The Problems with Giving the Elderly Raw Data
Medicare wants…. demands… you communicate with your geriatric population through a “patient computer portal.”
Sometimes, when elderly patients fret about losing their ability to drive, I mention the marvelous convenience of Uber. Then, they pull out their feature phone with its gigantic numbered buttons and I realize my mistake.
The concept of giving raw medical data without explanation is fraught with problems.
Rarely does a CBC or CMP have 100% normal numbers. Our job as the doctor is to interpret and explain the results.
Patient portals give the raw data to the patient without any explanation.
You know what happens next:
Panic and phone calls of “Why are my monocytes slightly elevated?”
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Personally I like having access to the results, but then I have 20 years’ experience as a physical therapist, 20 years’ as a medical transcriptionist, and a husband who is a retired dentist. I am much more likely to freak out over NOT knowing results before my next appointment than I am if I’m prepared and can ask questions from an informed position. Nothing pisses me off faster than a condescending doc.
I remember in particular one horrible month of pregnancy where one particular test result ended with me referred to the director of OB/GYN and hematology director in a large teaching hospital. The things they tested for ranged from lymphoma to an autoimmune disorder. If I’d had access back then to my records I would have seen that the really scary diseases had been ruled out fairly early. A few weeks later when I hadn’t heard anything I called and they were just waiting on the rheumatoid factor to come back before telling me I was okay. At that point R.A. was the least of my worries.
Personally I think that all patients panic (even younger patients)when they get their results without an explanation if something is wrong.
This is called ageism and paternalism. Young patients don’t call the office because of slightly abnormal results? Patients have the right to their test results directly from the lab, without them going through the doctor first, by law. The purpose of the law is exactly that, to prevent patients from being dependent on a doctor to “explain” the results to them.
“This is called ageism and paternalism.”
Last time I looked at Dr. Mussey’s photo (above), it looks to me like he’s an old guy, and I’d put decent money down to bet he’s a father.
Just sayin’.
And if patients have a legal right to their results straight from the lab, it’s news to me. They didn’t order them, I did, and they don’t get them, I do.
The idea of giving patients direct access to their labs without the intervention and interpretation of a doctor is ludicrous. If it’s true, tough, then from now on, when I want to order labs, I’ll just turn the screen to the patient, and let them select their own. They can pay out of pocket for any the insurance doesn’t deem “reimbursable” After all, the patient knows best, right?
I agree and would write more but my iPhone 3 is getting low again.