TBTAM’s Healthcare Team Tips for New Players

In my last post, I complained that I sometimes feels like I am a one person health care team. What can I say? I had a bad week.

The truth is, the overwhelming majority of my patients are doing more than their part playing on our little healthcare team. In fact, they do most of the work keeping themselves healthy. They exercise, eat right, take their meds, and get their paps and mammograms and colonoscopies. And they ask me what more they can do to optimize their health.

With patients like these, all I am is a coach who doesn’t do much more than stand on the sidelines, occasionally acting as a relief pitcher or pinch hitter for them when the score gets close, sometimes bringing in reinforcements when our opponents are tough. We play well as a team, and usually we win the game.

If you’re just joining my team, I’ll need to know a little bit about you. Here are a few tips from the playbook so you know what I need. Feel free to ask me for what you need. After all, we’re a team.

TBTAM’s Tips for New Patients

1. If you are coming to see me for the first time, bring your old records. If it’s a big pile, that’s fine. I may not have time to review it during your visit, but I promise I will later when I have time.

2. Keep a current list of your medications. Include drug names and doses, and update it before every visit. Include herbs and vitamin supplements. An index card or word-document on your computer is fine. Give me a copy when you come in. Make sure your name, birth date and today’s date is on it. You don’t have to write it all down again on my intake form – just say “See attached” and I’ll know what to do.

3. Know when you last had a mammogram, colonoscopy, bone density and pap smear. If you brought your records, it will be in there. Keep track of these things on an ongoing basis.

4. Keep copies of all your test results. When you have a test done, I will send you a copy. Ask your other docs to do the same. After all, it’s your result.

5. If you are having a mammogram done at a new place, you’ll need to bring your old films. Just call your prior radiologist and ask for copies. Pick them up or have them sent to yourself, not me or the new radiologist. Then carry them yourself to your visit. This avoids things getting lost or misplaced.

6. Know your family history. Things you’ll want to ask your parents about are cancers in the family, birth defects or major pregnancy complications and diseases that run in families like diabetes, thyroid problems, hypertension, blood clots, strokes, heart disease and neurologic diseases. Write it all down somewhere so you’ll have it. If someone has had breast cancer, find out if it was pre-or post menopausal. If they’ve had colon cancer, find out how old they were at diagnosis. Not all families talk about these things, but find out what you can. It’s important.

7. Keep a menstrual calendar. If I ask for the date of your last menstrual period, the exact date is not so important unless you are pregnant, so just ballpark it for me.

8. Keep track of all your surgeries. Again, a card or printed word document list is fine. It really is important for me to know if your appendix and ovaries are in or out. If you ever have surgery, ask your surgeon for two things – the op note and the path report. If you had post op complications, the discharge summary from the hospital would also be helpful. Bring these with you to your visit with me and I’ll scan them into my chart. If we’re both lucky and your surgery was at my hospital, this is unnecessary as I now have it all ONLINE!

Which brings me to the topic of the online personal health record.

The Online Personal Health Record

Wouldn’t it make this entire post irrelevent and obsolete? Should you have one? The answers to these questionsa are “Yes” and “I’m not sure”.

There are multiple OHR’s cropping up out there. Here are just a few that I found googling “online health record”-

iHealth Record
Health Records Online
Microsoft’s HealthVault
Web MD’s Personal Health Record

And at least a dozen more. Not to mention the eagerly awaited Google Health.

From what I can see, these programs seem to be a very good way for you to organize your personal health information in one place.

But unless they interact with my EMR, they’re not going to save me much time and effort, except that they allow you to answer my questions more easily. I still need to organize your data according to my own EMR system. I know some EMRs have an an online patient component to them, but mine does not (yet). And so your online health record is unfortunately not a substitute for my well-taken medical history. But bring in print outs of what you’ve got, by all means.

I’m no tech expert, so I won’t speak to the issues and potential solutions related to privacy of these online records except to say that I started to fill one out for myself, then stopped almost as fast as I had started. I did not like the idea of having my personal health info out there on the Internet with some vendor. I know that most of it is out there already, but it’s scattered around at my hospital and my insurance company and you don’t necessarily know where that is. But you will sure know where it is if we all put it on Google, won’t you?

And that scares me just a bit.