Patient Access to Medical Records
Recently I was asked to interpret a CEA from a person who had undergone chemotherapy for cancer. The question was what to do about a CEA that was 5.0 and had increased to 13.0 in less than a year. It appeared that these values had NOT been discussed with the patient, but the person had accessed the data without discussing them with the physician.
The question that this raises is are there times when laboratory results should not be given to the patient without the clinician physically present? I asked a friend of mine who was part of a cancer clinic. Here is what she had to say about this dilemma: "At my cancer center, the lab is not allowed to give results directly to the patient. We used to, but the doctors got tired of patients seeing results before they reviewed them. The docs would get frantic calls from patients that had a change in a tumor marker and the doc would not have even seen the result yet! So they instituted the rule that the lab could not give results out directly to the patient. We had a lot of upset patients because they felt that they were their results, their medical record, and they had a right to see them. But at least they weren't getting results without the accompanying explanation from a physician."
This situation is not isolated to one cancer center, but I am sure is to be found in many cancer centers as well as in primary physicians who order PSAs and other tumor markers. It has been my experience that HIV screening results were given before the confirmatory results were available. Think also about genetic testing.
Without doubt there are many unanswered questions about access to medical records.