Aa
EMR's and your medical history rights
this applies more to the USA than elsewhwere, but similar things are worth being aware of in other lands;
Your right as a patient is to see all your medical records.
You will really want to do this now in that your rights to be treated as an individual are about to take a huge nosedive.
EMR software technologies have been around a while, but just got a new boost from the Obama health plan, which plans to phase out doctors, or rather financial penalize those who refuse to participate in them, one or both.
EMR companies lobby very hard to force docs and hospitals to subscribe to their services....big bucks. Sold as timesavers they have pluses and minuses both. The rub is the down side can allow for complete incompetance to rule every exam.
it's no big surprise that some docs love these things....it makes them look better and more efficient than many actually are, and gets them to their golf tee-offs on time.
FYI...EMR's a boiler plate "doctor notes" software that a physician can pull up after your exam with a few key words.
The EMR will look and sound as if the physician examined and discussed everything related to that condition with you, whether they did or not.
EMR's have a one size fits all approach and cover docs more legally, plus cost them less time..no need for dictation etc.
The problem is, half the time the items written in these type notes were not discussed with the patient, or the physical exam or observations were not really made. Sometimes something the doctor suspects may have a whole canned paragraph written about it, even though not one word was said to the patient.
This is the reason that I now ask for my doctors notes each time I go for a visit. I stay current up to the last visit this way. This way I know what was discussed last time...and I know if there were inaccuracys and can correct them.
You can call most offices a few days ahead of your visit, ask for records, and ask that your records for a certain time period be waiting for you at the front desk. Then pick them up right before your exam...(most offices do this service free of charge although if you want several years of records they farm it out and there is often a per page charge for that....so keeping your record currect saves you this.)
Example of EMR's and physician incompetance:
I went into ER with sepsis caused from a leaking gallbladder. I told the doc I knew it was gall bladder disease, and listed off 8 or ten common GB disease symptoms as my reasonings, that and I had been in a medical field for 15 years so had some experience.
Unfortunately, I was in a lot of pain at the time...doubled over, so he gave my a shot of Ativan as a tranquilizer and a numbing agent to drink because my stomach was upset.
I then told him than my stomach had been hurting so bad earlier that day that I had to force myself to throw up...because the waves of nausea were unbearable yet nothing was coming up, so I gagged myself hoping for some relief.
(I've done this when having the flu to avoid hours of nausea, but at no other times in my life).
I told him I had every symptom of GB disease and named them.... but added that my GP had refused to give me a Hidascan because my ultrasound showed nothing....he therefore refused also, even while acknowledging that hidascan was the definitive test.
None of this discussion with him showed up in the EMR canned notes, so legally he was off the hook...or would have been, except that I brought a witness..
ER guy concluded instead that I was an anxiety prone anorexic. and sent me home with prilosec for stomach acid.
to be continued....
Your right as a patient is to see all your medical records.
You will really want to do this now in that your rights to be treated as an individual are about to take a huge nosedive.
EMR software technologies have been around a while, but just got a new boost from the Obama health plan, which plans to phase out doctors, or rather financial penalize those who refuse to participate in them, one or both.
EMR companies lobby very hard to force docs and hospitals to subscribe to their services....big bucks. Sold as timesavers they have pluses and minuses both. The rub is the down side can allow for complete incompetance to rule every exam.
it's no big surprise that some docs love these things....it makes them look better and more efficient than many actually are, and gets them to their golf tee-offs on time.
FYI...EMR's a boiler plate "doctor notes" software that a physician can pull up after your exam with a few key words.
The EMR will look and sound as if the physician examined and discussed everything related to that condition with you, whether they did or not.
EMR's have a one size fits all approach and cover docs more legally, plus cost them less time..no need for dictation etc.
The problem is, half the time the items written in these type notes were not discussed with the patient, or the physical exam or observations were not really made. Sometimes something the doctor suspects may have a whole canned paragraph written about it, even though not one word was said to the patient.
This is the reason that I now ask for my doctors notes each time I go for a visit. I stay current up to the last visit this way. This way I know what was discussed last time...and I know if there were inaccuracys and can correct them.
