Letting patients read their own progress notes...

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drusso

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our patients are offered a "clinical summary", includes the A&P of the note but leaves out exam and HPI. I can still hide stuff that I want only other physicians to see which is nice. Forces me to get the note done while they're in the office or we mail them a copy.

Have only had a couple patients ask to have something changed. Overall doesn't affect me much.
 
I always document in a way I wouldn't mind the chart being read by the patient, a judge, jury, attorney, etc

Why? Because it might.

That doesn't mean I candy coat the chart, make it politically correct or leave out signs of aberrant behavior. But I keep to just the facts.
 
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notes are written to appease billers, insurers, audits, and lawyers. patients will never understand this
 
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I rotated with a pmr physician who would always say "I am going to say this and this in my note. Does that seem right?" I always thought that was brilliant.
 
Isn't it a meaningful use requirement to allow pts full access to the notes? At the VA, for the past year, pts have full access to their notes electronically.
 
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