This advice to scrutinize one’s own medical records is more appropriate for physicians than laypersons, because as physicians we often know what is important and what is not. An incidental nodule on a CT may be important, but an “abnormally low” serum lipase is not. With this new access to medical information, patients often become unnecessarily anxious about irrelevant or insignificant things that the computer has flagged as statistically abnormal.

A Rube Goldberg situation ensued when I was transferred between hospitals with incompatible electronic medical record systems. The physicians at the receiving institution could not easily access many of my test results from the referring hospital. In contrast, I was receiving real-time notifications from its patient portal, which I would dutifully report to my physicians on their morning rounds.

Medical Errors Don’t Just Happen To Other People

The frequency of medical errors is high enough that you or someone close to you will likely be on the receiving end of one.³ Several years ago, about to undergo arthroscopic shoulder surgery, I told the anesthesiologist that I was not feeling any effects of the brachial plexus block that he had just administered. He responded that the onset would take a few more minutes, but before I could insist that there was a problem, I had been injected with propofol and was unconscious. I emerged from anesthesia with excruciating shoulder pain due to the complete lack of regional anesthesia.

In my own extended family, there has been a metastatic spread of melanoma following a misread skin biopsy, mismanaged care of a tibial-fibular fracture in a teenaged athlete resulting in a malunion, a death from semi-elective surgery, and a misplaced breast biopsy sample that degraded before it was located. Many of these occurred at “world class” institutions. Even the best physicians at the best hospitals can make mistakes.

I even uncovered a more sinister side of medicine. A relative told me that she was newly diagnosed with severe aortic stenosis because on her initial visit with a gastroenterologist, he had listened to her heart and heard a murmur. I took this to be prima facie evidence of primary care negligence and advised her to switch primary care physicians (PCPs). She then confided that her PCP routinely made inappropriate comments about her breast size while ostensibly listening to her heart. Until then she had been too ashamed to tell anyone. She filed a complaint, and the PCP was professionally sanctioned.