When Doctors and Patients Share Notes

Thursday, May 29, 2014

Lena Sun, health reporter at The Washington Post, discusses her story on a pilot program at a Boston hospital that allows mental health patients to read the notes their doctors are writing during therapy sessions. The program grew out of a national push for more access to health records for patients, but some patients and doctors worry that care will suffer.



Lena Sun

Comments [11]

Meredith from nyc

the computer is coming betw patient and doctor. Divided attention is the result. The main thing is accurate notes put into computer. The doctor has to think how to word the entries properly, so as not to spend time editing later, and this removes attention and eye contact from patient.
Hand written notes would not remove attention as much. The doctor is looking into the screen.
Maybe the whole visit will someday be by computer screens with occasional personal visits. Much of our lives is now spent looking at screens, at work and at home, and now with mobiles, as we walk in the streets, sit on park benches, take public trans, and some while driving. Not good.

May. 29 2014 08:25 PM
Glenn Dewar from Astoria, Queens

I found it very frustrating that during your discussion on sharing doctors notes with patients, Brian very casually lumped in going to see a therapist because you don't get along with your brother-in-law with Schizophenia.

These are two completely different areas of mental health.

One is the "Woody Allen neurosis" style therapy, in which white people of means pay to see a therapist to work out moral dilemmas, which is often a bad idea, because therapists make for awful ethicists.

The other, is the treatment of people with a truly compromised reality, where they may have auditory hallucinations, or believe that harmless neighbors are trying to kill them, or that there are insects living in their skin.

People with serious mental illness often need medication to keep them out of prison or the morgue. The sad truth is that medication itself really doesn't work alone, and should be accompanied by real therapy - and all to often, all they get are the pills.

Please Brian, in the future, do not mash these up into the same category.

It is like comparing a person that has a small cut needing a band aid, with a person that needs repeated spinal surgery that will never truly cure their disability.

May. 29 2014 11:57 AM
Susan Averello

My daughter has mental health issues - it's not the psychiatrist notes she would like but the therapist's. Personally she is afraid to to a therapist anything because she thinks the therapist will think she is weird, nuts or stupid.
Seeing what the therapist is actually thinking or writing would probably be a big help - she is too shy to ask questions and maybe by seeing the notices, they actually would have a starting point for more topics.

May. 29 2014 11:30 AM

I saw a urologist on referral who wrote a report back to the referring physician. I asked for a copy of the letter and the reporting doctor was very reluctant to give me a copy and I soon learned why. The tone of his prose while clinical was unpleasant and showed a somewhat adversarial stance, questions I answered about myself where characterized as "patient claims" and patient denies" and so forth. The letter ended with "please let me know if I can help manage any other patient"—to me it just exposed the mercenary, uncaring aspect of the physician -patient relationship.

May. 29 2014 11:20 AM
ellen diamond from Manhattan

credit should be given to Boston doctor Tom Delbanco, who spearheaded this movement.

Good for patients - when doctors speak with you you often don't hear what he's saying.

Doctors may not like it because bad diagnoses on record.

Psychopharmacologists see pts for a vey short time and often shockingly get basic facts wrong.

May. 29 2014 11:13 AM
Paula Beckenstein from Chappaqua

As a therapist is private practice I have no objection to patient's viewing the notes after a session. It minimizes anxiety that a patient may feel about what I'm writing or thinking.I actually write only new information or impressions and it is therapeutic for each person to read.I keep a lot of thoughts to myself which i may or may not write down at a later time. Any issues about the notes can be discussed.

May. 29 2014 11:11 AM
ellen diamond from Manhattan

1) Credit should be given to the Boston doctor who spearheaded this movement, Dr. Tom Delbanco.

2) Doctors may not want to go on record with temporary diagnoses, which may be found to be very wrong.

3) When you talk with your doctor after the exam, you often don't really hear what he's saying. Having access to notes is a counter for this as well as correcting inaccuracies.

4) Re mental health, it's sometimes shocking how psychopharmacologists who only see patients briefly how wrong they get basic information and forward it on to insurance companies!

May. 29 2014 11:10 AM

Someone needs to remind Brian that psychiatrists are doctors.

May. 29 2014 11:09 AM
Amy from Brooklyn

Horrible idea, destroying privacy of thought for the doctor.
I would never read my shrink's notes OR a friend's diary.

May. 29 2014 11:03 AM

Having Doctors type rapidly to enter digital records while in the midst of patient appointments has greatly decreased real MD attention, eye contact and patient satisfaction in many Dr/patient encounters. Back in the 'bad ol days' MDs actually looked at their patients during office visits. Now MDs look at their screens. As a patient, I feel that my doctor has no time to listen, no time to give attentive eye contact and that does not foster patient confidence.

May. 29 2014 10:01 AM

And thus was uncovered a trove of brilliant submissions to the New Yorker's Caption Contests...

May. 28 2014 10:07 AM

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