - if that's so - why do you have to cover your arse? Why should you care that a previous doctor might have to cover their arse?
Don't let me delete them or modify them, but I should at least be able to view them on demand and provide notes/comments as necessary if there's a dispute. How else can I be assured that the data you have is accurate? I can even query my entire criminal record and have it corrected if necessary (e.g. if someone falsely used my identity to commit a crime, which is quite a common thing), so why can't I do the same for medical records?
In the UK, the PNC has an access and appeals process because there are recorded instances of someone being refused a job only to discover that the things on their record WEREN'T THEIRS - computer error, deliberate fraud, etc. is quite common - enough that there's a procedure to identify you with fingerprints in that case and modify criminal records accordingly, and have an appeals process.
You're not telling me that medical records can't have exactly the same problem and solution, especially in countries where that person's insurance is going to be paying for that medical treatment?
Hell, in the UK, even the Data Protection Act can be brought in here - you're storing data concerning my personal details on a computer system - that's automatic right to query, appeal, correction, etc. before you even start whether that's your image on CCTV (yes, under the UK DPA you can ask for all 'personal data' about yourself, including CCTV of you, from anyone who records it and stores it - there's even an official FAQ about it and they have 40 days to respond, so long as you provide enough details to isolate the data you require), the details your employer holds, or what a certain website holds on you in terms of cookies and stored data on their systems.
It's entirely a malpractice cover, from what I can see. And if you're scared of someone potentially discovering malpractice, then maybe you should deal with your patients more carefully, not try to hide your tracks. And, honestly, that would be #1, top-of-my-list reason for records TO be opened, if that's the case.
The difference between doctors and god (Score:5, Funny)
In related story ... (Score:4, Insightful)
Brokers don't think you should have full access to your investment account (after all THEY are professionals and you are too stupid to understand what they are doing).
Mechanics don't think you should have full access to your car's maintenance record (see above).
file this under ruductio ad absurdum [wikipedia.org] - I can understand the physicians point of view. I simply disagree...
"sed quis custodiet ipsos custodes"
Possible compromise? (Score:5, Insightful)
Split the record into a "data" section and a private "remarks" section. Patients get unrestricted access to their own data sections, but require a court order to see the remarks. Establish clear rules for what can go in the remarks section: everything else must go into data, and inappropriate use of the remarks section itself counts as a minor form of malpractice.
This should strike an appropriate balance. Patients can still get at the significant stuff, and they have recourse to get the rest if it's truly necessary. Doctors can continue to comment frankly about patients-from-Hell, without having to worry about being embarrassed unless they already have much bigger problems.
Obligatory Seinfeld (Score:3)
Psych patients (Score:4, Interesting)
I think one reason why medics might have a problem sharing is that there are issues if there are suspected psychiatric issues. Imagine a situation that a patient is prone to aggression and the doc thinks this might be related to schizophrenia or something along those lines. In my experience, anyone dealing with patients like this really try hard to keep themselves distant from the patient, in case they turn up on their doorstep... and this does happen. So I would look closely at how the question was worded in this survey. I would imagine most medics can think of at least one person who they would prefer didn't see their notes and for very good reasons. So if the question was along the lines of "should all patients" have access then the answer must be no.
Foolishness (Score:5, Informative)
My mother has worked in the medical industry her whole life on the administrative side. Since I was a kid, she would always go on and on about "always get your full medical record, check it for errors. Always ask for an itemized bill and check it as well." Then, a few years ago she got cancer, and thankfully survived and is cancer free after several surgeries and radiation treatment. And guess what... her persistence paid off. She again asked for an itemized bill, something that, over the years they've gotten more and more reluctant to give us... and the hospital had literally double charged her for everything. 2 pillows, 2 blankets, 2 room stays. They tried to argue this with her, but she had experience in the medical field and pointed out to them that if she had received the dosage of general anesthetic listed on the bill she'd be dead. The insurance company hadn't even caught it. She saved them hundreds of thousands of dollars, and they sent her a letter thanking her for her diligence. She only saved herself a few hundred dollars in co-pays, but she was proud none-the-less. Your medical record is yours, not the doctors. You should have full access to everything in it, and should be able to remove anything that you feel is inaccurate at will.
I'm paying for a service, and my records are (Score:4, Insightful)
.... proof of that service rendered.
