Health Care. Part I, Medical Records.

It is hard for me to understand the aggressive idiocy demonstrated by the many people who have come out in general opposition to health care and insurance reform. I admit, I've been distracted this summer by needing major surgery and a diagnosis of cancer. Up until this posting, I've said more about that on my Star Trek blog than on this one.

Most states require hospitals to treat people in their very expensive emergency rooms, which means that we all pay, through our own health care, for everyone's health care. Getting the less well-to-do into clinics or doctors' offices saves everyone money. It's not like people are left bleeding in the streets now, then thrown into potter's graves, and if we have health care reform we'll have to pay for them. It's more like they are bleeding in the emergency room at $1000 a pop now, and we'll have to pay $100 for the same problem in a clinic.

Electronic medical record keeping has already been passed, and that's a blessing. Let me share my own medical record keeping problems with you to explain.

When I was in my 30s, I needed surgery for a grapefruit-sized cyst on my ovary. We didn't know what it was made of. It could be dried blood or cancer. It turned out to be the first. It gave me early menopause, barely into my 40s. Then, in December of 2007, when I was 52, I started feeling a little weird down there. I had never previously asked my gynecologist of 22 years, Dr. Jay Bauman, for an extra test. But I did then, since I was concerned about cancer. I had purposely lost 50 lbs, but it had come off too easily, and my stomach didn't go down at all. He told me to do sit-ups. I concluded my concerns were without merit, but that he was rude and I would get a new doctor. But I still wanted that test. My mother had died of cancer, and my father's mother was one of four sisters, three of whom got cancer of the reproductive system. I wanted to be tested for uterine cancer. My grandmother had had it. So I selected a doctor who made a hypochondriac woman I know happy. The new doctor put off my appointment for six months but was willing to do a biopsy when she did see me. That lead to the removal of my cancer, which was found not only in my uterus, but also in my fallopian tubes, earlier this month.

When I was preparing for the surgery, it was clear that records of my prior surgery were relevant, and I asked Dr. Bauman's office for their files. I got a photocopy of only the files in the last 12 years, which did not include the relevant surgical data, and they were in shorthand, unreadable to my new doctor. In other words, they did not comply with New York law about providing my medical records, and even if they had, I would have had to hire a secretary to read them.

If this does not make a case for standardized medical record keeping, I don't know what does. I'm sure I told Dr. Bauman of my family history of cancer when I first came to his office over 22 years ago. We were dealing with a grapefruit sized growth and he did the surgery. He clearly had purged the files. Lacking those files, he made a bad judgment, refusing me a test. That refusal may still cost me my life.

Of course, it would have been impractical for medical records to have been kept electronically in 1987. But there is no reason for this to be repeated 22 years from now, for somebody else. And, under the one part of Pres. Obama's health care package, which has already been passed, it won't be.

EDIT: It shows the sad state of medical research that a cousin of mine who recently become a doctor informed me that even though the rate of uterine cancer in my father's family (yes, she's in my mother's family) is over 50 per cent among the women of prior generations, it's a 'rare cancer' and therefore my original doctor was 'correct' to refuse to run a cancer test. Of course, that correctness may have cost me my life (TBD). It is simply nuts that the issue of whether a cancer is common or not is determined by studies in the general population and not effected by family history. I realize that genetics is not yet advanced enough to spot special markers, but come on people! Does science ever get to the point they can spell the word, "obvious."

NEXT TOPIC: Health Care Proxies, Living Wills, DNRs, and "death panels."