Doctors writes too bad (poor hand writting) that sometimes patients cant understand. In India we are talking about a rule ( law ) where doctors have to write in CAPITAL only.
When Patients Read What Their Doctors Write
11–20 of 110 posts
Re: When Patients Read What Their Doctors Write
#12I work in a family practice every other week as a requirement for medical school. I've noticed that EMRs are very disruptive to a doctors bedside manner. For every visit the doctor types notes into a laptop while the patient speaks to her. Communication is inhibited and the doctor struggles to maintain rapport with her patient.
I would love to see the patients EMR displayed on a screen so the patient could see what the doctor typed as he spoke. This would make the process collaborative instead of one sided. It would also be a great feedback mechanism where the patient could double check that his doctor understood what he just said.
Re: When Patients Read What Their Doctors Write
#13Not having access to my own medical records is something that continues to annoy me to this day. I've heard a few arguments as to why the security is better than Fort Knox, many of these touched upon in the article ["Doctors want to be Free" and "Oh my, Liability"], but I have yet to buy any of them.
I hope this "open note" deal continues to trend, and becomes more so; horray for privacy, but bleh to "so secure, I can't see it".
Re: When Patients Read What Their Doctors Write
#14One problem with this approach is patients who are making stuff up entirely. They're not a large part of the population, but since they relentlessly seek medical attention (often to the point of self-harm), every doctor is familiar with them. Giving such patients editorial power over doctors' notes gives them a further lever with which to manipulate the system. It's a weird situation in which the doctor/patient relat…
> patients who are making stuff up entirely
I'm not sure how making notes visible, or invisible, to patients would change the adage that "patients lie". Exacerbation or reduction arguments, perhaps, but the fundamental principle I'm not sure would change.
Toward the "further lever to manipulate the system", that may be something to consider in terms of who has editorial access to the records vs. simple readability access to the records... little more.
Re: When Patients Read What Their Doctors Write
#15I work in a family practice every other week as a requirement for medical school. I've noticed that EMRs are very disruptive to a doctors bedside manner. For every visit the doctor types notes into a laptop while the patient speaks to her. Communication is inhibited and the doctor struggles to maintain rapport with her patient. I would love to see the patients EMR displayed on a screen so the patient could see what t…
A doctor also might theorize about possible causes of the issue while trying not to implanting ideas of symptoms in the patients head. When I did computer repair, I was very careful not to put my own words in the clients vocabulary when I was still trying to gather information, as I wanted to keep from coloring their memory / experience. Same thing would apply here. Maybe a good compromise would be for the doc to summarize their notes at the end and ask for feedback.
Re: When Patients Read What Their Doctors Write
#16One problem with this approach is patients who are making stuff up entirely. They're not a large part of the population, but since they relentlessly seek medical attention (often to the point of self-harm), every doctor is familiar with them. Giving such patients editorial power over doctors' notes gives them a further lever with which to manipulate the system. It's a weird situation in which the doctor/patient relat…
Editorial power? I must have missed that in my reading of the article. As far as I understood it, patients weren't able to redact/change their notes.
Reported symptoms and complaints are listed comprehensively, but the doctor is not compelled to do any unnecessary testing, or even falsify test results.
Because of the outrageous amount of data that is dumped into a doctor's head, he is able to recognize "hypochondriac" at a glance on the record, without that term or any other negative comments to that nature being in there.
Re: When Patients Read What Their Doctors Write
#17One problem with this approach is patients who are making stuff up entirely. They're not a large part of the population, but since they relentlessly seek medical attention (often to the point of self-harm), every doctor is familiar with them. Giving such patients editorial power over doctors' notes gives them a further lever with which to manipulate the system. It's a weird situation in which the doctor/patient relat…
Editorial power? I must have missed that in my reading of the article. As far as I understood it, patients weren't able to redact/change their notes. Reported symptoms and complaints are listed comprehensively, but the doctor is not compelled to do any unnecessary testing, or even falsify test results. Because of the outrageous amount of data that is dumped into a doctor's head, he is able to recognize "hypochondriac…
This is not about hypochondria, but people who knowingly fake illness. They can be extremely manipulative.
Re: When Patients Read What Their Doctors Write
#18One problem with this approach is patients who are making stuff up entirely. They're not a large part of the population, but since they relentlessly seek medical attention (often to the point of self-harm), every doctor is familiar with them. Giving such patients editorial power over doctors' notes gives them a further lever with which to manipulate the system. It's a weird situation in which the doctor/patient relat…
Giving patients a copy of doctors' notes != giving them editorial power over doctors' notes.
They're doctors' notes, after all. Both the doctor and the patient can look at the screen, but only the doctor has the keyboard.
Of course, the psychological pressure to bend to the patient's wishes might be stronger if the patient can see what is being written down. But that's a kind of problem that rigorously trained professionals can learn to avoid to some extent. As you said, most doctors already know how to tell when a patient is seeking unnecessary drugs and/or procedures. Refusing to make unwarranted modifications to the records shouldn't be too different from refusing to prescribe unnecessary drugs and/or procedures. Liars gonna lie. Their ability and determination to lie is not one bit hampered by their inability to read the doctors' notes.
If someone tries to turn doctors' notes into some sort of wiki that both sides can edit, I'd be concerned. But not yet.
Re: When Patients Read What Their Doctors Write
#19I work in a family practice every other week as a requirement for medical school. I've noticed that EMRs are very disruptive to a doctors bedside manner. For every visit the doctor types notes into a laptop while the patient speaks to her. Communication is inhibited and the doctor struggles to maintain rapport with her patient. I would love to see the patients EMR displayed on a screen so the patient could see what t…
For other readers, like me, who are not doctors, I will share that I have discovered that EMR means Electronic Medical Record.
Re: When Patients Read What Their Doctors Write
#20I would imagine a lot of the concern over this is more of the existential fear resulting from the balance of power between patient and doctor than anything else. The Internet started that, with patients able to become much more knowledgable about their own conditions (with the unfortunate side effect of every symptom being cancer). Once patients become knowledgable, the doctor moves from a pillar of all knowledge to…
> In the process, I've stopped medications and have had to teach my doctor certain things (like why I'm not gong to either worry about my cholesterol or take any drugs for it).
People have many values, one of which is health. Deciding not to worry about cholesterol may fit with your value system, but is unlikely to benefit your health. As a doctor, it would be reasonable to try to convince you of the benefit of caring about cholesterol, and then working with you to improve your health along the axes in which you are interested in making changes. If cholesterol is not one of them, that shouldn't sever the remainder of the therapeutic relationship. In other words, your physician may have recognized that global optimization sometimes requiring abandoning local optimizations (such as cholesterol control, in this case).
Obviously I don't know anything of the specifics of your case, but yours is an interesting comment.