It is absolutely important for a doctor to understand the medical history of a patient and it is very beneficial to the patient, because frankly, every patient is different. I also believe it is important for a patient who is seeking medical services to be fully informed of what doctors prescribed and the reasons for those prescriptions. I feel that if you don't like the relationship with your doctor, don't go back to that doctor again. Let that doctor keep the information records that you provided for that visit, but you as the patient are the original owner of that info, not the doctor, not the hospital, not the insurance company. As a standard of practice, I feel it is vital for a patient to make sure he/she review their own medical records from all their physicians every 2 years or so.
Our government recommends that we review our credit history every year, so why not your medical records? I also believe that a patient should be responsible for all of their own records. This information is about you and you have a right to understand if say an eye doctor is noting down psychological opinions about you and your mental state where he/she is not an expert. They have a right to an opinion, but it observations should be as non-biased in nature as possible, the information they write down should be factual, not conjecture, and if your copy of the medical records is not exactly the same as the physician's copy, then this should be an issue for everyone.
When a patient volunteers information such as "I've just lost my job and I'm struggling to get out of bed, because I feel so deflated", that can and should be reported. If the doctor responds with the following, "It sounds like you're experiencing depression." I feel the patient/doctor should both have to initial this discussion. Unfortunately, this will open up a can of worms on a legal front should the mental capacity of the patient come into question.
What happens when a doctor has his own medical issues such as a drug and alcohol addiction and is treating a patient, and the above statement is made, who is still scrutinized worse the patient or the doctor?
Sadly, I have met many doctors in my life, some are excellent and will take time to talk to a patient and are happy to share all medical records, while some (that I've met) believe that since you're not a doctor, you're too stupid to understand your issues and that's why you came to me complex. These are people who believe that they are more intelligent than their patients and that patients have no right to look at medical records that they cannot possibly comprehend. (to that I say Horse-shit)
I'm a voluptuous blonde haired woman who has had many doctors think that I couldn't possibly understand anything, and then when I actually ask intelligent questions, they are condescending in their response..."that's a difficult question my dear.../patknee" and that's the only response I've received. Those doctors never see me again, and if anyone inquires as to their abilities, I state that they refused to answer my questions and I won't see them again.
I've been lucky also to have doctors ask questions of me about my medical conditions and are forthwith in their lack of knowledge in a particular area, and these are the ones who will also state that they need to perform a little research to familiarize themselves with my conditions before they are willing to discuss them or call those conditions into the current diagnosis.
No one doctor knows everything, they need history, they need the knowledgeable patient to work with them. Let us not forget, long before medical degrees existed, people were pretty capable of diagnosing their own ailments.
Doctor's POV (Score:5, Interesting)
Let me give you a real-life example of what doctors are bracing themselves for. My wife saw a patient, and that patient later requested a copy of her medical records. No problem; my wife's office gave them to her. I personally witnessed this exchange afterward while I was picking up my wife from work:
Patient, storming into office: I WANT TO SEE DR. MRS. JUST SOME GUY!
My wife: Hi! What's wrong?
Patient: You slandered me and you're going to Fix. It. Right. Now!
Wife: What... what did I say?
Patient: You called me a drug abuser!
Wife: No, I did not!
Patient: It's right here! shows everyone who will look a highlighted section from her chart
Wife: Right...
Patient: I told you I didn't do that, and you said I'm in denial about it! If you don't fix that, I'll sue.
Wife: But that's not what we mean by "deny".
Patient: FIX IT OR I'LL SUE!
I swear that's not an exaggeration or misrepresentation. The patient was threatening to sue for defamation of character because my wife wrote "patient denies excessive drinking, tobacco, and drug use." That's medical jargon for "I asked the patient if she did this stuff and she said no" and is the industry standard way of documenting a "no" answer to a question.
Of course patients deserve complete access to their records, but I fully understand doctors who'd just as soon disarm a hand grenade as to hand over records to people who aren't trained in their interpretation.
Re: (Score:3)
sentence carries a clear implication that the Dr. considers it likely that the patient is a drug/alcohol abuser.
