Should patients have ready access to what doctors write about them in medical… (Myung J. Chun / Los Angeles…)
Have you ever wondered what’s in your doctor’s notes? I have, although I’m not quite sure if I want to see … what would be written there? “Malingerer“? “Noncompliant”? "Royal pain in the rump?" “Only has one kidney and likely to check out early”?
This week’s Annals of Internal Medicine took a look at the issue. Turns out, not surprisingly, that most people really want to see what’s in their doctor notes. And many doctors -- also not surprisingly -- are a little uncomfortable with the prospect.
Jan Walker of Harvard Medical School/Beth Israel Deaconess Medical Center and coauthors at a variety of institutions decided to conduct an experiment in which patients would have access to not just basic items such as test results and medication lists (which many already have online) but also to the notes doctors make about them.
To get the experiment rolling, the authors asked primary care doctors in Massachussetts, Pennsylvania and in Washington state if they’d be willing to take part in this plan, with the agreement that they could exclude patients they thought might be harmed by having this access.
The scientists then polled the doctors who’d agreed and not agreed, as well as nearly 38,000 patients who attended their practices, for their thoughts on this plan.
Of 173 physicians that replied to the survey, 114 (64%) agreed to take part in the open-notes experiment.
The surveys took place before the plan got rolling.
Not surprisingly, the doctors who’d agreed to participate were a lot more positive about the potential benefits of doctor-note-sharing than those who declined to take part. (The authors of the paper were actually taken aback by how positive doctors seemed.) They were far more apt to agree that it would make care safer, improve patient satisfaction, make patients better prepared for visits, more likely to take care of themselves, among other things.
Doctors who declined were more apt to think that this access would confuse or worry patients, make doctors less inclined to be candid in the notes or increase the time they’d spend in medical visits or in editing the notes.
And patients? More than 90% of them liked the idea. “Fewer than 1 in 6 was concerned about being worried or confused by reading their notes,” the authors wrote. This held for patients with high as well as modest education.
Many patients also said they’d be inclined to share their notes with others, including family members and other doctors. So even though such notes are meant to be strictly confidential, "open visit notes put the patient in control of whether the note will remain private,” the authors noted.
Next up, the study itself: Patients and doctors are now participating. “We anticipate that reports from doctors and patients at the close of the 1-year study period will differ from their predictions,” the authors write.
By the way, by law you can access your medical files, though you may have to pay to have them copied. Here’s a website that describes the laws state by state.
For more health news, check out other items at the Booster Shots blog.