Ken Farbstein is a professional patient advocate and president of
Patient AdvoCare. Below, he shares two excerpts from his new book,
"Getting Your Best Health Care: Real-World Stories for Patient Empowerment,"
which he shared with the audience at
My dog Jackson had a well-dog checkup recently with his veterinarian.
A month earlier, we had received a postcard reminding us that he needed certain vaccinations and was due for a yearly checkup. Does your doctor's office remind you?
When I phoned the office to make an appointment, they asked me my last name, and looked up his record on the computer so they could verify for me which
shots he would need, and what the purpose of the visit would be. Would your doctor's office do that?
Knowing he'd need a fecal test, they suggested I bring in a (poop) sample, and gave the necessary instructions. They entered the information into their
computer scheduling program.
At the visit, much of the equipment was not much better than that of a doctor's office: a stethoscope to listen to his heart, a thermometer to measure
his body temperature, a digital scale built into the floor, a pair of highly trained hands and eyes for the physical exam.
At the end of the visit, the vet handed me an individualized, four-page, neatly formatted and typed summary of what he had found, for each bodily
system, with his advice on diet, exercise, and hygiene, a thumbnail photo of Jackson, lab test results and their interpretation, and target dates and
types of future vaccinations. Does your doctor routinely do that?
At check-out, I also received a receipt and itemized bill, which clearly named on an 8.5 x 11 inch sheet each shot and service Jackson had received,
and showed the name of the receptionist, phone number, and future vaccine and exam dates, to keep for our records. Does your doctor do that?
They even advised on the preferred flavor of the toothpaste for daily brushing: poultry.
Advice for people searching for a doctor: Find a doctor who uses an Electronic Medical Record to educate patients and themselves about the care you
It's your medical record, but you can't see it
Two of my encounters with the health care system yesterday ranged from the sublime to the ridiculous. First, the sublimely good one: I went to our
veterinarian's office to buy some toothpaste for my dog. When I asked for it, they asked my last name. I was given the toothpaste, and I paid for it.
With the receipt, the clerk handed me a one-page printout listing the dates for Jackson's next well-dog checkup and the next three years of
immunizations, with his photo and name, address, and owners at the top of the page. I was delighted: without my even asking, they gave me tailored
information to keep my beloved pet healthy.
Then, later in the afternoon, the ridiculous. I brought my daughter, to see a sports medicine doctor for a minor issue. I asked the clerk to see her
medical record. They couldn't give it to me. Why? For privacy reasons. Whose privacy?!
"Well…it's policy, so we can't."
Why did I want it? To do my homework in advance and to save the doctor's time during the appointment.
Following their procedure, I filled out a paper release form, to be handled by Medical Records. Could I fax them the release, and have them fax me the
record? You'd need to call Medical Records for that. OK; I called, but could only get a recording that said they'd need 7 to 10 days to mail the
doctor's progress note to me. I talked to the Practice Administrator. I couldn't get my daughter's record in advance, nor could my daughter. Well,
whose record is it? It's yours, but our policy says you can't see it. Who set the policy—the Director of Nursing? No. The CEO? No, a committee. They
had me; I was stumped, and we both knew it. Those were the magic words: "policy" and "committee." That meant logic and reasonableness wouldn't matter.
Advice for dealing with a very old-fashioned medical system: To get "your" medical record, either keep a copy of the doctor's last note about your
visit, or ask your doctor's Medical Records unit, two weeks in advance, to send it to you.