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Can deciphering your doctor’s notes improve care?
By federal law, you can get a copy of everything in your medical chart, visit notes included, by filing a formal request, but it can be difficult. Clinics may take two or three weeks to respond, and Delbanco says copying fees can run as high as 75 cents a page. Seattle’s Elmore last week saw a woman who’d succeeded in getting records from just one of four care sites; her office intervened to help get the rest.
Given the hurdles, patients rarely seek copies of their medical records unless they’re facing a big illness, says Stephen Downs of the Robert Wood Johnson Foundation, which is funding the $1.4 million OpenNotes study.
With growing use of electronic records making easier access possible, the question becomes whether doctors will write easier-to-understand notes to help engage patients in their care, he says.
“The way I view my relationship with the doctor is, I’m the CEO of me and he works for me,” says Ed Leonard, an engineer in Acton, Mass. He’d never seen a doctor’s note until a recent visit to Delbanco, but he welcomed the change.
Another patient stopped an error by telling a doctor that her note didn’t mention the tests she’d promised to order, Walker says.
And in New Hampshire, where the Dartmouth-Hitchcock Medical Center provides routine electronic access to doctor’s notes, Dr. Mary Merkel inadvertently shamed a diabetic into better health. Three months after she wrote that he was “noncompliant,” he returned 30 pounds lighter, saying he’d felt bad at her disappointment in him.
“I don’t want to hurt my patients’ feelings,” says Merkel, admitting she’d had a hard time telling the man how badly he was doing. “Who knew this could be such a powerful tool?”
EDITOR’S NOTE _ Lauran Neergaard covers health and medical issues for The Associated Press in Washington.
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