Bismillah, alhamdulillah: Are you ready to share your notes with your patients? Your paternalistic side will probably shrink from the idea. You may start to imagine horrific consequences but the world seems to be in the let’s move forward gear. This article in Medscape presents the idea and gives helpful tips to all those who wish to engage in this approach. The idea to me sounds like one of those really good ideas but I do worry about the way this increasing oversight is going to affect the way doctors will start to behave and how it will affect the privacy of the consultation. 

Medicine was an altruistic profession where helping others was an important motivational factor in choice of career. The trend of patients becoming clients, health institutions becoming health industries mark the increasing influence of a profit metric on every aspect of care. 

While there is nothing wrong with business and profit motivation,  like all good things balance is the key. Sharing notes can be great but is it motivated more by better patient outcomes or by the Health Information Industry and the great potential – and cost – of designing systems that allow patients to read their notes and gain access to many “add ons”.

Possibilities include:

  • Automated note review by Oogle analytics or 
  • A medical record check by Real Doctors from St Elsewhere who will offer many helpful suggestions for the next consultation.
  • Will patients be required to co-sign their own notes, to confirm they actually said what they said?
  • League table of misspelled words.

While the speculative list can be endless and some may seem a bit far fethced the advantages and pitfalls clearly exist. What is needed is  a common sense rather than a ‘can do’ approach.We also need to learn from our colleagues who are used to patient held records such as obstetricians, radiologists and pathologists.

The above three fields have a limited scope or well structured layout to their notes and these help the physicians ‘stay on track’ and not get derailed into areas that are likely to prove to be problematic or embarrassing in the future. Writing for the select few is a different art than writing for the many. Medical schools would do well to start training their students on what to and what not to write. 

The article link on Medscape is given below:

http://www.medscape.com/viewarticle/870796?nlid=110445_430&src=WNL_mdplsfeat_161108_mscpedit_fmed&uac=114786DZ&spon=34&impID=1230645&faf=1

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