Yes, but the records aren't in English: they're in jargon. There's a world of difference. Consider a common IT phrase "click the OK button". Although the words appear to be standard English, the sentence most certainly is not. There is no "small disk or knob" sewn to the computer screen. You are not causing the "button" to "make a short, sharp sound". Instead, you're moving a mouse (not a mammal) to reposition a cursor (not a piece of a slide rule) on the screen (not a room-dividing partition) until it's ov
Physician perspective (Score:4, Interesting)
I'm a doctor in the US, and I'm stepping into the line of fire here as there is some serious doctor hate going on in this thread, but here goes...
First of all (in the US at least) most of these arguments are moot because patients by law have the right to their medical record. So, regardless of what your doctor thinks, by federal law you have the right to request and get access to your medical record.
In regards to the attitudes about IF patients should have this access I would be willing to bet that older physicians would be more against it than younger physicians. Doctors above a certain age tend to be more paternalistic towards patients than younger doctors.
My personal opinion is that any individual should be able to obtain access to their own medical notes.
However, most people are not familiar with the diagnostic process and jargon used in medical records. This could definitely lead to misinterpretation or confusion by a patient or the feeling that information was withheld when that is not the case at all. For instance I may write in a chart "left lung cavitary mass - malignancy vs TB vs fungal infection" indicating that I'm not yet sure what it is and more workup is needed. Do I tell the patient every possible differential diagnosis? No, because that tends to freak patients out, I say "I don't know what it is yet, we need to do some more tests."
If the patient read my note without understanding how to interpret it they may feel that information was withheld or the doctor has no clue what's going on.
I think that is more what is behind the results of this survey than doctors "covering their ass", because if a patient wants to sue they will sue, and every single piece of information about that patient will be subpoenaed and scrutinized by lawyers. You cover your ass by putting complete and accurate information into the medical record, and not trying to cover up mistakes if they happen.
Personally I would not care if any of my patients read their chart. I will even show it to them "See, last time I wrote that this was going on, is that still a problem?"
Re: (Score:2)
Re:Access your doctor's server using a HOST file (Score:4, Funny)
Re:Necessary for MD's to do their job (Score:5, Insightful)
Re: (Score:3)
Your average HR lackey doesn't have people's lives in their hands.
Doctors do. So it's an entirely different kind of situation.
The idea that the process should be open to auditing shouldn't even be in question. Nor should the idea that doctors would be exposed to "code review" and examination by their peers.
Re: (Score:3)
It has been proven over and over again that the mere visit to the doctor and the placebo effect has a significant effect on the reconvalescens. It basically hinges on the fact that you feel better, understood and taken care of. It totally destroys the effect if you learn that half of the medication or treatment you get is actually just feel good or placebo medication.
Re: (Score:3)
If patients had free access to this, it would be very difficult for the physician to document their true findings and impressions for fear of "offending" their patient. This would also jeopardize the relationship between the doctor and patient, which is necessary in any setting.
But witholding this data offends me more than anything that could be inside it, and damages the relationship between me and my doctor. If my doctor cannot be completely honest with me, how can I be completely honest with her?
Re: (Score:3)
When I write, "drug seeking behaviour" in the notes I don't want to show it to the patient, because I know all that is going to happen is I'm going to have to sit there whilst they scream at me until I finally give them the damn Diazepam just to get them out of my hair.
Legalize it so they don't have to lie to you. Problem solved.
Re:doctors are overpaid (Score:4, Insightful)
Are you kidding? To become that pediatrician that doctor went to 4 years of undergraduate college, then 4 years of medical school (which has an average cost of >100,000), then completed 3 years of residency (making around 45k/yr). So now they are in their mid 30's, have a mortgage payment due every month, and all so they can work 120 hours a week so they can see enough patients to keep the doors to the practice open and pay their insurance company the ludicrous amount needed for malpractice protection from the sea of parasitic attorneys looking for a quick settlement.
Get real, the waste in the healthcare sector is not in doctor's earnings. If anything, they deserve more for all the crap they have to deal with day in and day out.
Re: (Score:2)
How is this news for nerds? Taco is really starting to let this site go downhill.....
I guess you haven't noticed what's happened to every other type of data over the last 20 years.
Re:Fuck the medical profession (Score:4, Funny)
Well at least you seem totally mentally balanced now...
Re:Fuck the medical profession (Score:5, Funny)
I wonder what hidden gems are in his medical notes.
Re: (Score:3)