Skip to content
  • About
  • Contact
  • Contribute
  • Book
  • Careers
  • Podcast
  • Recommended
  • Speaking
  • All
  • Physician
  • Practice
  • Policy
  • Finance
  • Conditions
  • .edu
  • Patient
  • Meds
  • Tech
  • Social
  • Video
    • All
    • Physician
    • Practice
    • Policy
    • Finance
    • Conditions
    • .edu
    • Patient
    • Meds
    • Tech
    • Social
    • Video
    • About
    • Contact
    • Contribute
    • Book
    • Careers
    • Podcast
    • Recommended
    • Speaking

The cure for a poor historian? A good medical record

Eric Beam, MD
Physician
September 4, 2016
Share
Tweet
Share

Think keeping your life organized is hard? Try keeping your doctors organized.

In this era of fragmented health care, patients find themselves in the impossible position of having to coordinate their care themselves — a task that many can’t meet. Having multiple chronic medical conditions often means being subjected to a dizzying assortment of specialists, medical terminology, and tests that can quickly overwhelm patients.

How many times have you found yourself in this situation: You have a patient in front of you who is a “blank slate,” so to speak — no notes in your EMR, no labs, no imaging. The only information you have to go on is what comes out of her mouth (or, in some cases, history that the family offers). If the patient is sick, sometimes you have to take action on this information. You don’t know if it’s accurate, but it’s all you’ve got.

Did a doctor ever tell you you had a heart attack? “No, they said I almost had one.”

Did you ever have stents put in your heart? “I think so.”

What medications do you take for blood pressure? “A blue one and another one that starts with b.”

Any allergies? “I once took an antibiotic, and it made my throat swell up.” Which one? “I forget.”

Many times we label these patients “poor historians,” but in reality, their only mistake is placing too much trust in their doctors. Hospitalization is a stressful and confusing time, and sick patients can’t be expected to ask a lot of questions and keep everything straight. What’s more, we’re not very good at telling patients what’s happening to them in the hospital. And when we do, we tend to explain things to them in simplified terms that may not be sufficient when it falls on them to relay this information to the next provider they see. It might be enough to tell a patient they were admitted for an abnormal heart rhythm, but if I’m seeing them in the clinic I need to know which one.

This kind of system is frustrating and unfair, for patients and providers alike. Patients should not be required to be their own medical record, recalling diagnoses and treatments from decades ago, symptoms that they have long forgotten, and chronologies that have been blurred and distorted through the lens of time.

One solution to this problem is to hire a patient advocate, a growing trend recently highlighted in the New York Times. But these professional health care navigators — some of whom are doctors themselves — are a costly luxury, out of reach for those who would benefit the most from their services.

The real systemic fix for our current piecemeal delivery of health care is the institution of a universal integrated EMR that facilitates record sharing and communication amongst the multiple interdisciplinary members of a patient’s care team. As much as EMRs are maligned these days, this is one area in which they are indispensable. I am already beginning to see improvements in continuity of care. As more New York hospitals adopt Epic, I have been able to review my patients’ histories at the click of a button — a huge upgrade over the archaic process of faxing a medical records request and then waiting days for a response. And being able to review lab tests and imaging from an outside facility saves the hospital the cost of doing a duplicate workup.

It’s hard enough living with multiple ailments without also having to serve as one’s own advocate and care coordinator. The fact that we often find ourselves stuck with incomplete information after taking a history is not the patient’s failing — it is ours. And despite their shortcomings, EMRs with broad intercompatibility are a win for patients. I look forward to the day when fragmented health care is a thing of the past, and the hospital can dump its fax machines once and for all.

Eric Beam is an internal medicine resident who blogs at The Long White Coat.

ADVERTISEMENT

Image credit: Shutterstock.com

Prev

A simple suggestion to doctors: Subscribe to a newspaper

September 3, 2016 Kevin 2
…
Next

NEJM vs. the NYT: Which should medical professionals read?

September 4, 2016 Kevin 8
…

Tagged as: Health IT, Primary Care

Post navigation

< Previous Post
A simple suggestion to doctors: Subscribe to a newspaper
Next Post >
NEJM vs. the NYT: Which should medical professionals read?

ADVERTISEMENT

More by Eric Beam, MD

  • Antibiotic resistance is the climate change of medicine

    Eric Beam, MD
  • Welcome to the world of post-truth medicine

    Eric Beam, MD
  • Endorsing Tom Price: Does the AMA owe us an explanation?

    Eric Beam, MD

Related Posts

  • A universal patient medical record

    Michael R. McGuire
  • Digital advances in the medical aid in dying movement

    Jennifer Lynn
  • How the COVID-19 pandemic highlights the need for social media training in medical education 

    Oscar Chen, Sera Choi, and Clara Seong
  • A medical student’s physician inspiration

    Uju Momah
  • Why this physician teaches first-year medical students 

    Mark Kelley, MD
  • Why a gap year will make this medical student a better physician

    Yoo Jung Kim, MD

More in Physician

  • a desk with keyboard and ipad with the kevinmd logo

    How to advance workforce development through research mentorship and evidence-based management

    Olumuyiwa Bamgbade, MD
  • The truth about perfection and identity in health care

    Ryan Nadelson, MD
  • Civil discourse as a leadership competency: the case for curiosity in medicine

