From: sbharris@ix.netcom.com(Steven B. Harris)
Newsgroups: sci.med
Subject: Re: Lack of comapassion among many doctors (Was: "Excedrin Migraine")
Date: 13 Apr 1999 07:43:57 GMT

In <3712E2B6.9405BF@cs.uoregon.edu> Bret Wood <bretwood@cs.uoregon.edu>
writes:

>Well guess what John, you're a doctor a hell of a lot more often than
>you're a patient.  So you don't get to see things from our side of
>the ball very often.

    Just to begin with, we doctors don't always see patients alone.  Do
you suppose lousy doctors only display their lousiness with patients
when they're far away from other doctors?  So it's sort of like trying
to tell if the light really goes off when you close your refrigerator?
I won't say I've never seen really unexcusable behavior with a patient
from a fellow doctor. I have.  However, I have been amazed at how rare
it's been, considering the temptations.  I've seen patients made fun
of, in private-- but that's quite a different thing.  I am not sure
that such humor is even unhealthy, and that it's not necessary in some
way.  The profession is far too grim to bear without something of this
sort.  I've seen doctors make fun of other doctors just as savagely,
among themselves.  It's this way in every stressful profession. I do
not begrudge (for example) the way cops talk about perps and even
citizens, when they talk shop.  If they didn't, they would go nuts, and
who wants a guy with a sidearm to be nuts?


>Where's your defense for medical chart notations such as:
>
>FLK -- Funny Looking Kid
>BUNDY -- But Unfortunately Not Dead Yet
>PIA -- Pain In the Ass
>
>among many, many others.


    No defence is needed, for I've never seen any of these in a medical
chart.  And I've read tens of thousands of medical charts-- more than
you can ever hope to even see in your lifetime unless you're a medicare
auditor, nurse or another doctor.  Somebody must have been telling you
stories.  Perhaps this kind of thing occured in the 1950's or
something.

    I've never even HEARD of any of the above except for "funny looking
kid."  This one is never written in charts but is indeed used
doctor-to-doctor, however not in any malicious or derogatory way.  What
it means is that there's something odd about the way this child or
infant looks which is hard to put a finger on, or even describe.  Some
asymmetry or subtle disproportion, combined with an odd illness.
Something which makes one wonder about a subtle genetic defect.
Perhaps one which has yet to be described, or won't be recognized
unless you look through some tome written at John Hopkins (with a lot
of photos of---well--funny looking kids).  Perhaps odd-looking kids
would be more politically correct?  No.  Aesthetically challenged?
Again still too judgemental.  Subclinically dysmorphic?   The problem
is that the concept is too useful (in pediatrics, at least) to get rid
off, and you have to have some kind of name for it.  FLK got picked.
Perhaps Dr. Fox would like to comment here.


>Doctors are PART of the human race, not above it.  And although
>there are many _excellent_ doctors in the world (many of them
>on this group), there are way too many assholes who think that
>they are better than the rest of society.  It's the EXACT same
>problem that afflicts politicians and managers.  Doctors have
>the power over life and death, and many of them have been
>corrupted by it.
>
>-Bret Wood


    I would certainly agree that doctors are part of the human race and
are not above it.  Just as I would rabbis and priests and the pope and
the president (especially the president...sigh).   But I've long felt
there's something special about doctors, just as I have about nurses
and firemen and astronauts and paramedics and other people who have
chosen lives which require a certain amount of grit, knowledge, and
responsibility in the face of nasty situations.  I feel this way even
for lawmen, especially the old-time ones who had to opperate without
car radios and SWAT teams and other backup (that lets out the Rodney
King crew and so on).  I don't feel that same admiration for doctoring
as a profession because I'm a doctor, rather I felt that way before I
became a doctor.  That's WHY I became a doctor, not the other way
around.  You're quite free to disagree.  Had you been a mile in my
shoes-- yea, had you been 100 yards, you'd understand better.  The
difference between you and me is that I've BEEN a patient, going
through a number of painful operations before I ever got to be a
physician.  I've been on the other side, at least some.  You haven't.

