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  February 29, 2012


In The Name of ALLAH The Almighty

Should Patients be allowed to View and Possess Their Own Medical Records?

Patients should or should not be allowed to view and possess their own medical records is a controversial issue all around the world and different countries are working on it. Some countries like various states of United States of America, Norway and United Kingdom already have it in their law that people are allowed to view their own medical records and this was being added in the UK law named “access to medical report act, 1998” whereas in Pakistan, viewing and possessing the medical records is not permitted. The test reports, on one hand, are accessible but the doctor’s notes and in patient medical records are not available to the patients. Patients should be allowed to view and possess their own medical records because it augments practicality, enriches client doctor relationship, and supplements health.

Firstly, viewing and possessing personal health records augment practicality of the health care. It cuts off costs of the institute for instance when there is lots of paper work, more and more medical record staff is needed to handle that paper work (Gilhooly & Mcghee, 1991) whereas, if the patients would be allowed to possess their own records, the medical record staff would be cut off and hence, the hospital or the institution would have to pay lesser and subsequently, patient cost would be reduced. Moreover, many people prefer house calls (Gilhooly & Mcghee, 1991) and have to call doctors at their home for either emergency purposes or convenience. Unquestionably, in patient data is not accessible and available to the patients in Pakistan, so the house calls are not worth it since proper medical history is not obtainable. In other words, possession of medical records would supplement more house calls which subsequently would help people, for whom it’s hard to mobilize, to a care facility. Moreover, it would also augment high profile people to acquire holistic health care at home. Furthermore, if the client wants to shift to another health care provider, for instance across the world, it would be more feasible and less time consuming with one’s own records in hand then getting it transferred from the institution (Gilhooly & Mcghee, 1991). In case of general physician; it is hard to explain them why actually we want to get the transfer or a second opinion and hence, client doctor relationship is endangered (Teutsch, 2003). Regardless of all the positive points associated with practicality, there is a fair possibility that patients might lose their records if they hold the only copy (Gilhooly & Mcghee, 1991). Moreover, the paper on which the records are maintained is the possession of the organization (Gilhooly & Mcghee, 1991) and it might be costly for the patients to get it (Delbanco, et al., 2010) but on the contrary, (Tufo & Speidei, 1971) have found out that many a time, even hospitals loose the records or are unable to find it on the time of the consultation. moreover, Ali & Kuroiwa, (2007) study conducted in 170 health care facilities in Pakistan found poor record keeping and lost records. One example of this is Kennard’s study (1985) which clearly highlights that out of the 500 parents given the authority of the records, not even one of them lost it. Moreover, the patients are saving money on one hand from paying lesser to the institution, that money can be compensated here.

Secondly, possession of one’s own medical records enriches client doctor relationship. It adds on to the confidentiality since if the records are with the doctor or with the institution, there is a fair chance that they might be over seen or leaked by the administrative and other non health care staffs working in the health settings since they are not under the oath of confidentiality (Gilhooly & Mcghee, 1991). There is also a reasonable possibility that those records would be used for the research purposes without being informed to the patient (Miller, 2008). Furthermore, the client doctor relationship is also enhanced when the doctor takes the time to explain his notes to the clients since it is very difficult for a lay men client to understand the medical terminologies all by himself (Wibe, Helleso, Slaughter, & Ekstedt, 2011; Teutsch, 2003). As a result, when more time is given to the patient, the patient is more satisfied and the communication between the doctor and the client is enhanced (Teutsch, 2003). Moreover, queries are resolved due to this open communication and patient education gets promoted. In contrast to the positive aspects, for some patients, it might just be anxiety provoking to read those notes. The doctors, in turn, would have to be more careful in what they document for patient would be reading it, hence, more time would be required for documentation. In contrast, Fewer errors would take place if the doctors would be more careful, hence, adding on to the benefits for the patient (Teutsch, 2003).

Finally, possession and viewing one’s own medical records supplements health (Delbanco, et al., 2010). The patients could easily pick out and correct the inaccuracies in their records since many studies have highlighted (Delbanco, et al., 2010; Wibe, Helleso, Slaughter, & Ekstedt, 2011; Teutsch, 2003) that there are many inaccuracies in the documentation. This correction in the inaccuracies would decrease the anxiety of the patients of what the doctor actually thinks of their medical conditions. Knowing about the medical conditions would increase compliance of the patient since now he is aware of the options available and his prognosis (Delbanco, et al., 2010). This would make the client more autonomous to his treatment and enhance the self-efficacy and adherence. In contrast, the medical jargons might cause distress in some patients (Teutsch, 2003). Likewise, it would not be helpful for the patients who are on placebo (Gilhooly & Mcghee, 1991) but placebo is questionable on ethical grounds and its use is controversial and is a dilemma in itself (Schindel, 1978). In the case of medical jargons, patient would seek help from their doctor in understanding, thus getting reassurance which would supplement health (Wibe, Helleso, Slaughter, & Ekstedt, 2011).

From the above arguments, we infer that the ownership of own medical records can bring about tremendous changes in the health care in terms of space, cost and personnel. Likewise, the receiving end could practice their autonomy more conveniently and gratify their individual wellbeing by using their medical records for their wellbeing in a more convenient manner which would enhance their quality of health by providing more options for the betterment of their quality of life. Hence it can be concluded that patients should be allowed to view and possess their own medical record since it is more practical, enhances patient doctor relationship and improves health. In Pakistan, this law should also be introduced that everyone should be given this opportunity to decide for their own selves whether to keep their own medical records or to let the hospital keep it for them. This decision should also be autonomous since everyone has a right to decide for their own health. This would be an important milestone of the movement of Pakistan from being a developing country to a developed one.

Sadaf N. Huda
Aga Khan University School of Nursing Karachi



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