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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."
What could possibly be in my medical records that they don't want me to know about?
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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.
File a US disability claim, and find out how much fun it is to get all those records, and then get your doctor to contradict the governments doctors in court.
C|N>K
The easy way around this is to treat a medical records system like an accounting system. You can't delete any record you can only add corrections. Anyone reading the record would be able to see the "erroneous" entries as well as the justification for correcting them.
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.
Is it just my observation, or are there way too many stupid people in the world?
The problem with limited access and the record keepers determining what is/isn't available is that it creates a strong pressure to hide things that should normally be available for less-than-honest reasons. Just look at all the information our government classifies and the types of things we've seen declassified years later. It's as likely as not that information is being hidden not to protect the patient, but rather to protect the doctor.
"They that can give up essential liberty to obtain a little temporary safety deserve neither liberty nor safety."
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.
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
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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 - I can understand the physicians point of view. I simply disagree...
"sed quis custodiet ipsos custodes"
It ain't what they call you. It's what you answer to. http://mylyceum.us/
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.
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.
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 HUGE problem because disease processes are complicated and there are a lot of subtle distinctions the lay-person will not know anything about. Yes, sometimes the doctor might miss something but the vast majority of the time you will observe the doctor having a better batting average on the diagnosis than the patient.
.... 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.
Life takes interesting turns, but the most interest is when you're off the beaten path.
This is an absurd position to take. In any field, people who are overconfident of their abilities have a far greater likelihood of making mistakes than those who are cautious and believe that they have more to learn. Doctors, regardless of whatever delusions of grandeur they may possess, are still just people.
I'd much rather have a doctor with a cautious, inquiring attitude than an arrogant, patronising one with a god complex who has become incapable of listening to a patient or learning anything new as a result. Quite frankly, many doctors have an attitude and respond in a way that in any other profession would be considered to be a serious mental health problem.
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?
The Doctors have been colluding with government to fuck over patients well and good for a long time. There'd be some justice in seeing them take the shaft in their turn, but I'd rather just end the power of their guild to control may access to health care services and treatments.
Why do you exclude the AMA, who artificially restricts the number of doctors, from the list of those colluding against us?
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