Saturday, October 15, 2011

Score one for the US medical system

UK expats often have a lot to say about the differences between the National Health Service and the lack of a national health service here in the US. Although there are many criticisms to make of the NHS, at least you know you won't go bankrupt in the UK because you need medical treatment. I'm lucky in that my husband's employers are Europeans and they have made it a priority to make sure their employees have decent health insurance.

I discovered recently that the American system has a small advantage over the NHS, that I have never heard anyone mention before. It is the idea that a patient's medical records belong to the patient and that the patient is entitled to copies of them. I've had a couple of MRIs done recently (actually four) and the staff at the MRI center are quite happy to give me a copy of the MRI CD as soon as the notes regarding the findings have been transcribed - so I can actually know what was found (or not) BEFORE my appointment with my doctor to discuss the results. My sister commented in a recent email to me "in the UK doctors are really secretive about results of tests - they seem to think that a little knowledge can be very dangerous."

I recently asked for a referral to a specialist, and he asked for copies of my records from the other doctors I had already seen, including my opthalmologist, to be faxed or fedexed to him before he would even make an appointment with me. I assumed the other doctors would send the notes directly to the specialist, but in almost every case their office staff told me I could pick the records up myself. One of the doctors I've seen recently said that he always writes his patient notes with the expectation that at some point the patient will see them. One specialist sent me a copy of the report that he sent to my primary care physician/GP without me even asking for it. Another dictated the notes before I left the room "so you'll know what I'm telling your primary care doc. and you have a chance to correct me if I make a mistake."

It was interesting to see what gets included in the reports.There were entertaining comments such as:
"Denies recent illness. Denies sore throat, cough or nasal congestion."
"well developed and nourished; appropriately groomed; in no apparent distress."
"Communicates appropriately for age"  
Then there's all the detail about my health of course, most of it understandable, but I did have to look some words up: apparently I have no diploplia, dysdiadochokinesia, ataxia or dysmetria - and that's a good thing! If it sounds like I've had a lot of doctor's appointments recently, yes, I have and there are more to come. Despite the way it may sound, I do not have a life-threatening condition and am not even feeling ill. I do have an immense gratitude to my husband's employer for not going with a high deductible health insurance plan, and I have a cool new photo I can use for my Facebook profile for Halloween!

8 comments:

Paul said...

Although my experience of the health system is very limited, what you say sounds very believable - I think the openess of American culture is preferrable to the UK generally and a breath of fresh air in many respects.

Having said that, my American wife, who is the daughter of a doctor, feels strongly that many (most) of the MRIs and tests done generally in the US are entirely unnecessary - partly it's cultural, but much of it is financial driven, rather than health.

Almost American said...

Agreed Paul - I do think many of the tests that doctors order are unnecessary - a lot of CYA going on! In my case, the doc (actually a Physician's Assistant) who ordered the MRI told me in advance that he was sure they wouldn't find anything significant, but my mild symptoms justified it. Basically he admitted that he had no idea what was wrong with me and he was covering all the possibilities. I suppose you could see it as a financial decision (avoiding a potential lawsuit for failing to treat me properly) but I think in his case there was a serious curiosity and need to figure out what was going on. He told me he was absolutely stunned when he saw the results - and now I have to have annual MRIs for the foreseeable future!

MrsB @ crankymonkeys in london said...

That photo is AWESOME :)

Expat mum said...

I agree about the lack of secrecy. I also like the way the doctors tell you everything and include you in the treatment decision-making. Sometimes it's a little overwhelming and I wish they would just tell you what they are going to do, but I like doctors who listen to their patients.

Michelloui | The American Resident said...

I love the comments in your notes 'communicates appropriately for age'! Hilarious!

But my husband is a Dr in the NHS and I just asked 'if a patient asks for their notes do you have to give them to them?' And he said 'yes of course, all clinical notes are the patient's property.' This includes any imaging, lab results, whatever.

But it's the fact that this is not widely known that might be a bit naughty of the NHS. In the States people Know Their Rights, but in the UK people are afraid to ask what their rights might be and the Powers that Be don't see the need to enlighten, I guess.

Great post!

Hope you're ok x

Circles in the Sand said...

So true! Plus they're also very quick to do tests in the US, to cover their butts, I found! while in the NHS, you'd have to go home and come back in a few weeks if it's not better.....pros and cons, of course - ie, en ECG they gave me in the US after an anxiety attack probably only made the anxiety worse! but then again it's so reassuring to have things ruled out so quickly. Good luck with your appointments, very glad to hear it's nothing serious and love the photo!

Circles in the Sand said...

So true! Plus they're also very quick to do tests in the US, to cover their butts, I found! while in the NHS, you'd have to go home and come back in a few weeks if it's not better.....pros and cons, of course - ie, en ECG they gave me in the US after an anxiety attack probably only made the anxiety worse! but then again it's so reassuring to have things ruled out so quickly. Good luck with your appointments, very glad to hear it's nothing serious and love the photo!

Anonymous said...

I live in the UK and have copies of mcuh of my medical notes. Never had any problem obtaining them. In fact it was my doctor that suggested the idea when I was travelling about quite a bit and had a condition that needed careful managing.

Peter Bond

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