                                    Steve Harris, M.D.

From: jrfox@no.spam.fastlane.net.no.spam (Jonathan R. Fox)
Newsgroups: sci.med
Subject: Re: Lack of comapassion among many doctors (Was: "Excedrin Migraine")
Date: Tue, 13 Apr 1999 18:56:09 GMT

On 13 Apr 1999 07:43:57 GMT, sbharris@ix.netcom.com(Steven B. Harris)
wrote:

>In <3712E2B6.9405BF@cs.uoregon.edu> Bret Wood <bretwood@cs.uoregon.edu>
>writes:
>
>>Where's your defense for medical chart notations such as:
>>
>>FLK -- Funny Looking Kid
>>BUNDY -- But Unfortunately Not Dead Yet
>>PIA -- Pain In the Ass
>>
>>among many, many others.
>
>
>    No defence is needed, for I've never seen any of these in a medical
>chart.  And I've read tens of thousands of medical charts-- more than
>you can ever hope to even see in your lifetime unless you're a medicare
>auditor, nurse or another doctor.  Somebody must have been telling you
>stories.  Perhaps this kind of thing occured in the 1950's or
>something.
>
>    I've never even HEARD of any of the above except for "funny looking
>kid."  This one is never written in charts but is indeed used
>doctor-to-doctor, however not in any malicious or derogatory way.  What
>it means is that there's something odd about the way this child or
>infant looks which is hard to put a finger on, or even describe.  Some
>asymmetry or subtle disproportion, combined with an odd illness.
>Something which makes one wonder about a subtle genetic defect.
>Perhaps one which has yet to be described, or won't be recognized
>unless you look through some tome written at John Hopkins (with a lot
>of photos of---well--funny looking kids).  Perhaps odd-looking kids
>would be more politically correct?  No.  Aesthetically challenged?
>Again still too judgemental.  Subclinically dysmorphic?   The problem
>is that the concept is too useful (in pediatrics, at least) to get rid
>off, and you have to have some kind of name for it.  FLK got picked.
>Perhaps Dr. Fox would like to comment here.

"Funny-looking kid" is a phrase occasionally used by some
pediatricians to reflect suspicion of dysmorphic features.  It is not
intended to be derogatory, but rather is an indicator of the subtle
findings in an infant's appearance that can lead to the diagnosis of a
chromosomal or developmental abnormality.  The initial recognition
that a child is dysmorphic ("funny-looking") leads to a more careful
evaluation of the specific dysmorphic features and/or chromosomal
studies.  It is important to recognize these early on because there
can be serious implications on a child's health depending on the
eventual diagnosis.  A child with midface hypoplasia will be at risk
for panhypopituitarism, a child with Down syndrome needs to be
screened for congenital heart disease, and so on.

I doubt anyone would actually write "FLK" in a chart.  Noting to a
colleague that a patient is a funny-looking kid, then writing
"dysmorphic features consistent with fetal alcohol syndrome" in the
chart, is the same as saying a child's wrist is broken, then writing
"fracture of the distal radial metaphysis" in the chart.  And while
many of us have heard of the term "FLK," most of us don't use it,
precisely because it sounds insulting and we would not want a parent
to hear her child described that way.

--
Jonathan R. Fox, M.D.

From: sbharris@ix.netcom.com(Steven B. Harris)
Newsgroups: sci.med
Subject: Re: Lack of comapassion among many doctors (Was: "Excedrin Migraine")
Date: 23 Apr 1999 11:49:37 GMT

In <19990421085706.23271.00000421@ngol02.aol.com>
shapere@aol.comicrelief (Shapere) writes:

>but let's not kid ourselves and imagine that a medical record is
>"private." (Again, *not* to say that *most* doctors (, nurses, PAs, etc.)
>do this.)
>
>I was having a debate about paternalism with a psychiatrist recently: he
>argued that psychs (unlike other doctors) should be able to, at their
>discretion and for whatever reason they consider a good one, deny
>patients access to their records. As rationale for this position, he said
>that sometimes psychiatrists (presumably meaning himself) write notes
>that could "sound like malicious gossip" to the patient (but implied that
>this gossippy-sounding rhetoric is really just technical terminology - or
>something like that). People, if it's too nasty to be heard in a court of
>law, it's too nasty to put in a patient's chart!


