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Do you think your medical records are private, released only to those who need to treat you at the time?
When I first moved here, I had one visit with a doctor that I preferred not to stay with. I found another. I never mentioned the first doctor at all. Yet the second doctor came in with his computer, started typing and turned to me to ask if I would please bring in my records from the first one and he named her.
I was looking for a new doctor. The doctor whose office I called has admitting privileges at a different hospital than the previous one had. Nevertheless, the woman who answered the phone typed my name into her computer and said "Oh, you've been seeing Dr (*****) Now, I did not tell her that. She found it on the computer.
I finally ended up with a doctor who had admitting privileges at another hospital -the same hospital where, four or five years ago, I had seen that first doctor mentioned above. The person who set up my appointment not only found my old record and reminded me of the doctor's name but apparently got that record. When the doctor came into the room, he had a printout of it and started talking about items on it.
None of this is cause for raising a ruckus. It is just saying your records are no long private. At least not in this area.
Unless you gave some sort of consent for every doctor sharing the computer system to have your records, it should not be possible to do that. My guess is that when you became a patient of the first doctor you signed something acknowledging that the system was shared by multiple doctors.
No one should have access to your clinical information without your consent.
Exactly. This is how it was done. Doctors practiced in their own offices, had admitting privilege at the hospital of their choice, admitted the patient when they felt it necessary and treated the patient in the hospital, leaving instructions for the hospital staff about medications and tests wanted. If needed, he called in a surgeon or other specialist. He also did this own billing - had a staff member doing it. If anything didn't look right on your bill, there was someone in his office to meet with you and explain or correct, as necessary. Still is that way for the most part - the truth is, solo practice is very expensive, so many PCPs pool resources for such things as billing or scheduling/reception, and have a separate office staff.
All this has changed now and this is the point we are trying to make. How many in the receiving end of treatment know all about this and how to deal with it? I've been asking friends and neighbors and have not yet met one that knew a business office at the hospital was doing their doctor's billing now. for the inpatient care received. In the office, consolidating the billing at a separate location cuts down on expenses and overhead All the rest, hospitalists, etc., is brand new to me and I imagine also to a lot of other people Hospitalists have been around about 10 years or so
Then there is the fact that, somewhere in the dark labrynths, someone is controlling how doctors practice in their own offices. Insurance reimbursements They are allotted ten to fifteen minutes per patient (45 for a new patient) and, if they go over that too often, they hear about it. That ten minutes may do fine if you have a cold or an easily diagnosed rash but what if your problem is more complicated and he needs more time to diagnose? Not allowed. of course it is - unless it's a "Oh, by the way, I've been ...." as the provider is walking out the door.
Years ago, if I went to a new doctor, I got a complete physical, head to toe. My last (non-complete) physical was a listen to my heart and lungs. That was it. Was that what your appointment was for - a complete physical with pap/pelvic or a specific complaint-type visit? Even on regular checkup visits, I got more than a listen to heart and lungs followed by a seal of approval. No more.
(bold is mine) Have you found a healthcare provider yet? I still think you ought to consider a nurse practitioner. S/he can manage patient care and consults regularly as needed with a collaborating MD/DO.
Who would take care of you if you had something that your "regular physician" thought you needed to be hospitalized to treat? That is the function of the hospitalist. Hospitalists do not do surgery. They practice complicated internal medicine in a hospital setting. After you are discharged from the hospital, you do not go back to the hospitalist for follow-up care. You go back to your own primary care doctor.
The hospitalist frees up your primary care doctor to do primary care --- in an outpatient setting.
I can't think of anything I'd need to be hospitalized for, that is -not- surgery, that would -not- require the same doctor to check me after treatment in a follow-up visit, that would require that I make use of a hospitalist rather than a specialist who has private practice and hospital privileges.
My primary care physician doesn't follow up on treatments given by other doctors. Those other doctors follow up on their own treatments. This is a very strange system you're talking about. I'm still old-school and rarely go to any specialist at all. But the ones I do go to, are all private practice physicians, with hospital privileges, who treat patients for the things they specialize in, and follow up on the treatment to ensure that the patient is healing as predicted. My PCP is the one who does the yearly physicals and tries to get me to do a colonoscopy and prescribes my meds. I might go to her if I have a cold that's so bad that I can't shake it after two weeks, or if I sprained my arm and want to make sure it's not broken.
But she doesn't refer me to anyone, unless I ask her to. I go to whatever specialist I want, as long as they're on the list of in-network physicians.
bluedevilz, I'm trying to say that I don't know of ANY specialist who works in a hospital, who doesn't also have a private practice/group practice outside the hospital. I think the idea of a specialist who works exclusively in a hospital, and nowhere else, to be bizarre. The concept is totally foreign to me, and so defining a word, to someone who has no experience of the concept, isn't helpful.
^^^^yes, that's how it works here too and it is a little disturbing if something serious happens. There was another
discussion similar to this a while back regarding billing and costs. I mentioned that there was a test that was ordered
and I made a point that I did not want the nuclear test but the other one which was just as reliable. The doctor agreed
but when I went to schedule it - he ordered the nuclear test. I was polite but clear that I did not want that test and
he did rewrite the order. The interesting thing about it is that the nuclear test cost 3-4 thousand dollars more.
It seems to me that all the debating and disagreeing going on here just proves my original point - the medical world has changed drastically and no one is explaining it to the patient. They are all just saying "do this; do that" or not saying anything at all.
