Access to medical records seems like a perfectly fine idea.  After all they are your records.  I have always been a supporter of that contention.  Problems occur, however, under conditions when medical records are released to patients without explanation.

Patients have had access to their lab work for years. Abnormalities that are noted by these print outs may have no real clinical meaning and yet will induce immediate and unnecessary distress.

 Now patients have access to radiology reports with detailed discussions of findings.  Many of these are “incidental” meaning they have no clinical significance.  But does the patient know that?  No and they should not be expected to know.

What then occurs in the real world is a frantic attempt to read, comprehend and analyze medical terminology by the lay public who do not possess medical knowledge and experience. The inevitable results–internet searches, panic, despair and immediate calls to doctor’s office to make sense of it all. Patients want immediate phone discussions or internet responses.  That sounds just great.  The problem is that communication which is not in person is much more difficult and often leads to more confusion.

 I would prefer to discuss medical records/ radiology documents, pathology reports, endoscopy papers, lab data etc. etc. face to face in front of my patients.  Then I could immediately put their concerns to rest, or offer explanations, or suggest subsequent testing or referrals.

So hurrah for full disclosure. Let’s bring some practical sanity back to the situation.   Now I understand the impracticality of ALL discussions in person.  When a quick call can dispel immediate fear, I all in favor of it.  But when then there is further confusion or significant complexity, the examination room, not the phone or internet is the best place to do so.

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