Stephen Baker

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Your doctor might not want you to see your records

March 25, 2013General

It sounds retrograde at first, more or less what you might expect from the industry that still deals with data on clipboards: Less than one of three doctors, according to a Harris Poll survey, believe that patients should have full access to their own medical records.

There is, however, an explanation for such secrecy. Picture a patient walking into an exam. The doctor takes notes. Among other details, he or she writes (or types): "Obese. Bruises on neck and shoulders. Abuse issues?" These are important notes for the doctor. Some are only notes to self and are not edited for the public. Is it any surprise that doctors aren't eager to share such data?

This is one of the problems of so-called transparency. Some notes are private, and if they must become public, doctors will have to censure themselves--or find another channel for their most personal observations.

This would not be a problem if we, as a society, weren't so hypersentive to "hurtful" words, and eager to sue in cases of errors. Our tender feelings interfere with communication at almost every level. In an age of open data, a doctor might refrain from writing "obese" and simply write "weight issues" or "heavyset." In such a case, the patient would be less likely to be offended, perhaps at the price of not learning an important truth.

If we want the data, we should be ready to see and accept it, even when offensive. This openness would pay off richly. For example, we'd be much more likely to spot mistakes in our records, and clear them up. This would eliminate loads of medical errors and misdiagnoses.



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