Monday, December 01, 2014

Why doesn't the UK medical system trust patients with their own medical records ?

I have a patient who lives in the UK who needs to have an HSG done , because she needs a ZIFT treatment at our clinic. She has found a X-ray clinic who is happy to do the HSG for her, but they are refusing to give her the X-ray or the report. They insist that they will FAX the report only to the referring doctor – me . The problem is that we stopped using FAX over 10 years ago , and I can't believe that doctors continue to use such outdated technology – after all, email is far more efficient, and can be just as secure as a FAX !

However , what I find even more perplexing is the fact that the  UK medical system is not willing to trust patients with their own medical records ! This is something which makes no sense to me . She’s paying for the test – and it’s her body, which means her medical records are her property. Why can’t they just give her the HSG and report, so she can do with it as she sees fit ? She can email them to me – or get a second opinion from another doctor ; or share them with her sister-in-law , who happens to be a doctor in the US .

I can't understand this old-fashioned paternalistic attitude, where testing centers and diagnostic clinics insist that reports will only be shared with the referring doctor. I think this is unacceptable in today's day and age , and I still can't understand why progressive countries like the UK are still stuck in the Middle Ages as far as their willingness to share medical information with the patient is concerned .

Are they worried that the patient will misuse this information ? This makes no sense – after all, it’s her information, so how can she misuse it ?

I understand the concern that patients may not be able to make sense of their medical reports, and may get worried or scared needlessly in case it is abnormal. This is why they need a doctor to help them interpret the report intelligently.

However, this does not mean that we should hide information from our patients, or censor it, or limit their access to it. Patients have the right to know what is happening to them , and especially when the patients wants her report and X-rays, I think it's unethical to refuse to give this information to her .

Perhaps one solution would be to get a permission letter from the doctor , which “ authorizes” them to “ release “ the report to the patient , but this is a completely ridiculous approach to take . Patients should be free to see their tests for themselves , and then use this information the way they want to, rather than having to depend exclusively on their doctor for access to their own medical records and reports.

The UK healthcare system waxes eloquently about the need for patient centricity and patient empowerment – and the first step in this direction is to share information with the patient. We need to respect our patients, and say – Yes, we trust you , and if you want your reports, here they are . If you need any additional information , we will be happy to provide it !  The present approach says, Yes, we have your reports , but we don't think you're smart enough to make sense of them, and because we can’t trust that you will be able be to understand them, we will send these reports to your doctor, who will then tell you what to do.

This is the height of condescension , and it seems to be a hangover from the past, when the approach was – The Doctor Knows Best. Isn’t it time we moved on ?

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