PATIENT PORTALS — Unintended Consequences

Everything new brings with its introduction unintended consequences.

Patient advocacy, access to our own medical records, the concept that we need to take ownership of our health care–all resonates as true and laudable.  What happens in the real world, however, is often chaos and unnecessary suffering.

Please allow me to offter real world examples of this notion.  Patients are able to access their radiology reports, blood work, endoscopy and surgical reports with their associated pathology reports even before their attending physicians.  Sounds great?  Not really. What immediately occurs is a frantic Google search for any medical terms which are unfamilar to the patient.  What often follows is sheer panic and misery when uncertainty and confusion ensue.  This is understandable.  Even the most intellectually gifted layman (my patients, of course) do not understand the  clinical significance or relevance of what occurs on a lab, XRay or pathology report.  

Traditionally (in past days) the patient would receive the initial information while in the presence of their doctors.  Immediate discussions would occur. Analysis of the real consequences of a radiology report which might recommend a follow-up procedure based upon some vague and usually benign finding could be quickly and easily placed in perspective. ” Yes, let’s order another study just to confirm that these findings are probably nothing.”  That would often assuage the patient’s fears and avoid unnecessary panic.

The situations is quite different now.  I find myself dealing with borderline hysterical (or nearly) patients who have convinced themselves via the internet that they are absolutely dying from what may be a totally innocuous condition.  

My plea to my patients and to the patients of other physicians is to bring your reports to your doctors and, in persons, review every line of the report itself.  Frankly, most of this interaction cannot adequately be performed over the telephone (sorry about that).  Often the emotional content of the discussion can only be dealt with on a person to person basis.  Often I rely on diagrams to elucidate the results.  That is the way to promote the best in doctor/patient connections and to alleviate unnecessary chaos and distress.

The system is assuredly changing. Let’s all take a deep breath and try to make it work to everyone’s benefit.

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