You can call most offices a few days ahead of your visit, ask for records, and ask that your records for a certain time period be waiting for you at the front desk. Then pick them up right before your exam...(most offices do this service free of charge although if you want several years of records they farm it out and there is often a per page charge for that....so keeping your record currect saves you this.)
Example of EMR's and physician incompetance:
I went into ER with sepsis caused from a leaking gallbladder. I told the doc I knew it was gall bladder disease, and listed off 8 or ten common GB disease symptoms as my reasonings, that and I had been in a medical field for 15 years so had some experience.
Unfortunately, I was in a lot of pain at the time...doubled over, so he gave my a shot of Ativan as a tranquilizer and a numbing agent to drink because my stomach was upset.
I then told him than my stomach had been hurting so bad earlier that day that I had to force myself to throw up...because the waves of nausea were unbearable yet nothing was coming up, so I gagged myself hoping for some relief.
(I've done this when having the flu to avoid hours of nausea, but at no other times in my life).
I told him I had every symptom of GB disease and named them.... but added that my GP had refused to give me a Hidascan because my ultrasound showed nothing....he therefore refused also, even while acknowledging that hidascan was the definitive test.
None of this discussion with him showed up in the EMR canned notes, so legally he was off the hook...or would have been, except that I brought a witness..
ER guy concluded instead that I was an anxiety prone anorexic. and sent me home with prilosec for stomach acid.
to be continued....
I get what you are saying....it's patially me own fault for sticking with someone after seeing the incompetance...and after all this I'm still there...but as to why...it's kind of like trying to switch horses in mid stream...by the time I realized just how much entranched callousness I was dealing with I was already in serious health straights, on chemo and heading into surgery.
I thought it over long and hard and just decided I needed to stay put rather than have some new person try to grasp all my health issues in the middle of all this.
Plus, even though I sound frustrated, and am, I separate my sense of injustice from my need to forgive....and I partly feel my doctor needed to have someone in her life who would forgive her, and yet eye ball to eye ball challenge her to stop making assumtions about her patients or dismissing the quality or voracity of their claims.
Trust me, you would have a legal pay day on at least 5 malpractice cases on me and this one doc alone...if I was the litigious type
I think you make a valid point in that EMRs could potentially help docs to cover their bases, but they are limited by the human element, will they use them as reminders to do more, and cover those bases, or just let the notes say that they did.
If not covering matters results in 8 not 10 hr days..how long before every patient gets the short end of that stick.
You know yourself you can pull up boiler plate specials that may save you tons of time, but not really be tailored to nor address your clients needs or issues, not address particular state laws.
If legal zoom really could fit the bills....your profession would become obsolete.
Truth is, it can't, and potential for abuse is a real and valuable discourse both in law and medicine.
How many times have you seen a trust botched so badly it did the opposite of protect the heirs?? same issues here, only here it's their lives not just their money that is being jeopardized.
mb
I thought it over long and hard and just decided I needed to stay put rather than have some new person try to grasp all my health issues in the middle of all this.
Plus, even though I sound frustrated, and am, I separate my sense of injustice from my need to forgive....and I partly feel my doctor needed to have someone in her life who would forgive her, and yet eye ball to eye ball challenge her to stop making assumtions about her patients or dismissing the quality or voracity of their claims.
Trust me, you would have a legal pay day on at least 5 malpractice cases on me and this one doc alone...if I was the litigious type
I think you make a valid point in that EMRs could potentially help docs to cover their bases, but they are limited by the human element, will they use them as reminders to do more, and cover those bases, or just let the notes say that they did.
If not covering matters results in 8 not 10 hr days..how long before every patient gets the short end of that stick.
You know yourself you can pull up boiler plate specials that may save you tons of time, but not really be tailored to nor address your clients needs or issues, not address particular state laws.
If legal zoom really could fit the bills....your profession would become obsolete.
Truth is, it can't, and potential for abuse is a real and valuable discourse both in law and medicine.
