3Qs: Patients' access to doctors' notes examined

November 20, 2012 by Lauren Dibble
Law professor Michael Meltsner discusses the impact of a recent study that sought to determine the effect of allowing patients to review their doctors’ notes after a visit.

In a pilot study called Open­Notes, more than 100 primary-​​care physi­cians vol­un­teered to invite more than 20,000 patients to review their doc­tors' notes fol­lowing an office visit to deter­mine the effects of facil­i­tating that access. The results of the study, pub­lished in the Annals of Internal Med­i­cine in October, found that a majority of patients felt more in con­trol of their care, adhered to med­ica­tion pre­scrip­tions and wanted the program to continue.

We asked Michael Melt­sner, the George J. and Kath­leen Waters Matthews Dis­tin­guished Uni­ver­sity Pro­fessor in Northeastern's School of Law, who par­tic­i­pated in the study and wrote an accom­pa­nying edi­to­rial, to dis­cuss the study and issues of trans­parency around patients' med­ical records.

What information are patients legally entitled to? How easily accessible is this information?

Patients are legally enti­tled to their records but access to them is dif­fi­cult. Obsta­cles are put in their way by health­care per­sonnel, many of whom aren't used to sharing the records or knowing just where they can be located. All too often, patients give up the quest in frus­tra­tion. But there is now a growing national movement for doc­tors to open their notes to patients. Recent research con­cludes that fears patients will be con­fused by what they are told or that doc­tors will have to waste valu­able time writing and dis­cussing their notes are overblown.

Why are some doctors and medical professionals viewed as being resistant to full transparency? Does transparency put them at any legal risk?

I think it's less fear of lia­bility than a sense that patients won't know what to do with the infor­ma­tion that doc­tors often feel they are writing for other doc­tors, rather than the patient. There may also be anx­iety that the physi­cian will lose some con­trol and be sub­ject to nag­ging ques­tions about the treat­ment and the patient's med­ical his­tory. But patients over­whelm­ingly want to see these records when they are given the chance and once health­care providers realize this, arrange­ments that facil­i­tate sharing infor­ma­tion are inevitable.

How does full transparency and access to medical information benefit patients? Does the healthcare system as a whole benefit?

I tried to sum­ma­rize the com­pli­cated answers to these ques­tions in my October edi­to­rial in the Annals of Internal Med­i­cine, but my sum­mary response is that infor­ma­tion is usu­ally valu­able, espe­cially if you believe that indi­vid­uals have to play a role in their own devel­op­ment, care and treat­ment. , for example, often suffer selec­tive amnesia after dis­cussing serious issues at an office visit. Having a copy of the doctor's notes allows a ready check of what was said and rec­om­mended as well an oppor­tu­nity to con­sult over the details with family and friends.

Explore further: Tracking America's physical activity, via smartphone

More information: annals.org/article.aspx?articleid=1363511

Related Stories

3Qs: When painkillers kill

August 3, 2012

The U.S. Food and Drug Admin­is­tra­tion recently intro­duced a series of safety mea­sures designed to reduce the risk of extended-​​release and long-​​acting opioid med­ica­tions, ...

3Qs: Many questions remain in meningitis outbreak

October 18, 2012

In recent weeks, an out­break of fungal menin­gitis has infected more than 200 people and killed 15. The infec­tion was traced back to a steroidal injec­tion pre­pared at a com­pounding phar­macy based in Fram­ingham, ...

Recommended for you

Mobile app records our erratic eating habits

September 24, 2015

Breakfast, lunch, and dinner? For too many of us, the three meals of the day go more like: office meeting pastry, mid-afternoon energy drink, and midnight pizza. In Cell Metabolism on September 24, Salk Institute scientists ...


Please sign in to add a comment. Registration is free, and takes less than a minute. Read more

Click here to reset your password.
Sign in to get notified via email when new comments are made.