Do You Want to Know What Your Doctor Really Thinks?

Many patients may only see their treating physician for a few minutes as the doctor explains the diagnosis and recommends a course of treatment. Those few minutes may be the only time that the patient will be able to communicate directly with the doctor, ask important questions and discuss concerns. But what if there was another option?

Three medical centers in Pennsylvania are piloting a communication tool that is used by doctors and patients to record and communicate about the diagnosis. The tool is called OpenNotes and it allows patients to view the doctor's notes after a visit or physical. The patient will receive an e-mail after the visit and can enter a secure online portal to view the notes the doctor took during the exam.

Will OpenNotes Improve or Compromise the Doctor-Patient Relationship?

At first glance, more communication between doctor and patient would only seem to improve the relationship, and patient care, in turn. But some doctors worry that patients will be offended by the comments they read in the doctors' notes. Doctors routinely write notes relating to the patient that document conflicts about diagnosis, options for treatment that they may decide against later, and honest observation about the patient's progress that may be hurtful or harmful to the doctor-patient relationship. Some doctors do not want these observations to interfere with their ability to work with the patient or to be second-guessed as to the course of treatment the doctor ultimately decides to follow.

But in some cases, patient access to the doctor's notes has improved patient care where patients have caught mistakes or omissions in the notes or have taking the doctor's observations constructively, such as by finally dropping the 30 pounds that the doctor has been recommending for years.

OpenNotes may not be a system that works for every patient or every doctor. And some patients may not have complete access to OpenNotes because they do not have access to the Internet or are not fully literate. It remains to be seen whether the OpenNotes experiment will continue with other doctors and patients or will go by the wayside as a good, but ultimately unhelpful, medical innovation.