How many times have you seen a trust botched so badly it did the opposite of protect the heirs?? same issues here, only here it's their lives not just their money that is being jeopardized.
mb
it's not the Rx straight to the pharm that's the prob...
it's the canned notes.
for one thing, instead of looking at you during the exam..now they are typing and pulling up whole paragraphs...some other doctors notes from a similar case...fits your converstion more or less...covers, or says they covered the basics of that topic (whether they did or not).
Sometimes they are so busy pulling up notes, they miss 3/4 of what you are saying to them....their eyes are on the screen the whole time...
Maybe it's just me, but when I read a whole page of notes, and only one of ten items in the remarks were things we actually discussed, or that I was asked about or actually examined for....then something is wrong.
The notes make a 10 minute exam look like an extended visit with the most efficiant competant doctor in the world.
the way I discovered the inneptitude was by asking "last time you wrote in my chart da da da da da.." would you explain that please...and getting blank stares back..because A. they did not discuss that, B. they didn't even proof the canned notes they plugged in, and didn't know that was even in that paragraph...
Or, say you have a lab result.....they may see from your lab results you have a low iron, or high blood sugar...and plug in an excerpt about you being prediebetic based on that lab...they are efficiently looking like they covered their bases...PROBlem is...what if they plug that in as if they explained the labs to you..but actually never did..only on paper it looks like they have....that's also what happened to me...she typed in "patient is prediebetic" and that word or condition was never discussed with me. The only thing discussed was...your BS is a little high come back for a fasting glucose...and I got a call saying that was normal....but NEVER was I told I was prediebetic.
So from what little I've observed the canned notes are not making anyone more efficient, meaning they have more time to discuss with patients, or that they take time to cover all the bases...all it's doing is giving them an easy way to look competant whether they are or not.
mb
it's the canned notes.
for one thing, instead of looking at you during the exam..now they are typing and pulling up whole paragraphs...some other doctors notes from a similar case...fits your converstion more or less...covers, or says they covered the basics of that topic (whether they did or not).
Sometimes they are so busy pulling up notes, they miss 3/4 of what you are saying to them....their eyes are on the screen the whole time...
Maybe it's just me, but when I read a whole page of notes, and only one of ten items in the remarks were things we actually discussed, or that I was asked about or actually examined for....then something is wrong.
The notes make a 10 minute exam look like an extended visit with the most efficiant competant doctor in the world.
the way I discovered the inneptitude was by asking "last time you wrote in my chart da da da da da.." would you explain that please...and getting blank stares back..because A. they did not discuss that, B. they didn't even proof the canned notes they plugged in, and didn't know that was even in that paragraph...
Or, say you have a lab result.....they may see from your lab results you have a low iron, or high blood sugar...and plug in an excerpt about you being prediebetic based on that lab...they are efficiently looking like they covered their bases...PROBlem is...what if they plug that in as if they explained the labs to you..but actually never did..only on paper it looks like they have....that's also what happened to me...she typed in "patient is prediebetic" and that word or condition was never discussed with me. The only thing discussed was...your BS is a little high come back for a fasting glucose...and I got a call saying that was normal....but NEVER was I told I was prediebetic.
So from what little I've observed the canned notes are not making anyone more efficient, meaning they have more time to discuss with patients, or that they take time to cover all the bases...all it's doing is giving them an easy way to look competant whether they are or not.
mb
I wasn't in acute pain for all 10 months..mostly I was only in pain folowing eating fat or protein...and I'd started avoiding that...so I suffered "bouts"....acute bouts....I was twice and only went to ER once for it...the other time it was so intense I refused to let my husband move me from the bed and laid there for 3 days shivering from the infection.
Evidently there was a lot of the contractions and tearing loose from the liver wall that I was not feeling however...the liklihood in when leaking occured is when the fevers and pain was the worse...but the liver has no nerves...so this gall bladder can go through so real contortions without folks feeling it much...
I did go to the doctor about 8 times during that period...she order a ultrasound the first time...but when it showed nothing she dug her heels in.
I went back time and again, saying there is something SERIOUSLY wrong....I think it's my gall bladder,,but if not it;''s my liver and spleen because everything now feels very swollen. And again I went in saying it hurts to move...my ribs feel like someone has taken a baseball bat to them.