    But at the same time let us remember that many courts of law are
not public and their records are not public, as are criminal
proceedings.  Civil and tort cases are often not open.  Divorce and
family law courts are closed as a general rule, and for good reason.
And you can bet that their records are under better security than your
doctors' usually are.  The same good reasons apply to some or even much
of what a psychiatrist writes down-- some of it is so sensitive it
shouldn't go into a hospital chart, or even an ordinary office chart
under office standards of security.  The same goes for medical
information about public figures (Liz Taylor's GYN complaints, etc.)
and also what psychiatrists think about their patients' thoughts.

   So there are two standards of security in medical record keeping.
There's probably nothing your GI doc can soberly say about your
hemorrhoids or prostate that is too shocking for you to read.  And
though your neighbors might find it vulgar, they'd get over it if they
did, and so would you, just as the President does.  However, your
psychiatrists' thoughts about your sex life, which you're supposed to
be discussing candidly, are probably nothing you really want, or need,
to read.  Or your insurance company or the defense team in a public
court.  And certainly not the general public.  On the other hand, your
psychiatrist does not have a good enough memory to keep all that stuff
in her head.  No one does.  And it would drive her crazy if she did,
anyway.

   I suppose it could be argued, of course, that what we need is not
two standards, but rather a higher standard for all medical records,
when it comes to readers other than the patient.  And it's true that
current standards for most records are rather palid compared with good
archival security, and certainly when compared with standard medical
security for drugs, and especially controlled drugs.   I've yet to see
an office that didn't have its *antihypertensives* under better lock
and key than its medical records, let alone the hydrocodone.   But
that's JCHAO for you.  Protecting people from embarrassment or privacy
invasion is way down on their list of problems.

                                      Steve Harris, M.D.

From: sbharris@ix.netcom.com(Steven B. Harris)
Newsgroups: sci.med
Subject: Re: Lack of comapassion among many doctors (Was: "Excedrin Migraine")
Date: 4 May 1999 10:37:21 GMT

In <372DCF82.C8EE74BA@Mindspring.com> Jim <JDBarron@Mindspring.com>
writes:
>> >
>> >Several years ago there was an argument about this in a bipolar
>> >support mailing list.  The argument was resolved rather quickly when
>> >the group member who was a practicing psychiatrist as well as a
>> >professor at a prestigious medical school said "There is no excuse for
>> >any doctor to write something in a patient's records which cannot be
>> >shown to the patient."
>> >
>> >-Bret Wood
>> >-bretwood@cs.uoregon.edu
>> >
>>
>>     I suppose that would be the argument from authority.  Which in this
>> case is rather self-contradictory, since the opinion expressed is a
>> minority one in the profession.  Enough said.
>
>It may be ONE opinion but it is one of the most SIGNIFICANT ones since it
>comes from someone who has looked at the issue from BOTH sides. And which
>side did he choose?  You can't say that it was because he just didn't
>understand where the doctor is coming from (one of your usual excuses)!
>
>To MOST people the significance would be blindingly obvious.  But not, of
>course, to someone in full throated denial.
>
>


    Show me this psychiatrist's office notes, and I'll show you the
notes of somebody who has his own little code.  He doesn't say
everything he thinks, but he has ways of putting things which jog his
own memory into supplying the missing detail, but merely sound a little
strange to the reader.  I've seen that.  I've done that.  I've
explained to you the reasons for some private notes of a doctor to
him(her)self.  And while doing it in the above way is convenient,
there's no ethical difference between this and having an eidetic
memory. Or having a second chart, for your own memory, that nobody
reads but you.

