Monday, March 31, 2014

Medical History Recited: Problems & Solutions (Part 1)

A life project of mine is to piece together the entirety of my medical record.  It worries me that I don't know my exact vaccination history or my whole family's medical or mental health history. I cling to the most essential pieces of information so that when I see a doctor I can retrieve information relevant to whatever situation has brought me in.  Quite honestly my doctors and therapists will never learn about most of my medical and mental health history, which I have filtered out and judged to be irrelevant.  Admittedly this doesn't sound like the most responsible way to manage my health, but I'm willing to bet that millions of Americans, especially young adults, will relate to this kind of decision making.

At 29 years old, my choice of credit cards has proved far more stable than my medical insurance or primary care physician.  To date, I have met my primary care physician once, a situation which feels par for the course in my adult life.  Thanks to the fact that my dad held the same job until I was 18, my experience with doctors as a minor was remarkably consistent.  In college, I got my care from the university, and once out of college, my experience has been like a pinball, bouncing from doctor to doctor, trying to get only what I need in the moment.

When I meet a new health care provider, not only would it be impossible to give my whole medical history and painfully inconvenient, deep down, I know I will probably end up at another doctor soon enough asking me the same questions, so why bother.  As I am sure others would attest too, it takes me no more than the 15 minutes I am asked to arrive early to sign off my entire medical history.

As a behavioral health professional, I watch my own way of navigating health and mental health care, and I can't help but feel sorry for my clients whom I require to answer the same litany of questions.  Surely they are withholding information from me, so what should I do?  Do I get a consent to track down their chart from their last provider?  What if they withheld information from that provider too?  Is it really worth the money to be faxing?  Why on earth are we still relying on fax machines!?

Americans are great at criticizing the status quo of health and mental health care.  It's not hard to do.  But what can we do within the constraints of our patchwork system to make things work better?  Stay tuned next week for solutions in part 2.

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