She called me up after those 4 visits pleading with her to test me more and chewed me out...saying there's NOTHING wrong with your liver of gallbladder!! "I still have a recording of her dismissive lecture".
It was only after months of going back again and again and again, like a bad penny that she referred me finally to a GI guy...who found nothing wrong with me at first...confirming in her mind that I was nuts and she was vndicated.
But when discussing her lack of care I mentioned that she had been telling me for 10 years my liver enzmes were high but it was no big deal. I told her I did not drink, but she said, well lots of other things could do it...a bug, many things...
then he decided to check my blood a viola..I had HCV....cat scan confirmed enlarged liver and spleen...explaining the pressure and pain, but the lower quadrant he wasn't sure of...after endoscope he sent me back to her saying she really should have allowed me the hidascan...
so finally I had to go BACK to my GP (as he did not want to "get in the middle of her treament"..).and by this time I was pretty adamant...give me the test already!!
So yes, I had advanced GB disease, AND an enlarged liver, and an enlarged spleen...and those liver enzymes she'd ignored for 10 years...well that was Stage 3/4 HCV....so I was right on all three counts...all 3 organs were diseased.
as to why it took me so long...I don't know Guy...I can only say I was so sick at the time all I wanted was to lay in bed....also I was tired of fighting with her...
it seemed like every darn thing wrong with me I had been forced to do the research and figure out what was going wrong....and that's what we pay and expect the doctors to do FOR us when we are sick!!
All I can say, is I've seen dismissiveness at it's worst....and I remember sitting on the couch one night, and praying to God....and hearing a really strong voice in my head saying "YOU are going to have to figure this out for yourself, sick or not, because if you don't get serious about this now you will be dead soon...and nobody else is going to think this through or solve this for you." The patient should not have to play "House" when they are half dead...but that's whaere it was at.
thinking back....my first big health issue had been exaustion and fevers..for years...
I now know this was both the HCV and the Pituitary, but at the time, I only suspected the pituitary because every symptom fit, and I had the symptoms primarily after the accident....earlier symptoms she had attributed to menopause...
however anterior pituitary dysfunction fit ALL my symptoms, including a tremendous sleep disorder and severe exaustion..
so I had asked for a test.
that all happened right before my GB went south...
ergo
it had been a HUGE issue when I had brought her the info concerning pituitary disease
She was angry that I went over her head and went to the University to get my pituitary checked when she refused..... INSISTING I could not have this....and she was pretty embarrassed when 3 pituitary doctors and 12 tests confirmed I did have it.
So it was on the heels of all this that my GB got so angry...and she was just not listening to me...
the funny thing is, our bodies tell us when things are wrong....if we listen....I could feel the change...the enlargements....it was only 2 or 3 inches of swelling...but it made a huge difference....quite frankly I don't know why any doctor would assume the patient cannot possibly know what's wrong with them....especially when we have such an elaborate nervous system to tell us whenever things go seriously wrong..of course many things we cannot know, but when there is swelling and pain it's silly to ignor.
I have a friend that also goes to the same doctor.....the doctor recently told her that 90% of her patients "our age" are alcoholics or drug seekers.
That attitude, that most all her patients were seeking drugs might explain why she was so dismissive of me. She might have thought I was sekking drugs and making up pains to try to get stuff like others.
What is weird though is just the opposite was true...I was the one patient who kept asking for weaker and less meds....even turning down morphine when she suggested it for my spinal cord injury....so it really makes no sense that she would assume what she did.
I think what happened is, 14 years earlier, when my mother-in-law and I had first started going to her, my MinLAw ended up with GB symptoms...she went to our doc 5 times complaining of the same symptoms...and then asked me to go with her...I researched her symptoms...and she had 6 out of 8 classic GB symptoms, so I went with her and said...you really need to check her gall bladder...she's got, this this this and this symptom. So she did..and I was right....and so when I went to her about MY gall bladder...I made the mistake of reminding her that Grandma had GB disease, and she had missed it until I pointed out all her symptoms...
