Patient Participation

Should patients be able to access their charts? Of course, everyone can get their medical records, but doing so is often a big hassle, requiring signatures and time and visits to medical records. But recently, some practices have started opening up their charts to patients through secure internet connections. Indeed, a study of a small primary care office showed that patient satisfaction increased when they could see their providers' notes and that this did not increase burden on providers.

How do I feel about this? Obviously, anesthesia won't be affected much, but in thinking about it more broadly, I am a little apprehensive yet see the world moving towards more open information. If you knew a patient was going to read your progress note, would you be a little more wary with what you write? Would you say "a 50 year old obese woman" or "a 50 year old woman with BMI 32" or omit it completely? Would you mention psychiatric assessments? Would you write down that innocent heart murmur? We worry that patients will go through what we write with a fine-needle comb or take offense or contest our assessments. Would we start getting more phone calls and emails and visits? Small studies have suggested that this isn't the case. And there are so many reasons for patients to know our findings, assessments, and plan. It seems unethical if there were a disconnect between what we tell patients and what our charts say. Though one carries jargon, they ought to say the same thing. Furthermore, one way to solve the problem that electronic medical record systems between hospitals don't communicate is to give that information to patients so that when they show up to a different provider, they know what tests they have had and what their last provider was thinking. In a world where everyone else - politicians, companies, industries - are encouraged to share information openly, there is no reason why physicians should be exempt.