I keep remembering my long-ago and still favorite doctor. When I went to ER and they called him, he showed up within the hour. When he found I needed an appendectomy, he made some calls and returned to tell me who the surgeon would be. He explained that the surgeon would be my "primary care doctor" while I was in hospital. The two doctors consulted with each other about what was being done and both doctors visited me daily, keeping me informed. The surgeon did all the ordering, of course, but there was open communication between them and with me. One day, when the surgeon was going to be away, he explained the day before who would be replacing him for that day and what I should expect. No surprises ever.
The lights were bright all over the world back then. It is terribly dark now.
I can't think of anything I'd need to be hospitalized for, that is -not- surgery, that would -not- require the same doctor to check me after treatment in a follow-up visit, that would require that I make use of a hospitalist rather than a specialist who has private practice and hospital privileges.
My primary care physician doesn't follow up on treatments given by other doctors. Those other doctors follow up on their own treatments. This is a very strange system you're talking about. I'm still old-school and rarely go to any specialist at all. But the ones I do go to, are all private practice physicians, with hospital privileges, who treat patients for the things they specialize in, and follow up on the treatment to ensure that the patient is healing as predicted. My PCP is the one who does the yearly physicals and tries to get me to do a colonoscopy and prescribes my meds. I might go to her if I have a cold that's so bad that I can't shake it after two weeks, or if I sprained my arm and want to make sure it's not broken.
But she doesn't refer me to anyone, unless I ask her to. I go to whatever specialist I want, as long as they're on the list of in-network physicians.
You could have pneumonia or a bad kidney infection, for example, and need a few days of IV antibiotics.
Next time you see her, ask your doctor whether hospitalists see her patients.
It seems to me that all the debating and disagreeing going on here just proves my original point - the medical world has changed drastically and no one is explaining it to the patient. They are all just saying "do this; do that" or not saying anything at all.
I keep remembering my long-ago and still favorite doctor. When I went to ER and they called him, he showed up within the hour. When he found I needed an appendectomy, he made some calls and returned to tell me who the surgeon would be. He explained that the surgeon would be my "primary care doctor" while I was in hospital. The two doctors consulted with each other about what was being done and both doctors visited me daily, keeping me informed. The surgeon did all the ordering, of course, but there was open communication between them and with me. One day, when the surgeon was going to be away, he explained the day before who would be replacing him for that day and what I should expect. No surprises ever.
The lights were bright all over the world back then. It is terribly dark now.
Many doctors still communicate with their patients. Where communication breaks down a big factor is the pressure for doctors to see more patients in a shorter time frame. I think that computerized records can interfere, too. I do not want to be talking to the back of a doctor's head during my visit while he clicks from page to page on an electronic record.
A hospitalist is just a specialist who takes care of sick people in the hospital. He needs to let your primary care doc know what is going on, but for the primary care doc to visit you when he is not actually treating you is a luxury most can no longer afford.
Many doctors still communicate with their patients. Where communication breaks down a big factor is the pressure for doctors to see more patients in a shorter time frame. I think that computerized records can interfere, too. I do not want to be talking to the back of a doctor's head during my visit while he clicks from page to page on an electronic record.
A hospitalist is just a specialist who takes care of sick people in the hospital. He needs to let your primary care doc know what is going on, but for the primary care doc to visit you when he is not actually treating you is a luxury most can no longer afford.
This is true. I worked for a few years in a very small community hospital up until 2012. Hospitalists admitted almost all of the patients, and were the primary physician for a vast majority of the patients were were admitted to the hospital. Almost all of the patients who were admitted by another physician were admitted by a surgeon for a planned surgery, or to the maternity ward for a delivery. Furthermore, surgeons often times asked a hospitalist to see their patients to address general medical issues, such as diabetes, since hospitalists have a lot more experience handling these kinds of problems.
I was in the hospital for a few days earlier this year. The hospitalist admitted me, and did an excellent job taking care of me. Of course, he needed some history, but my wife, parents, and I were able to provide this to him verbally. He sent my records to my PCP (per my request). My PCP and I reviewed the records at my last annual check-up, and he is managing the new medications that I started when I was in the hospital. Overall, the process went very smoothly, and I received excellent care.
One more point to keep in mind: hospitalists are needed to treat patients who do not live near the hospital. Even my PCP did have hospital privileges at my local hospital, he would not have been able to see me, since I was admitted to hospital in an adjacent county.
This is true. I worked for a few years in a very small community hospital up until 2012. Hospitalists admitted almost all of the patients, and were the primary physician for a vast majority of the patients were were admitted to the hospital. Almost all of the patients who were admitted by another physician were admitted by a surgeon for a planned surgery, or to the maternity ward for a delivery. Furthermore, surgeons often times asked a hospitalist to see their patients to address general medical issues, such as diabetes, since hospitalists have a lot more experience handling these kinds of problems.
I was in the hospital for a few days earlier this year. The hospitalist admitted me, and did an excellent job taking care of me. Of course, he needed some history, but my wife, parents, and I were able to provide this to him verbally. He sent my records to my PCP (per my request). My PCP and I reviewed the records at my last annual check-up, and he is managing the new medications that I started when I was in the hospital. Overall, the process went very smoothly, and I received excellent care.
One more point to keep in mind: hospitalists are needed to treat patients who do not live near the hospital. Even my PCP did have hospital privileges at my local hospital, he would not have been able to see me, since I was admitted to hospital in an adjacent county.
Your primary care physician is not allowed to visit you because you were in a different county? I would not expect him to be able to give any orders or do any treating but not to see you or discuss your care with the hospitalist? Hmmmm????
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