From: cgregory@gw-tech.com (Carey Gregory)
Newsgroups: sci.med
Subject: Re: Gregory demonstrates that Medical denial is a reality!
Date: Sun, 16 May 1999 23:09:15 GMT

Jim <JDBarron@Mindspring.com> wrote:

>So you are telling me that no doctor would ever request a patients records
>from another doctor?

Of course they would.  However, without your written permission the
other doctor cannot legally provide them, and no doctor who values his
practice would provide them without your permission.

>An just how IS is that a patient's records often include records from
>visits to prior doctors?  They just mysteriously teleport themselves to the
>new office, perhaps?

I think you'll find that the form most doctors ask new patients to
fill out includes a section that provides permission for them to
obtain prior records.  Under normal circumstances it's good medicine
for your doctor to know your prior medical history.

--
Carey Gregory

From: sbharris@ix.netcom.com(Steven B. Harris)
Newsgroups: sci.med
Subject: Re: Gregory demonstrates that Medical denial is a reality!
Date: 16 May 1999 23:18:06 GMT

In <373F1F02.EDEA1040@cs.uoregon.edu> Bret Wood
<bretwood@cs.uoregon.edu> writes:
>
>
>
>"Steven B. Harris" wrote:
>>
>>    The patient signs a release for the records to be sent to the new
>> doc.  I've never seen a doctor's office that would send records
>> anywhere (including to another doctor) without that all important
>> signed release.  That means signed by the patient or someone with
>> general power of attorney for the patient (in which case the power of
>> attorney document has to go also).
>
>I've switched doctors, and had my medical records transferred without
>signing anything.  I DID have to sign releases in order for the
>Social Security Administration to get copies of my records, but I've
>never signed a release to have my records transfered from one doctor
>to another.  I just asked them to do it over the phone.


   If you did, and they did it, they screwed up bigtime.  That's a
strict no-no.  They might squeek by if the officed nurse knows you
personally, knows your voice, documents the call and time, AND there is
a note in the chart from your visit that you intend to switch and
records are going to be transferred.  Your voice could be faked by
somebody know knew you were going to change doctors by some high tech
means, and was prepared to intercept them somehow- certainly. Courts
run on the "good faith" and "reasonable man" standard, and juries do
not ordinarily hold people responsible for running at the level of
security which it would take a Mission Impossible type con game to
circumvent.  But a phone call that says: "Hey, I'm Joe Blow.  Send all
my records to Doc Jones uptown, will ya?  Know the one I mean?"  is
not, in general, going to do it.

>
>Could it have something to do with the fact that most of the doctors
>in my town work for one giant medical corporation now?
>
>-Bret Wood
>-bretwood@cs.uoregon.edu



    That depends.  In a group practice, all docs generally have access
to all records of the others, because they share call.  Ideally, you
the patient are told this when you are seen by the first memeber of the
group for primary care.  Such responsibilities fade off from there to
HMOs where subspecialists might share call for each other, and records
are automatically transferred for subspecialty consults within the
organization.  The difference, however, is that this is ordinarily
covered in the contract you sign when you sign up with the HMO, so in a
sense, its still takes your signature to do it, albeit on autopilot
after the first time, and until you revoke the contract.  It's a major
bad think for your records to leave the HMO after you do, without your
written permission.  For PPOs, which are more losely knit, generally
patient signature is still required for each transfer of records.

    Finally, standards are more stringent for psych records everyplace.

From: David Rind <drind@caregroup.harvard.edu>
Newsgroups: sci.med
Subject: Re: Rights to medical file?
Date: Tue, 06 Jan 2004 23:06:19 -0500
Message-ID: <btg0nu$hpc$1@reader2.panix.com>

