"Do me a favor and take me a quick look at this," I asked my co-resident. "This is a positive finding on the echo, right? He should have totally been medicated, there should have been follow-up..."
"Sure, yeah. Definitely."
"Except now it's two years later, the patient is back, complaining of chest pain... and I look at the notes... he was told two years ago that he was fine, the echo came back negative. So there was no treatment, no follow-up."
"What?"
"I don't know if the doctor was looking at the wrong chart..."
"And you're sure the echo lines up..."
"Either the echo was labeled wrong, and so it's someone else's report I'm looking at, or whoever saw him two years ago looked at the wrong report and told him he was fine when he wasn't."
"Either way... there's a patient in there now who has chest pain and probably had a positive echo two years ago and nothing's been treated."
"Yep."
"That's not good."
"Nope."
This post is brought to you by the Association to Please Ask For A Copy Of Your Test Results, and the Committee to Double-Check Your Doctor.
Sunday, June 26, 2011
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I've asked for copies of my test reports and the doctor I went to refused to release them. I changed doctors, but was never able to get those reports.
ReplyDeleteYeah, my wife got an ultrasound for something not long ago, and it was only because I was sitting there watching that I noticed the tech saved it under somebody else's file name. There's definitely something to be said for paying attention to this stuff.
ReplyDeleteThis is a big hurdle for patients because there is no transparency built into the system. Patients have to beg, pester and pay to see their records, often a month or longer after the test was done. God help you if it's an acute issue where the time lapse is damaging.
ReplyDeleteWhen I had surgery for appendicitis that wasn't appendicitis and requested my medical records because no doctor ever spoke to me after the surgery to tell me what the hell had happened, they wouldn't give them to me for fear of lawsuit. I literally had to beg the office manager and swear I wasn't going to sue them to get my medical records so I could find out why I'd been in the hospital for 3 days on IV antibiotics (antibiotic resistant kidney infection that looked exactly like appendicitis).
Since medical care can't seem to police this on their own, I would like to see a law requiring health care to provide copies of all tests and reports at the time of visit.
How can I take responsibility for my body if the medical system treats my physiology like a state secret?
M
Do you have the legal responsibility to tell the patient the mistake happened 2 years ago?
ReplyDeleteThat is a good question, Anon at 8:03. Ethically yes, but legally? I am not sure.
ReplyDeleteIf the patient had the sophistication to interpret their records, that would probably be a huge liability for the clinic. I imagine the case was forwarded up the food chain at least?
M
yeah,,,CIA knows Gayle Manchin and Cho are the legs...El Salvador.
ReplyDeleteAnd Raphael and Cher " do".
A couple things ... Health care providers use HIPAA as an excuse to do a lot of annoying things, like not let you know if your mom is out of surgery. On the other hand, HIPAA states a patient has a right to a copy of their medical records. How can they be so concerned about HIPAA violations that would never be reported/enforced, but blatantly ignore others? So frustrating ... but then invoking the term "HIPAA" can be quite powerful in getting providers to act in seeing/sending records.
ReplyDeleteSecond, the mistake above is not actionable unless the patient can prove harm. Unless they can prove their condition is worse than it would otherwise be due to this delay, they would not have a case. That might help the powers that be decide whether to reveal the mistake. Obviously, ethically, there is no question they should be told.
@Anon 11:48 - That happened to me ONE time. I requested records, but didn't get them. My new doctor requested records, but didn't get them. Finally I wrote a short letter politely asking why they were having trouble releasing records that I was legally entitled to. It wasn't a threat, but they took it that way and made the copies pronto.
ReplyDeleteI've also discovered that if I want a copy of MRI/xray for myself, it takes a few weeks and costs money. If the copy is for another doctor, it takes half an hour and is free.
Ha. Warmsocks reminded me. When I switched Fertility clinics, the old one refused to forward my records, just out of competitive spite. The nurse finally called and raised holy heck with them. She told me it wasn't uncommon, but, luckily for her patients, she used to work at the old clinic and knew where to apply pressure.
ReplyDeleteThey dragged their feet on those records for over a month!
M
Unfortunate. Hopefully it's just the secretaries being lazy and not office policy to make it impossible for patients to switch doctors.
ReplyDelete