I think it ticked her off...I was only trying to say..look...remember there was that time when it was a familiy members GB and you missed it, so it's not like you might not be missing something here....but she didn't take it as a let's put our heads together here moment...she became defensive..
the problem is, being docile would not get me better care...its hard to know how to approach these folks, as like it or not most don't like being wrong or told how to do their jobs...yet if they aren't doing them then they still go home at night..and the patient may go to the morgue.
mb
Evidently there was a lot of the contractions and tearing loose from the liver wall that I was not feeling however...the liklihood in when leaking occured is when the fevers and pain was the worse...but the liver has no nerves...so this gall bladder can go through so real contortions without folks feeling it much...
I did go to the doctor about 8 times during that period...she order a ultrasound the first time...but when it showed nothing she dug her heels in.
I went back time and again, saying there is something SERIOUSLY wrong....I think it's my gall bladder,,but if not it;''s my liver and spleen because everything now feels very swollen. And again I went in saying it hurts to move...my ribs feel like someone has taken a baseball bat to them.
She called me up after those 4 visits pleading with her to test me more and chewed me out...saying there's NOTHING wrong with your liver of gallbladder!! "I still have a recording of her dismissive lecture".
It was only after months of going back again and again and again, like a bad penny that she referred me finally to a GI guy...who found nothing wrong with me at first...confirming in her mind that I was nuts and she was vndicated.
But when discussing her lack of care I mentioned that she had been telling me for 10 years my liver enzmes were high but it was no big deal. I told her I did not drink, but she said, well lots of other things could do it...a bug, many things...
then he decided to check my blood a viola..I had HCV....cat scan confirmed enlarged liver and spleen...explaining the pressure and pain, but the lower quadrant he wasn't sure of...after endoscope he sent me back to her saying she really should have allowed me the hidascan...
so finally I had to go BACK to my GP (as he did not want to "get in the middle of her treament"..).and by this time I was pretty adamant...give me the test already!!
So yes, I had advanced GB disease, AND an enlarged liver, and an enlarged spleen...and those liver enzymes she'd ignored for 10 years...well that was Stage 3/4 HCV....so I was right on all three counts...all 3 organs were diseased.
as to why it took me so long...I don't know Guy...I can only say I was so sick at the time all I wanted was to lay in bed....also I was tired of fighting with her...
it seemed like every darn thing wrong with me I had been forced to do the research and figure out what was going wrong....and that's what we pay and expect the doctors to do FOR us when we are sick!!
All I can say, is I've seen dismissiveness at it's worst....and I remember sitting on the couch one night, and praying to God....and hearing a really strong voice in my head saying "YOU are going to have to figure this out for yourself, sick or not, because if you don't get serious about this now you will be dead soon...and nobody else is going to think this through or solve this for you." The patient should not have to play "House" when they are half dead...but that's whaere it was at.
thinking back....my first big health issue had been exaustion and fevers..for years...
I now know this was both the HCV and the Pituitary, but at the time, I only suspected the pituitary because every symptom fit, and I had the symptoms primarily after the accident....earlier symptoms she had attributed to menopause...
however anterior pituitary dysfunction fit ALL my symptoms, including a tremendous sleep disorder and severe exaustion..
so I had asked for a test.
that all happened right before my GB went south...
ergo
it had been a HUGE issue when I had brought her the info concerning pituitary disease
She was angry that I went over her head and went to the University to get my pituitary checked when she refused..... INSISTING I could not have this....and she was pretty embarrassed when 3 pituitary doctors and 12 tests confirmed I did have it.
So it was on the heels of all this that my GB got so angry...and she was just not listening to me...
the funny thing is, our bodies tell us when things are wrong....if we listen....I could feel the change...the enlargements....it was only 2 or 3 inches of swelling...but it made a huge difference....quite frankly I don't know why any doctor would assume the patient cannot possibly know what's wrong with them....especially when we have such an elaborate nervous system to tell us whenever things go seriously wrong..of course many things we cannot know, but when there is swelling and pain it's silly to ignor.
I have a friend that also goes to the same doctor.....the doctor recently told her that 90% of her patients "our age" are alcoholics or drug seekers.
