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Most Doctors Don't Think Patients Need Full Access To Med Records
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."
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.
You do not have a moral or legal right to do absolutely anything you want.
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 found that here in the UK, doctors tend to develop shorthand just in case anyone (like a nosy relative) looks at the patients notes in hospital... a nice one that stands out in my mind is "NFN" which is taken to mean that the patient is mentally impaired and thus requires extra care/attention when being spoken to. When I asked a doctor friend of mine what "NFN" stood for he chuckled and said... "Normal for Norfolk".
http://en.wikipedia.org/wiki/List_of_countries_by_total_health_expenditure_(PPP)_per_capita
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.