SuperTech wrote:
> Perhaps this is the wrong place to ask, but I have a question regarding
> access to my medical file.  According to
> http://www.nwjustice.org/docs/5930.html, I can request copies of my
> medical file where-in the office can charge up to 69 cents per page to
> copy it.  I take it then that I cannot request the whole file and copy
> it myself?  The reason I ask is that I have been dealing with bumbling
> idiots at these doctor offices.  I switched doctors and doctor's
> offices and none of my medical history was transferred over to the new
> office. According to the new office, it is my responsibility to make
> sure these are transferred.  Well, before I left the old office, I told
> the them to send them my medical history to the new office.  And when I
> called the old office, they said they did fax the medical file to them!
> So who's to blame?
>
> Now the new office sends me to a specialist.  I get the fax number of
> the specialist where I can send my medical history for my problem and I
> call the new office to have them send that history over to that fax
> number.  I go to the office visit at the specialist and da...da...da:
> no medical history!  Zippo, zilch, nothing.  Now I call my new office
> and request copies of ALL paperwork regarding my specific problem.  "Oh
> well, we can make a copy of the order we requested, but you had the
> other work do at the other office, so you should request the paperwork
> directly from them".  Mind, you they HAVE this paperwork, but don't
> want to give it to me!
>
> Call the old office (actually, it was another specialist).  They won't
> mail me any of my medical history until I write them a letter
> authorizing them to mail me the information.  Amazing!  I wonder why
> they cannot send it to me in the first place?  I mean, if someone else
> is living at my current address, what difference would a letter make?
> None.
>
> I went to the new office today and picked up a copy of the latest order
> and on the bottom it said it was faxed to the new specialist on 12/09.
> I don't know who to believe anymore!  So I'm going to hand deliver the
> paperwork to the specialist's receptionist myself AND bring a copy on
> my person to my next office visit so that if the doctor cannot find the
> paperwork, I'll have to be medical archive and produce it for him!
>
> That's my rant for today.
>
> SuperTech

Stuff with medical records is always a total pain, but your
offices are actually mostly following the rules:

1) They need written authorization to release records

2) They can only release records that are "theirs". What this
means is that if office #1 has a note from office #2 because
you previously asked office #2 to make a copy for office #1,
office #1 usually cannot release that note to you. You need
to go back to office #2 to get additional copies.

It is definitely a good idea to get copies made for you so
that you can then make your own copies for whoever needs them.
Also, it's then much easier to figure out which office is messing
up, rather than getting the runaround of one office insisting
they sent the information and another office insisting they
never received it.

--
David Rind
drind@caregroup.harvard.edu

From: David Rind <drind@caregroup.harvard.edu>
Newsgroups: sci.med
Subject: Re: Rights to medical file?
Date: Thu, 08 Jan 2004 20:56:39 -0500
Message-ID: <btl1sq$aef$1@reader2.panix.com>

Beachhouse wrote:
> BUT if the consulting specialist requests those records directly -- there
> should be no need for any further authorization from the patient because:
> a) the records are needed for care of a mutual patient  b) the patient was
> REFERRED to the specialist by the original doctor.  If the *patient* is
> requesting that records be sent to somebody else, THEN new authorization is
> needed..   If the consulting specialist picks up the phone and calls the
> requesting doc and says, "hey, tell me about our mutual patient ms. Smith..
> and oh, can you send over the EKG you did last month" there should be no
> issue with HIPAA.
>
>
> correct?

Under HIPAA, yes, protected health information may be released
in this scenario. However, that may not cover all the information
in a given medical record. If Office A sent copies to Office B,
and office B referred the patient to Office C, when the request
comes through from Office C to Office B for records, they typically
are not supposed to copy the copies they have from A and send them
to C. They are, of course, free to write a letter summarizing the
information in those records and send them to C. This is not a
HIPAA restriction as far as I know -- it predated HIPAA and I
don't think was changed by HIPAA. It has something to do with the
legal status of the keeper of records, but I have no idea who
this restriction is supposed to protect. It may even by specific
to a given state in the US.

