The first thing the doc said when he walked in was “You’ve lost a bunch of weight!”. I was 257 on the scale. I was wearing some colorful shorts and a T-shirt he’d seen me in before, right before I started keto. I told him to hold my beer and watch this, fluffed out the shirt to show how loose it was, and then untied the drawstring of the shorts and pulled out the waist. At 63” the shorts would stay up untied; at 48” a skinny person could climb in there with me.
He saw I had the usual file folder with me. “What did you bring me this time?” and reached over and grabbed it. It was why I was there, what else I wanted to talk about, recent medical history, and this time a fresh health spreadsheet.
This was the first time I got to go over the health speadsheet with him. I’d left a couple of earlier ones at the front desk for him when I started doing them, but this is the first office visit since then. He’d just glanced at them and had a clerk scan them into my electronic record. I only printed out the last six months this time.
I unrolled the spreadsheet and taped it to the door. (yes, I brought my own tape…) It was two feet wide and four feet tall. “Yes, I know this is just a wall of numbers, but here at these gaps are the monthly averages… skip down and you can see how blood pressure has dropped, pulse pressure is mostly the same, lung capacity is up, weight is down, these are the BMI numbers, this stuff is all from the CPAP machine….” I gave him a sheet with explanations of all the columns in case my homemade abbreviations weren’t clear.
I should have printed out another lab sheet; I didn’t because I hadn’t had any more labs since I’d dropped off the last lab spreadsheet, but they’d cut it up and scanned it in. Having someone find the files, print them, and tape a copy together wasn’t worth the time.
The cardiologist thought the spreadsheets were wonderful; the doc sees where they can be useful, but it’s not a format he’s familiar with, and I think he found it slightly confusing. I pointed out that he could simply ignore the majority of the information; he only needed to look at the six monthly average lines; he only needed to look at the rest if something looked ‘off’.
The lab sheet would have been much better to use, where he could see all the labs at once instead of switching between multiple files on his computer and paper files for the older stuff.
We had a talk about looking at printed sheets vs. panning around in an Excel window, and a discussion - well, mostly me trying not to lecture - about data security. I probably sounded like some kind of paranoid anyway. There’s a certain amount of information his office has, that I can’t do anything about. Thirty years ago, that was all between me and my doctor, and any nosy staff who had time to poke around in the files. HIPAA was sold as a “medical privacy act”, but basically what it did was open up patient records to, basically, any government official, and make it legal for medical practices to “share” patient information with “partners”, which are generally the insurance companies and drug manufacturers. In recent years Google and Amazon have gotten into the healthcase business, and they’ve made serious inroads into medical IT, primarily their “cloud storage” products, though Amazon is now pushing toward patient care too. You can trust all that data is safe and secure in Google’s hands, anon. Almost as safe as letting a junkie hold your stash while you’re on vacation. Selling data is their *business*.
I worked in medical IT in the 1990s, right when HIPAA came in. There was a lot of WTF! involved.
“Doctor-patient privilege” is stone dead in the 21st century. Most people don’t know that. And their offices leak confidential information like a busted rubber.
But if he wanted the data anyway, I’d be happy to give it to him. As far as I know there’s nothing there that an insurance company could use against me. He said the paper sheet would be fine; he seemed more amenable after I told him to just throw them away after he looked at them and I’d bring a new one each visit.
Anyway, he carried the sheet into his office and taped it to the wall as I was leaving, so maybe he’s coming to terms with it.