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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."
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.
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.
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.
Oh no... it's the future.
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.
What could possibly be in my medical records that they don't want me to know about?
20 years ago my 35 year old friend died from stomach cancer. 8 years prior a radioligist failed to do his/her job correctly by not noticing a tiny white dot, so for 8 years the cancer grew until any swallowed food was blocked from continuing on into his body. Coincidentally, my friend's wife happened to work in the records room of his HMO (it's name rhymes with 'gyp'), and snuck his medical records out. The widow received a large wrongful death settlement only because of her having physical possession of his records, else no one would have known the true cause of his provider's negligence.
That's one reason why you would want full access to your own records.
"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.
I am not a crackpot.
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.
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.
Dewey, what part of this looks like authorities should be involved?
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.
You do not have a moral or legal right to do absolutely anything you want.