These were the words I heard overhead while I was having dinner with a friend recently. Within minutes I was ushered into a back room and encountered a true medical emergency, with confused and concerned bystanders. They ultimately showed excellent judgement by activating the emergency medical system and reaching out for help locally in the interim.
I have answered several public calls for a physician in the past few years, and each situation makes my heart sink out of compassion for both the unwilling patient and the people around them, who want to do whatever they can to help.
As it so happens, my friend found me as I was pondering the situation. He asked, “Ted, how would a patient having their medical records accessible to them on the Internet make a difference here?”
I didn’t have well formed answer then, but I do now. It could have made a big difference, and not because we would bring up a web browser and start surfing.
A physician who practices with the knowledge that their patient is a partner and will see everything they do is more likely to produce records that are (a) accurate (b) involve the patient in treatment planning (c) at the patient’s health literacy level (d) involve family members in assisting in ongoing care needs. Patients can carry accurate diagnosis and medical lists and learn more about how treatment impacts their daily living.
So it’s not about the web site, it’s about the way we respect patients when we involve them and their families in care. When I think about the types of very powerful compounds we prescribe patients and the amount of information we give them (in one study, only 62% of prescriptions were fully explained to patients, 26% of the time even the name of the drug was not told to patients), it is possible to think about how many of our friends or family could be in a situation like this against their will. Prepared, knowledgeable, patients may be less likely to have emergencies in the first place. I know for certain that this was the cause of one of the emergencies I responded to about a year ago. No one leaves their home in the morning hoping to ride in an ambulance later in the day.
As my friend and I parted for the night, it seemed that the story had a happy ending as the patient received the help they needed and life went on in the environment we were in. But just like the physician in “A Fortunate Man,” even if everything turned out just fine, I would still be sad.
Each time this happens I can’t help asking the question, “Why did this happen? And why didn’t the health system prevent it?” When I think about the answers, I become just a little bit more restless to change things.