That attitude, that most all her patients were seeking drugs might explain why she was so dismissive of me. She might have thought I was sekking drugs and making up pains to try to get stuff like others.
What is weird though is just the opposite was true...I was the one patient who kept asking for weaker and less meds....even turning down morphine when she suggested it for my spinal cord injury....so it really makes no sense that she would assume what she did.
I think what happened is, 14 years earlier, when my mother-in-law and I had first started going to her, my MinLAw ended up with GB symptoms...she went to our doc 5 times complaining of the same symptoms...and then asked me to go with her...I researched her symptoms...and she had 6 out of 8 classic GB symptoms, so I went with her and said...you really need to check her gall bladder...she's got, this this this and this symptom. So she did..and I was right....and so when I went to her about MY gall bladder...I made the mistake of reminding her that Grandma had GB disease, and she had missed it until I pointed out all her symptoms...
I think it ticked her off...I was only trying to say..look...remember there was that time when it was a familiy members GB and you missed it, so it's not like you might not be missing something here....but she didn't take it as a let's put our heads together here moment...she became defensive..
the problem is, being docile would not get me better care...its hard to know how to approach these folks, as like it or not most don't like being wrong or told how to do their jobs...yet if they aren't doing them then they still go home at night..and the patient may go to the morgue.
mb
The part I don't get is the 10 months. If you were in such a condition for so long why wait to see a specialist? You apparently knew that your GP wasn't one and going to the ER you'd know that he wasn't one either. I don't see your reason for delay. Acute pain for 10 months running should have at least sent a couple bells off.
I see poor medical care here. I do not see how electronic medical records would have worsened anything. In fact, EMR may make it easier for a patient to procure medical records and make any corrections and notify the physician of those corrections.
I agree that your care was terrible and I would guess that all of us have some horror stories of our own. I think that first and foremost we much choose our doctors very carefully. When looking for a PCP I paid cash for my fist visit because it was an interview and not a typical medical exam. We spoke together for 40 minutes or so and I came away with a very positive impression and he agreed to treat me - a diabetic and transplant recipient. And then I researched the doctor and all of the reports I got were stellar. I have been with him for 7 years and I could not be in better hands. I was not so fortunate with my prior PCP and I do the horror stories to prove it but, then again, I did not interview that doctor nor did I do diligent research.
I really don't know all of the possible ways in which EMR could affect medical care. I have heard and read about the concerns many people have. There is worry that the doctors will have less time for their patients due to the effort required to maintain their records, that older records may not be incorporated into the electronic records, that there will be conflicts among different systems, the cost of EMR will be an undue burden on physicians and the privacy issues inherent in a centralized system. Personally I see EMR as promising because it may make it easier for us to contact our doctors and interact with them. I know it would be easier to email my doctor about matters that don't require a visit - say a medication change request.
I think that poor care is dangerous but I don't feel threatened by EMR. If you have the right doctors you should be fine.
I agree that your care was terrible and I would guess that all of us have some horror stories of our own. I think that first and foremost we much choose our doctors very carefully. When looking for a PCP I paid cash for my fist visit because it was an interview and not a typical medical exam. We spoke together for 40 minutes or so and I came away with a very positive impression and he agreed to treat me - a diabetic and transplant recipient. And then I researched the doctor and all of the reports I got were stellar. I have been with him for 7 years and I could not be in better hands. I was not so fortunate with my prior PCP and I do the horror stories to prove it but, then again, I did not interview that doctor nor did I do diligent research.
I really don't know all of the possible ways in which EMR could affect medical care. I have heard and read about the concerns many people have. There is worry that the doctors will have less time for their patients due to the effort required to maintain their records, that older records may not be incorporated into the electronic records, that there will be conflicts among different systems, the cost of EMR will be an undue burden on physicians and the privacy issues inherent in a centralized system. Personally I see EMR as promising because it may make it easier for us to contact our doctors and interact with them. I know it would be easier to email my doctor about matters that don't require a visit - say a medication change request.