--
David Rind
drind@caregroup.harvard.edu

From: David Rind <drind@caregroup.harvard.edu>
Newsgroups: sci.med
Subject: Re: Rights to medical file?
Date: Fri, 09 Jan 2004 18:50:15 -0500
Message-ID: <btnerl$544$1@reader2.panix.com>

Beachhouse wrote:
> but that scenario is frankly a set-up for horrific malpractice.  the entire
> issue is making sure that you have accurate, complete documentation for the
> care of a mutual patient.  as long as the records are needed for patient
> care, there should be no need for incessant authorizations from various
> offices.  relying on a letter summarizing the information is totally
> inadequate.  we've not run across this problem yet --  thank goodness.  if a
> patient saw a cardiologist a year ago and copies of ECG's, stress test were
> sent to the patient's primary physician -- then any subsequent
> internist/cardiologists/consultant should be able to receive the patient's
> comprehensive record from their primary doc --without having to track down
> the previous cardiologist who "is on vacation.. "  'we can't find the chart"
> "it's in a warehouse."  i don't want a summary of the ECG -- i want the ECG!

I don't disagree, but a lot of the privacy laws around medical
records tend to be written as if privacy rather than good medical
care was the paramount concern of most patients.

--
David Rind
drind@caregroup.harvard.edu

From: "Howard McCollister" <hmac@nospam.net>
Newsgroups: sci.med
Subject: Re: How Do I Obtain Review Of Medical Records?
Date: 7 Sep 2003 18:22:04 -0500
Message-ID: <3f5bbce8$0$40607$45beb828@newscene.com>

"alburma4u" <alburma4u@yahoo.com> wrote in message
news:c35c171c.0309071324.4e4851fb@posting.google.com...
> But therein lays the problem.  If the patient is overly elderly you
> can't find a lawyer who will even offer to look into it.  Because an
> 89 year old (even a healthy and vigorous one) has outlived his book
> value it's not worth a lawyer's time.  This leaves me, the layman,
> with medical records that I would still like analyzed for my own peace
> of mind.  Where do I find a doctor who would help me?
>

I have never seen that to be the case. Did you actually talk to a few
lawyers, and they turned you down? Or are you just making that assumption?

First, get the medical records. All of them. Not just from this
hospitalization, but ALL of them. Including the records from his doctor's
office or clinic, and any nursing home records he may have.  No matter what
the state, you should have no trouble getting these records if you are the
next of kin.

Once you have the records, call your state's medical society, and ask them
if they can help you find a pulmonologist/ID specialist to do this work. If
they can't help you with that, the only thing you can do is call around, or
write, and personally ask each target doctor if they will review the
records. To find the doctors, you can look in the phone book, you can go to
your state's medical society and get a list of pulmonologists or ID
specialists. Or you can go to the American Board of Medical Specialities,
look at the section on American Board of Internal Medicine, and search for
pulmonologists, and/or ID specialists. Then call, write, or email them to
find out if they'd be willing to review the records. Look at
http://tinyurl.com/mkg4

You may find some that would be willing to do this, but my guess is that it
will be tough. Not because of any "conspiracy of silence" or such nefarious
thing, but simply due to the fact that reviewing such records is time
consuming, doesn't pay well, and isn't particularly emotionally rewarding. I
review medical records for attorneys all the time. I charge $500 per hour,
same as for medical testimony, and it often takes me a couple of hours to
review a full set of hospital and clinic records.

HMc

From: "Howard McCollister" <hmac@nospam.net>
Newsgroups: sci.med
Subject: Re: How Do I Obtain Review Of Medical Records?
Date: 7 Sep 2003 16:49:05 -0500
Message-ID: <3f5b7893$0$327$45beb828@newscene.com>

"alburma4u" <alburma4u@yahoo.com> wrote in message
news:c35c171c.0309070744.5f9f713f@posting.google.com...
> How do I go about finding a pulmonologist or infectious disease
> specialist to review hospital medical records?
>
> My elderly father passed away after receiving what I suspect is
> grossly substandard care.  I would like to find someone who would
> review the records and render an opinion.  I'm told that doctors
> within a medical community are usually reluctant to do this.
>

I agree with Dr. Riley; the most efficient way would be to contact a lawyer.
He/she will take care of all the details of obtaining all necessary records,
and finding an appropriate specialist to review them. Please do yourself,
and everyone, a favor by hiring a good one; someone who truly specializes in
medical malpractice. Please avoid your run-of-the-mill "personal injury"
attorneys with the full-page ads on the back of your phone book.

