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The Divide Between You And Your Medical Records

You have a right to your medical record. It’s true –- the record of every test and procedure you’ve had done, any films or studies, your doctors notes — it’s all yours if you ask for it. But it’s not that simple.

If you’re sick, your “record” is likely in pieces in lots of different places. Some of it is in paper files and computers in the offices of each of your doctors, or in the clinics where you had a test or procedure. It’s in multiple computer systems in a hospital, or in a folder in a radiology department, a container in a pathology department, or the computer system of a pharmacy. Each of these places has their own policy or procedure if you want your record. There are forms you have to fill out, fees you have to pay, time you have to wait.

So while you have a “right” to your records, for practical purposes, you’re going to have a very difficult time actually getting them. (By the way, this is something our team at Best Doctors does very well.) But let’s say you actually get all of your medical records. Now what? Read more »

*This blog post was originally published at See First Blog*

“Laxative Tantrums” In Kids?

This “Fletchers Castoria” ad from 1941 is priceless. And as someone who spends his days working with bound-up grumps like Mary, I was reassured to know that horrific constipation is not a me-generation problem born of chicken fingers and Goldfish. ”Laxative tantrums,” however, are new to me. I seem to have pretty good luck with Miralax and Kristalose in my office. Your mileage (or tantrums) may vary.

*This blog post was originally published at 33 Charts*

Anatomy 101: Are You Up To “Snuff?”

It’s time we get away from all of the serious nonsense and back to something I am far more comfortable with: Taking otherwise-useful information and twisting it into utter nonsense. Yes, it’s time to journey back to the wonderful world of the physical exam.

My ongoing mission is to explore the human body from my unique (albeit moderately unstable) perspective. For an overview of my previous posts on the physical exam see this post which features Dick Chaney on a Segway (reason enough to click on the link). Please visit a psychiatry blog to aid in recovery once you have done so.

My most recent post in this fine series covered the topic of psychics and about the examination of the hand. It was mainly about psychics examining the hand, but I did slip in a little doctor stuff to keep the cops off of me. But then I got a call from the department of homeland security and they said that if I didn’t shape up, I’d no longer be able to use the picture of Dick Cheney on the Segway. It’s hard to resist such harsh tactics. Read more »

*This blog post was originally published at Musings of a Distractible Mind*

What A ’68 Chevy Impala Can Tell Us About Primary Care

When I was a much younger man I had a 1968 Chevy Impala. I loved its V-8 engine and spaciousness, but I paid a steep price for it. It consumed gas like a drunk on a binge. It was prone to breakdowns, usually in the left lane of a busy highway. Even as it consumed my limited financial resources, I couldn’t count on it to reliably get me to where I wanted to be. Yet I held onto it. One day, though, its transmission gave out, and I finally had to resign myself to buying a new, more reliable, more modern, and efficient vehicle. Yet to this day, I miss my clunker.

I am reminded of this when I think about the state of primary care today. Many of us are attached to a traditional primary care model that may no longer be economically viable — for physicians, for patients, and for purchasers.

We hold onto a model where primary care doctors are paid based on the volume of visits, not the quality and value of care rendered. We hold onto a model where patient records are maintained in paper charts in voluminous file folders, instead of digitalizing and connecting patient records. We hold onto a model that generates enormous overhead costs for struggling physician-owners but generates insufficient revenue. We hold onto a model that most young doctors won’t buy, as they pursue more financially viable specialties and practices. Read more »

*This blog post was originally published at The ACP Advocate Blog by Bob Doherty*

Why Patients Are Unsure Of The Primary Care “Medical Home”

Say the words, “Patient-centered medical home,” and you’re bound to get a variety of opinions.

On this blog alone, there are a variety of guest pieces critical of the effort, saying it does not increase patient satisfaction, nor does it save money. And that’s not good news for its advocates, who are pinning primary care’s last hopes on the model.

Medical homes hit the mainstream media recently, with Pauline Chen focusing one of her recent, weekly New York Times columns to the issue. She discussed the results of a demonstration project, showing some positive results. Read more »

*This blog post was originally published at KevinMD.com*

Latest Interviews

IDEA Labs: Medical Students Take The Lead In Healthcare Innovation

It’s no secret that doctors are disappointed with the way that the U.S. healthcare system is evolving. Most feel helpless about improving their work conditions or solving technical problems in patient care. Fortunately one young medical student was undeterred by the mountain of disappointment carried by his senior clinician mentors…

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How To Be A Successful Patient: Young Doctors Offer Some Advice

I am proud to be a part of the American Resident Project an initiative that promotes the writing of medical students residents and new physicians as they explore ideas for transforming American health care delivery. I recently had the opportunity to interview three of the writing fellows about how to…

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Latest Book Reviews

Book Review: Is Empathy Learned By Faking It Till It’s Real?

I m often asked to do book reviews on my blog and I rarely agree to them. This is because it takes me a long time to read a book and then if I don t enjoy it I figure the author would rather me remain silent than publish my…

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The Spirit Of The Place: Samuel Shem’s New Book May Depress You

When I was in medical school I read Samuel Shem s House Of God as a right of passage. At the time I found it to be a cynical yet eerily accurate portrayal of the underbelly of academic medicine. I gained comfort from its gallows humor and it made me…

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Eat To Save Your Life: Another Half-True Diet Book

I am hesitant to review diet books because they are so often a tangled mess of fact and fiction. Teasing out their truth from falsehood is about as exhausting as delousing a long-haired elementary school student. However after being approached by the authors’ PR agency with the promise of a…

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