I think that poor care is dangerous but I don't feel threatened by EMR. If you have the right doctors you should be fine.
My new doc uses a laptop and can send my scripts to the pharm and my bloodwork results to my fax machine. There are also some docs using a system where you can look up your test results online. A friends doc uses this system but mine has decided not to due to all the puter hacking going on. This interests me also.
Denise
Denise
continue as long as you want. I find this very important to everyone. thanks for bringing it to our attention.
just to clarify, is there where the doctor puts everything into a PDA while at the visit? he can send prescriptions right to your pharmacy from it, look up symptoms, etc? My doctor don't do this but i have heard of it. most of the young docs are using it. I don't like the idea of my doctor being forced to get it. I kind of like the old school approach.
What's next the exam done by a robot :-)
just to clarify, is there where the doctor puts everything into a PDA while at the visit? he can send prescriptions right to your pharmacy from it, look up symptoms, etc? My doctor don't do this but i have heard of it. most of the young docs are using it. I don't like the idea of my doctor being forced to get it. I kind of like the old school approach.
What's next the exam done by a robot :-)
A month later, with fever chills and acute pain for the 10th month running....my condition was finally properly diagnosed, I had to point out "my husband is here for legal reasons...and then and only then was the correct test aquiesed to...only 15% function was the result...the thing was squezzing like crazy but could not empty itself....when removed the surgeon said it had been "tearing loose and reahering to the bottom of the liver hundreds of times and was a mass of scar tissue"....the gland was "shaped like a corkscrew not a pear", he said...and the surgeon who removed the gall bladder said also that the peritonitis caused by the leaking GB was the source of the great pain and stress and fever I was having.
We both knew, in this instance I could have died from all this boiler plate incompetance and over inflated egos.
Would someone with fever and sepsis present in pain and with anxiety? Peritonitis is the most painful of bowel conditions and often leads to death, so yes is the answer to both those questions.
Yet had I not gotten my records...I would not know that my GP just thought "I read too much on the internet" and ergo didn't need the test (in other words she thought it was in my head)....
nor would I know that in ER they had labeled me as anorexic which I am not nor have I ever been.
I also discovered that my GP had listed me as pre-diebetic 5 years prior, but she never told me of this condition.
Yet these type occurances are going to become more and more commonplace, no one really taking the time to listen or do the old fashioned hands on the patient diagnosis....one doctor never even palpated my abdomen!!
My assumption was, treat them as sentient being and they will return the favor...I could not have been more wrong.
It's very important people to supervise your own doctors if you want to be sure and get the best care.
I take my case file with me now, and ask them about things they have written or said.
Fully half the time I get a blank stare...or an "I said that?" back !!! NO LIE. MY GP even forgot I was a thyroid patient...after treating me for 20 years for it....
BTW several news services ran the EMR story, one saying Obama's plan proposed a $44,000.oo dollar fee for doctors refusing to go to the canned notes, another said they may not be allowed to even participate in whatever new system is put in place...both of these punitive measure would merit legal challenge but will that happen is the question...it will take some group of physicians serious about patient care to protect us and their own civil rights. Take the humanity out of the practice of medicine and it is humanity that will suffer.
It's no wonder some docs are unfamilar with a case who have worked on us for years...they spend 10 minutes, followed by 5 minutes of pulling up tagged words and writting your scripts...yet efficiency does not spell efficacy in treatment.
The problem is: Many people trust their doctors and do not think them capable of error.
My experience has taught me to trust but verify. Doctors are also human, have way too many patients to remember everyone well...and sometimes have their own memory issues, not to mention not all are equally intelligent or well trained.
Experience also teaches that some professions have a preponderance of big egos amongst their ranks. Doctors are right up there is this arena as any nurse worth her salt will be only too happy to tell you...this, only exaserbated by patients blithly going along with all treatments or lack thereof in what many label "the God syndrome",,,,"they know so much they must be always right"....in this case...it spells disaster for patients to take that attitude...better to question than to assume...better to query which may just jog the doc into thinking of something they overlooked...which may take 5 more minutes but could spare us untold sufferings.
The trouble with patients is we have become all too patient and complacent...to our own undoing.
