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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Steven Mussey MD

Steven Mussey, M.D. is a physician in Internal Medicine, practicing in the Fredericksburg area for more than twenty years. He grew up in Springfield, Virginia and earned a degree in Physics from The University of Virginia, Phi Beta Kappa. He earned his medical degree at The George Washington University and was inducted into the medical honor society AOA. He is Board Certified in Internal Medicine. He served in the Air Force for four years before entering into private practice. He particularly enjoys geriatric medical care and working with complex patients. For almost a quarter century, he has been practicing with one other Internist. Both doctors enjoy practice in a small, but busy office, and plan on working into their 70s, as long as they can still find their way to the office. Dr. Mussey is also an avid cartoonist and has a weekly cartoon in the local newspaper. He also enjoys cartoon animation and has had several public service cartoons playing regularly on the television cable systems. 

  5 comments for “The Problems with Giving the Elderly Raw Data

  1. Scribe/Former PT
    June 12, 2019 at 3:26 pm

    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.

  2. Mary Lang Carney, MD
    June 11, 2019 at 3:11 pm

    Personally I think that all patients panic (even younger patients)when they get their results without an explanation if something is wrong.

  3. Gabi
    June 11, 2019 at 12:47 pm

    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.

    • Sir Lance-a-lot
      June 11, 2019 at 1:33 pm

      “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?

      • Steve O'
        June 11, 2019 at 2:07 pm

        I agree and would write more but my iPhone 3 is getting low again.

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