Other options: file a complaint with your state's medical licensing board.
They will be obligated to investigate the care your father received and
discipline the doctor involved if they determine a deviation from the
standard of care. Or you can contact the physician's malpractice insurance
carrier and file a claim without engaging a lawyer. In many states, the
carrier is (supposedly) obligated to investigate and pay off on a reasonable
claim if they determine that there has been a deviation from the standard of
care. If they investigate and deny the claim, you still have the option of
getting an attorney and filing a malpractice lawsuit. An attorney might get
you more money, but you will pay him/her a LOT of money.

Whatever you do, be prepared for it to take a LONG time.

HMc

From: "Howard McCollister" <hmacXX@XXcharter.net>
Newsgroups: sci.med
Subject: Re: How Do I Obtain Review Of Medical Records?
Date: 8 Sep 2003 07:28:24 -0500
Message-ID: <3f5c7533$0$97103$45beb828@newscene.com>

"Howard McCollister" <hmac@nospam.net> wrote in message
news:3f5bbce8$0$40607$45beb828@newscene.com...

> You may find some that would be willing to do this, but my guess is that
> it will be tough. Not because of any "conspiracy of silence" or such
> nefarious thing, but simply due to the fact that reviewing such records
> is time consuming, doesn't pay well, and isn't particularly emotionally
> rewarding. I review medical records for attorneys all the time. I charge
> $500 per hour, same as for medical testimony, and it often takes me a
> couple of hours to review a full set of hospital and clinic records.

I should add that, although I review a moderate number of charts in a year,
I have never done so for anyone but an attorney, a liability insurance
company,  a medical board, or a formal peer review organization. I've never
done that for a private party, nor would I be inclined to do so. Nor do I
know of anyone who would. As I said, it will be tough to find a reviewer
outside of the conventional channels I mentioned.

HMc

From: "Howard McCollister" <hmacXX@XXcharter.net>
Newsgroups: sci.med
Subject: Re: How Do I Obtain Review Of Medical Records?
Date: 8 Sep 2003 07:21:41 -0500
Message-ID: <3f5c7364$0$30069$45beb828@newscene.com>

"PF Riley" <pfriley@watt-not.com> wrote in message
news:3f5c194d.44269684@news.nwlink.com...
> On 7 Sep 2003 16:49:05 -0500, "Howard McCollister" <hmac@nospam.net>
> wrote:
> >
> >Other options: file a complaint with your state's medical licensing
> >board. They will be obligated to investigate the care your father
> >received and discipline the doctor involved if they determine a
> >deviation from the standard of care. Or you can contact the physician's
> >malpractice insurance carrier and file a claim without engaging a
> >lawyer.
>
> And I would stress that in either case (contacting the licensing board
> or insurance carrier) that you be very specific in your allegations,
> with details about what actions or inaction were deviations from the
> standard of care, and how you believe such actions or inaction of the
> medical professionals were the cause of your father's death. Do NOT
> complain simply that he died while under their care. In our society
> now, some people tend to believe that they have hit the jackpot when
> misfortune befalls them, especially if there is someone who they
> perceive has deep pockets. This can occur when a family member dies as
> the survivors go through the stages of grief, one of which is blame,
> i.e., whom do I sue?
>
> And remember also that filing a complaint against a doctor does leave
> a near indelible mark on him for potentially the rest of his career.
> Because of this, some doctors are actually countersuing for frivolous
> lawsuits, so please make sure that, despite your assumption that an
> 89-year-old patient is not worth a lawyer's time (because this is not
> true), the reason the lawyers are turning you down is not because
> there was indeed no tort that occurred.
>

I don't know...that's not exactly how it works in this state. No record of
complaints is maintained by the board of medical practice unless the board's
investigtation finds merit in the claim and actually takes some kind of
sanctioning action against the doctor. The patient can complain to the
board, but it is the board that will then review the complainant's
assertion, and investigate only if they find merit. That investigation is
conducted by the board (usually with the assistance of an outside contracted
reviewer), and the complaint (if merit is found) is filed by the state
Attorney General. The doctor will then have the opportunity to defend
him/herself and the board will either dismiss the claim (in which case there
is nothing on his/her record) or sanction (in which case there is a record
which is published, maintained, and sent to the National Practicioner's Data
Bank). If the complaint is dismissed, all of those records are  sealed and
non-discoverable.