    All Levels Leadership
  • When a medical office sublease turns into a legal nightmare

    Ralph Messo, DO
  • Why the heart of medicine is more than science

    Ryan Nadelson, MD
  • How Ukrainian doctors kept diabetes care alive during the war

    Dr. Daryna Bahriy
  • Most Popular

  • Past Week

    • Forced voicemail and diagnosis codes are endangering patient access to medications

      Arthur Lazarus, MD, MBA | Meds
    • The One Big Beautiful Bill and the fragile heart of rural health care

      Holland Haynie, MD | Policy
    • America’s ER crisis: Why the system is collapsing from within

      Kristen Cline, BSN, RN | Conditions
    • Why timing, not surgery, determines patient survival

      Michael Karch, MD | Conditions
    • How early meetings and after-hours events penalize physician-mothers

      Samira Jeimy, MD, PhD and Menaka Pai, MD | Physician
    • FDA delays could end vital treatment for rare disease patients

      GJ van Londen, MD | Meds
  • Past 6 Months

    • Forced voicemail and diagnosis codes are endangering patient access to medications

      Arthur Lazarus, MD, MBA | Meds
    • How President Biden’s cognitive health shapes political and legal trust

      Muhamad Aly Rifai, MD | Conditions
    • Why are medical students turning away from primary care? [PODCAST]

      The Podcast by KevinMD | Podcast
    • The One Big Beautiful Bill and the fragile heart of rural health care

      Holland Haynie, MD | Policy
    • Why “do no harm” might be harming modern medicine

      Sabooh S. Mubbashar, MD | Physician
    • Here’s what providers really need in a modern EHR

      Laura Kohlhagen, MD, MBA | Tech
  • Recent Posts

    • Addressing menstrual health inequities in adolescents

      Callia Georgoulis | Conditions
    • How to advance workforce development through research mentorship and evidence-based management

      Olumuyiwa Bamgbade, MD | Physician
    • The truth about perfection and identity in health care

      Ryan Nadelson, MD | Physician
    • Civil discourse as a leadership competency: the case for curiosity in medicine

      All Levels Leadership | Physician
    • Healing beyond the surface: Why proper chronic wound care matters

      Alvin May, MD | Conditions
    • Why specialist pain clinics and addiction treatment services require strong primary care

      Olumuyiwa Bamgbade, MD | Conditions

Subscribe to KevinMD and never miss a story!

Get free updates delivered free to your inbox.


Find jobs at
Careers by KevinMD.com

Search thousands of physician, PA, NP, and CRNA jobs now.

Learn more

View 6 Comments >

Founded in 2004 by Kevin Pho, MD, KevinMD.com is the web’s leading platform where physicians, advanced practitioners, nurses, medical students, and patients share their insight and tell their stories.

Social

  • Like on Facebook
  • Follow on Twitter
  • Connect on Linkedin
  • Subscribe on Youtube
  • Instagram

ADVERTISEMENT

  • Most Popular

  • Past Week

    • Forced voicemail and diagnosis codes are endangering patient access to medications

      Arthur Lazarus, MD, MBA | Meds
    • The One Big Beautiful Bill and the fragile heart of rural health care

      Holland Haynie, MD | Policy
    • America’s ER crisis: Why the system is collapsing from within

      Kristen Cline, BSN, RN | Conditions
    • Why timing, not surgery, determines patient survival

      Michael Karch, MD | Conditions
    • How early meetings and after-hours events penalize physician-mothers

      Samira Jeimy, MD, PhD and Menaka Pai, MD | Physician
    • FDA delays could end vital treatment for rare disease patients

      GJ van Londen, MD | Meds
  • Past 6 Months

    • Forced voicemail and diagnosis codes are endangering patient access to medications

      Arthur Lazarus, MD, MBA | Meds
    • How President Biden’s cognitive health shapes political and legal trust

      Muhamad Aly Rifai, MD | Conditions
    • Why are medical students turning away from primary care? [PODCAST]

      The Podcast by KevinMD | Podcast
    • The One Big Beautiful Bill and the fragile heart of rural health care

      Holland Haynie, MD | Policy
    • Why “do no harm” might be harming modern medicine

      Sabooh S. Mubbashar, MD | Physician
    • Here’s what providers really need in a modern EHR

      Laura Kohlhagen, MD, MBA | Tech
  • Recent Posts

    • Addressing menstrual health inequities in adolescents

      Callia Georgoulis | Conditions
    • How to advance workforce development through research mentorship and evidence-based management

      Olumuyiwa Bamgbade, MD | Physician
    • The truth about perfection and identity in health care

      Ryan Nadelson, MD | Physician
    • Civil discourse as a leadership competency: the case for curiosity in medicine

      All Levels Leadership | Physician
    • Healing beyond the surface: Why proper chronic wound care matters

      Alvin May, MD | Conditions
    • Why specialist pain clinics and addiction treatment services require strong primary care

      Olumuyiwa Bamgbade, MD | Conditions

MedPage Today Professional

An Everyday Health Property Medpage Today
  • Terms of Use | Disclaimer
  • Privacy Policy
  • DMCA Policy
All Content © KevinMD, LLC
Site by Outthink Group

The cure for a poor historian? A good medical record
6 comments

Comments are moderated before they are published. Please read the comment policy.

Loading Comments...