My Records are My Business! (Medical records and DNA Testing)

Member Name: chrispitts

Product:	Medical records and DNA Testing
Date:	04/12/02 (101 review reads)
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I'm a doctor. So my personal beliefs about medical records are based, in part, on what the legalities are regarding entitlement to view. Currently, there are very few people who are entitled to unrestricted access to a patient's medical notes, and in very few circumstances. One is the patient. Another is me (of course!). And the third is in certain legal proceedings (although not all). Many insurance companies request a Doctor's report. This is broken down into sections, allowing the doctor to divulge certain information, but also enabling him/her to withold irrelevant information. As doctors, we are not entitled to fill in this report without the written consent of the patient.

I understand the difficult situation insurance companies are put in. I'll be honest, if I didn't already have life insurance (I do) and I was suddenly diagnosed with a terminal illness, I'd be highly tempted to apply, and just "skip over" the recent diagnosis. Wouldn't you? So there has to be a safety-net in place somewhere. And that's where the doctor comes in. As we've established, your GP is one person who has total, unrestricted access to your medical notes. That may well be a frightening thought (if you met me, it'd be a terrifying thought...), but as we are allowed access, and we're medically trained, surely we should be the ones to confirm or deny suitability for life insurance. Forget all the (several pages long) forms to fill in. I can browse someone's notes in 10 minutes, and would then be able to write a note to the insurance company saying either "yes, go ahead", or "no, this patient's ill". Surely no more clarification is necessary.

And as to the question of fraudulent GPs being bribed to falsify reports.... in all honesty, I'm sure it happens already, and I suppose my method would make it even easier, but if a GP was found to have done that, he/she would undoubtedly be stru
ck off.

There is no reason I can think of why insurance companies would require unrestricted access to a patient's full medical history. In fact, there are several reasons why it would be a bad idea. Two in particular:
One: By allowing the GP to fill a form in, he/she is the one wasting time sifting through completely irrelevant letters and consultations. If a specific employee of the company was employed to do that for every applicant, he'd run out of time.
Two: How do the notes get to the company. Transport of medical notes is always a dodgy issue, and the photocopying costs alone would be extortionate, let alone transport costs. (when compared to an envelope with a form inside...)

Moving on to DNA testing. I think we all have to accept this is something which will become more commonplace in the future. We've already discovered the Alzheimers Disease Gene, and several cancer-related genes, and more is being discovered daily. My personal view is that this is fortune-telling, at un-necessary cost. Sure, having a problematic gene might predispose you to a certain condition, or you might be carrying a disease, but that might not be what kills you. Hey, you might be run over by a bus - what's next? - the insurance companies follow you around, and base your premiums on how many roads you cross every day? There are only so many factors that can feasibly be taken into consideration. DNA testing is expensive, time-consuming, and, in all honesty, is likely to remain so for quite some time. I personally don't want to know if I've got a cancer gene.

In summary, my personal belief is that if the doctor says it's OK to insure a person's life, then that should be satisfactory. No extra tests. No notes changing hands.

As to what I think WILL happen. By 2004, we will be introducing a "Patient Held Medical Card", like a credit card, which holds your medical notes. Then, it'll be much easier
for insurance companies to quickly scan it into their computers and draw out relevant information. It'll also make our lives much easier, because filling in these forms is fairly time-consuming (and mind-numbingly boring). Technology, eh?

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