Saturday, May 17, 2008

The Doctor Went Dumpster-Diving (Medical Records Delivery)

Ever take your child to a new specialist with a sense of happy anticipation that this time will be different—this time the doctor will listen and help—only to be left confused at the end, wondering how everything went so horribly wrong, so fast? Ever wonder how to minimize the chance the same thing will happen with the next specialist you see?

My daughter’s GP keeps meticulous records, keeping not only all the information sent from all the other doctors, but he consolidates lab results into what he calls a “Laboratory Flow Sheet.” It has all the lab test names and normal ranges down the left side, and dates along the top. All abnormal results are printed in red. If your own child’s pediatrician does not do this, I suggest that you create your own spreadsheet. Keep track of all the lab results yourself.

Previous doctors used to refer my daughter to various specialists expecting us to just explain the situation to the specialist. This does NOT work. Even if we type up what the situation is, and run it by the various doctors wanting the specialized tests, and tweak it so everyone is happy, the specialist usually looks at us like we are nuts and sends us on our way.

Anxious to get my daughter proper care by a local endocrinologist, for what he felt was a complex problem, the GP referred her to one that he wasn’t familiar with but was supposed to be able to handle her issues. He then faxed my daughter’s pertinent medical information to the specialist’s office. In spite of that advance preparation, the appointment still ended disastrously.

First of all, the endocrinologist was more experienced with handling diabetes and mundane thyroid issues than issues arising from brain, pituitary, or adrenal function, or issues that were complex and rare.

The biggest problem may have been that the endocrinologist was missing information! I had been complacent about the GP faxing the pertinent information over in advance, so I didn’t have copies of lab results with me. The doctor had only one sheet of several that had been faxed. She looked at it, and did not understand why in the world my daughter was even referred to her. When we tried to explain all the trouble my daughter was having, she snorted, saying the GP should be able to handle it, and dismissed the case.

So, for the next referral, the GP faxed just a couple pages to the new endocrinologist he chose and had us hand deliver the rest of the medical records he wanted the endocrinologist to look at. The GP had the lab flow sheet, results and analysis from another out-of-state specialist my daughter was seeing, and a carefully typed up summary. It was all stapled together into a ½ inch thick stack.

At the doctor’s office, the receptionist asked me to hand over the medical records so she could put them into my daughter’s file. That way, she could hand them to the doctor to review before he saw my daughter.

To make a long story short, between the time I handed the records over to the receptionist, and the time the file was handed to the doctor; my daughter’s medical records had been thrown into the garbage.

This doctor, just as the previous endocrinologist, did not understand why she had been sent to him. He must have thought I was a lunatic jumping up, agitatedly rustling through the papers on his desk, insisting he was MISSING the information he needed! He finally got up saying he would go find out what happened to the medical records I was professing to have brought. He left the office while grumbling about all the other patients piling up waiting to be seen.

He was gone a long time before returning with the records, saying he had to go dumpster-diving for them. He had a completely different attitude looking at the more complete medical records with her GP’s summary and pages of lab results.  He read through them, occasionally uttering an surprised  "OH!" and finally understood why we were there, and what my daughter's problem was and WHY the GP could not handle this more rare, complex case by himself.

It took us a long time to learn this simple lesson. When being referred to a specialist, a letter, summary, and lab results need to be hand-carried—not mailed or faxed—and placed directly into the doctor’s own hands. We came very close to having this latest visit to a new specialist be one more fiasco.

We'd had enough visits to specialists end in failure.

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28 September 2011


Anonymous said...

This is certainly good advice. When we take our son to see his specialist we bing along a two paged sheet listing all meds and supplements he takes, a short narrative of events since the last appointment, a symptom by symptom review and pertinent comments from other specialists.


Herb said...

cwolfsrLet's hope that the doctor reads the information you provide. After all, the bigest single failure of most in the medical profession is arrogance!

MrsOgg said...

Oh, that is so awful! It is kinda weird how much power the front desk staff try to wield. I mean why would they think they could toss that out?! This only confirms what I have decided from personal experience that the staff at an office is almost as important to consider when choosing a doc (especially one you see regularly) Thanks for sharing your experience so we can learn from it!