Doctor also suffer from being threatened by informed patients, not all do this, but some indeed do. They are not used to proactive patients supervising or participating fully in their own care or treatment. They also feel themselves to be so vastly superior in their knowledge and training that they could not possibly entertain the idea that a patient may be right in knowing their own body, while they in their diagnosis might, just might be wrong. This type informed debate is all too often akin to questioning the Pope, in my experience.
This may be the only down side to requesting all your records...however, in this case, what you don't know could kill you...so IMHO it is worth the risk of ruffled feathers to take those risks. If that means you end up with a different doc, who finds your curiosity and willingness to study refreshing instead of threatening...than so much the better. If not, at least you watching them may keep them fully on their toes for once that day.
Yet either way, stay informed, it's your body, and you only get one of them.
mb
We both knew, in this instance I could have died from all this boiler plate incompetance and over inflated egos.
Would someone with fever and sepsis present in pain and with anxiety? Peritonitis is the most painful of bowel conditions and often leads to death, so yes is the answer to both those questions.
Yet had I not gotten my records...I would not know that my GP just thought "I read too much on the internet" and ergo didn't need the test (in other words she thought it was in my head)....
nor would I know that in ER they had labeled me as anorexic which I am not nor have I ever been.
I also discovered that my GP had listed me as pre-diebetic 5 years prior, but she never told me of this condition.
Yet these type occurances are going to become more and more commonplace, no one really taking the time to listen or do the old fashioned hands on the patient diagnosis....one doctor never even palpated my abdomen!!
My assumption was, treat them as sentient being and they will return the favor...I could not have been more wrong.
It's very important people to supervise your own doctors if you want to be sure and get the best care.
I take my case file with me now, and ask them about things they have written or said.
Fully half the time I get a blank stare...or an "I said that?" back !!! NO LIE. MY GP even forgot I was a thyroid patient...after treating me for 20 years for it....
BTW several news services ran the EMR story, one saying Obama's plan proposed a $44,000.oo dollar fee for doctors refusing to go to the canned notes, another said they may not be allowed to even participate in whatever new system is put in place...both of these punitive measure would merit legal challenge but will that happen is the question...it will take some group of physicians serious about patient care to protect us and their own civil rights. Take the humanity out of the practice of medicine and it is humanity that will suffer.
It's no wonder some docs are unfamilar with a case who have worked on us for years...they spend 10 minutes, followed by 5 minutes of pulling up tagged words and writting your scripts...yet efficiency does not spell efficacy in treatment.
The problem is: Many people trust their doctors and do not think them capable of error.
My experience has taught me to trust but verify. Doctors are also human, have way too many patients to remember everyone well...and sometimes have their own memory issues, not to mention not all are equally intelligent or well trained.
Experience also teaches that some professions have a preponderance of big egos amongst their ranks. Doctors are right up there is this arena as any nurse worth her salt will be only too happy to tell you...this, only exaserbated by patients blithly going along with all treatments or lack thereof in what many label "the God syndrome",,,,"they know so much they must be always right"....in this case...it spells disaster for patients to take that attitude...better to question than to assume...better to query which may just jog the doc into thinking of something they overlooked...which may take 5 more minutes but could spare us untold sufferings.
The trouble with patients is we have become all too patient and complacent...to our own undoing.
Doctor also suffer from being threatened by informed patients, not all do this, but some indeed do. They are not used to proactive patients supervising or participating fully in their own care or treatment. They also feel themselves to be so vastly superior in their knowledge and training that they could not possibly entertain the idea that a patient may be right in knowing their own body, while they in their diagnosis might, just might be wrong. This type informed debate is all too often akin to questioning the Pope, in my experience.
This may be the only down side to requesting all your records...however, in this case, what you don't know could kill you...so IMHO it is worth the risk of ruffled feathers to take those risks. If that means you end up with a different doc, who finds your curiosity and willingness to study refreshing instead of threatening...than so much the better. If not, at least you watching them may keep them fully on their toes for once that day.
Yet either way, stay informed, it's your body, and you only get one of them.
mb
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