Reading your doctor's notes may make you a better patient
October 2, 2012By Carolyn Beeler
Reading the notes your doctor takes during visits may make you feel more in control of your health care, and help you stick to your medications.
That is according to a study published Tuesday in the Annals of Internal Medicine. It documented a yearlong pilot program that had doctors at medical centers in western Pennsylvania, Boston and Washington email patients after visits with links to the notes they took during appointments. After the program, about two-thirds of patients in the yearlong study reported they adhered to their medication schedules better than they used to.
After a year of seeing their health issues spelled out in black and white, most patients said they felt more in control of their care, says Jan Walker, a researcher at Beth Israel Deaconess Medical Center in Boston and co-author of the study.
"We have several stories of patients along the lines of, 'I went to my doctor and I came home, I read my note, and she called me obese,'" Walker said. " 'I suddenly understand, this is really serious. Believe it or not, I joined Weight Watchers, I want to turn this around.'"
A spokeswoman from Geisinger Health System in western Pennsylvania said, based on the results of their pilot participation, officials plan to expand the program to many of their specialty-care doctors.
But, some warn, there may be unintended negative consequences to encouraging this kind of access.
Patient notes are important in doctor-to-doctor communications, agrees Dr. Caroline Goldzweig of the Los Angeles Veterans Administration. But she worries providers might change the way they document cases if they know patients are going to see their notes.
"For instance, if you thought maybe that there was a mental health explanation for why a patient had certain symptoms," Goldzweig said. "While you might want other providers to know that you had that thought, it might not be something you wanted the patient to think that you were thinking."
Goldzweig, who wrote an editorial accompanying the study, argues more study is necessary to see if changes in how doctors write up their notes have any clinical implications.
Still, Goldzweig sees access to routine online records as an inevitable, and positive, way of better informing patients. Patients can already ask to see their records, either in hard copy or, for the minority of doctors and hospitals that have digital health records, electronically. Still, few ever do without the kind of prodding in this pilot.