I assume that you have seen the commercials (especially if you watch half as much football as I do) with the Viking and the credit cards, extolling the virtues of one credit card over another. Ever since MasterCard and Visa went national  I’ve not given it much thought. I assume privacy, assume competence, and am oddly reassured when they call me and ask about suspicious purchases rather than concerned that they are building a profile to use against me should I run for public office.

This is unlike medical record keeping. The medical-industrial complex has convinced the public that the only way to protect their privacy is to maintain difficult to retrieve paper records that are controlled at the local level by armed guards. In fact, people want their information shared. In a presentation to the Patient Centered Primary Care Collaborative, David Hanekom reported on the MediQ  experience regarding informing people on how their data would be shared amongst care providers and offering them the opportunity to opt out. Approximately 0.001% of people opted out.

What is everyone so worried about? I suspect people are concerned for one or two good reasons and a lot of unfounded ones. The unfounded ones center around now dated (we hope) beliefs about chronic illness. Medicine up until very recently was centered on acute illness. A patient would report a symptom and either get better or die as a result of that symptom. Diabetes was a disease of grossly elevated blood sugars inadequately monitored using urine test strips. Hypertension was commonly “malignant” because it foretold a future of strokes as well as because the treatment (mercurial diuretics leading to mercury poisoning) was worse than the disease. When I was in medical school we were often told not to diagnose someone with a chronic illness because it would lead to poor health and an inability to get health insurance. Fortunately, over the last 25 years we have become much more enlightened about chronic illness and the Affordable Care Act will protect those who suffer from chronic illnesess  from losing their ability to get health insurance in 2014. Believe it or not, good record keeping leads to improved chronic illness care. Rather than seek out physicians who falsify information in the records, seek out those who wish to improve care by keeping better records.

Many people are concerned about the safety of their secrets as well. I suspect that priests do not keep records in the confessional. Physicians do take notes. There are many urban legends about celebrities who have sought medical attention for “unusual activity” and the information has been released to the general public. Interestingly, in the information age,  personal health information is more secure. When compared to paper, electronic information transfer is more easily traceable and information leaks are auditable. As a physician, I offer an additional level of security. When I hear people’s deepest, darkest secrets and I enter a note I boil it down to “Personal concerns discussed.”

In summary, it is time to move from information being hoarded in separate offices to being electronically stored and shared. Demand that your physicians use electronic health records and share information with others. As a primary care physician, I offer our shop as a central repository for your information. If you are the suspicious type, you can store information yourself.  I would encourage you to share all information with all of your physicians at the time you seek care. They need to know “What’s in your record.”

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