There have been instances where, even if a non-meritorious compaint is filed
with the board, dismissed, and the doctor's reputation left unsullied, the
doctor has indeed countersued the complainant for Abuse of Process. In the
case of Board investigations, that's a tough case to try, however, and
success rates are low. Doctors are having substantially more success
countersuing where civil cases are filed and unsuccessfully tried. In that
situation, all proceedings are a matter of public record.

HMc

From: "Howard McCollister" <hmacXX@XXcharter.net>
Newsgroups: sci.med
Subject: Re: How Do I Obtain Review Of Medical Records?
Date: 8 Sep 2003 09:04:05 -0500
Message-ID: <3f5c8bb8$0$286$45beb828@newscene.com>

"Richard Cavell" <richardcavell@mail.com> wrote in message
news:YW_6b.89191$bo1.22838@news-server.bigpond.net.au...
> "Howard McCollister" <hmacXX@XXcharter.net> wrote in message
> news:3f5c7364$0$30069
>
> > I don't know...that's not exactly how it works in this state. No
> > record of complaints is maintained by the board of medical practice
> > unless the board's investigtation finds merit in the claim and
> > actually takes some kind of sanctioning action against the doctor.
>
> In Melbourne, the Practitioners' Board publishes names of all the doctors
> who've had serious complaints made about them, plus the nature of the
> complaint, and the findings, even if the doctor was cleared of wrongdoing.
> It is mailed to every doctor in the state.  How's that for professional
> reputation going down the drain for a frivolous accusation?  On some
> allegations, particulary the sexual ones made by females against male
> doctors, some of that mud *has* to stick.

Ack!!


> Making a complaint really does harm the doctor concerned.  It's been
> shown time and time again that it harms a doctor's reputation, massively
> increases their stress, and causes an enormous bother when they simply
> can't "win" other than to not lose.  It's a good reason why complainants
> shouldn't be frivolous in their claims, which unfortunately many are.


I don't know if it works that way in other states in the US, but in this
state they recognize that frivolous or malicious complaints can be filed and
apparently they take the approach of "innocent until proven guilty".

HMc

From: "Howard McCollister" <hmac@nospam.net>
Newsgroups: sci.med
Subject: Re: How Do I Obtain Review Of Medical Records?
Date: 10 Sep 2003 09:16:13 -0500
Message-ID: <3f5f31a7$0$94068$45beb828@newscene.com>

"alburma4u" <alburma4u@yahoo.com> wrote in message

> -And if such a discrepancy cost a man his life (ie he *may* have had a
> shot at getting out of the hospital) should it cost the doctor his
> medical license?
> I don't think there is an ombudsman per se but the hospital did offer
> to have a meeting with me.

I would take them up on that on the possibility that they will be able to
address your concerns without the same degree of entrenched hostility that
you say you've encountered from the doctors that were taking care of your
father Often, these situations are more the result of misunderstanding due
to poor communication. They may agree to have it reviewed by an outside
reviewer. The problem you may have is that even if they agree to have it
reviewed by an outside reviewer, that  review and opinion will fall under
the category of peer review and as a result will be privileged and
non-discoverable. They won't be able to share anything about that review
with you, nor even with your attorney. They would have to be very careful
with what they could tell you about such a review, since if they tell you
*anything* about it, an attorney could make a case that they have to tell
you *everything* about it.

Nevertheless, you may find that clearing up any communication problems
*might* give you the peace you are looking for. Given the intransigence of
the attorneys you have talked to, your only other option would be the rather
unlikely chance that you can find a qualified specialist to review the case
for you.

HMc