Open Notes: "Our" Chart

My recent posts set the stage for asking: Does the opportunity for patients to read their medical charts help or hurt patients' ability to become Healthy Survivors?

For the reasons listed in my August 14th post, open notes can facilitate Healthy Survivorship for some patients.

Unfortunately, other patients may learn something about their condition that makes it more difficult to get good care or live as fully as possible. Or they may experience feelings that threaten the physician-patient bond. Patients take a risk when reading notes intended for a medical audience.  

Wait! If open notes become the norm, physicians will adapt their notes to accommodate the possibility their patients will read what is in the chart.

We've seen this happen before. After insurance representatives and malpractice lawyers began using physicians' chart notes, clinicians notes began including information intended for insurance representatives and malpractice lawyers. For example, "Discussed with patient the risks and benefits of each treatment option."

Similarly, as open notes become standard, clinicians will change their style of recording their findings, prognosis, conclusions and plans. Willingly or reluctantly, clinicians will change the possessive adjective from "my" to "our" when talking about a patient's medical chart. 

Are charts intended for both clinicians and patients helpful or harmful to Healthy Survivors? To answer, in my next post I'll address the role of transparency in Healthy Survivorship.

Comments

[Jeanne M. Hannah]

This is a very informative series of articles. Would it be helpful for a patient to take a patient advocate along when looking at open notes? Jeanne M. Hannah

[Wendy S. Harpham, M.D.]

Dear Jeanne,
Yours is a good question that foreshadows a forthcoming post on how Healthy Survivors use open notes to get good care and live as fully as possible.

The short answer is "Yes," but stay tuned because I will be getting into this in more detail in upcoming posts.
With hope, Wendy