Did you bring a note ?

Back in the old days when you got sick and ended up in the hospital, it was probably because your primary care doctor put you there. Boy, have things changed.

Nowadays you have one set of doctors who see you in the clinic when you’re doing well, another set of doctors who see you if you need emergency care, and yet another set of doctors who take care of you if you become hospitalized . Many times these “hospital” doctors know little, if anything, about you except what they observe right there on the spot and /or what they can read about you from prior admissions. If you receive your medical care at a huge teaching institution like I do, it gets even more impersonal, because you have multiple teams of student doctors and residents that rotate through the system a every 3 or 4 months. Chances are, you’re gonna see a different doctor every time you go in.

This system seems to work fine if you’re generally healthy and don’t need frequent medical care, but if you have a complicated medical history and don’t fit the mold ( like yours truly), then things can get a little frustrating…especially in the Emergency room.

That’s when I thought, there has to be a better way to communicate to medical staff who dont know you. So I came up with what I call the “patient intro letter” comes in. More and more patients and/or their Physicians are writing these kinds of letters for their medically complex patients (not just severe asthmatics) to carry with them. If you ever end up having to go to an Emergency room ,the letter basically introduces you to the staff and provides the physician with some basic information about current health problems. It can save you from having to recite your entire medical history over and over again to people who don’t know you ( this is especially helpful, when you can”t breath). It can include valuable information on what seems to work best in treating your condition.

The latest rendition of this letter was just updated a few days ago and is the actual letter I bring with me to the ER . I update it anytime something changes, including new medications, treatments or new diagnosis. The key to making this kind of letter effective, is to keep it short, sweet and to the point. The nurses like these kinds of notes as much as the doctors do, because they can use them to relay info to the caregivers working the next shift.


Hosp note 2016

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2 Comments

  1. Matt says:

    This is a great idea. Mine is more like a booklet with different subheadings, in order from vital information (name, DOB, hospital number, allergies, meds) through information I always get asked (peak flow zones all colour-coded, normal heart rate as I have tachycardia) and important notes (don’t wheeze, sats always good, please check airflow).

    Then things which are worth knowing or I might want to communicate when I can’t speak (where is best to get a line in, what size is usually best, I need to sit upright), meds I don’t respond to (most painkillers, anti-emetics, antihistamines), and those I am not allergic to per se but absolutely must not be given (NSAIDs apart from aspirin, and opiates).

    A list of recent or important medical admissions and any highlightable outcomes (was I with CCU, did I have any attacks while I was hospitalised, any new conditions such as SVT or IDA), and previous surgeries again with complications and outcomes noted.

    I have a brief list of notes which may help them understand me better such as I have a high pain tolerance and tend to remain calm and cheerful even in extreme situations (the sheer amount of times this has come up…when I was in surgical triage before my appendicectomy/tumour resection, they asked me to scale my pain and I said ‘3’. The surgeon saw me after the operation and effectively called me a liar haha). I am looking at a career in medical research or medicine and am quite knowledgeable about asthma and its treatments and pathophysiology. I can sort my own oxygen flow rates, neb liquid, and needy beepy machines or my dad, previously a medical physicist, can if I am incapacitated. I have Asperger’s so to cope with pain or breathing difficulty or nausea I often put in earphones although I will take them out if someone comes in. I also request a couple of inches of tape for each cannula to keep it from dangling everywhere.

    Lastly comes notable family history/stuff that runs in the family, such as cancer and Type II diabetes, and two ICE numbers: my dad’s, for most weekdays, and my mum’s for the evenings she doesn’t work.

    It’s long but it sure is helpful!

    • Hi Matt, I try to keep the intro note short and sweet, because #1) most doctors will only spend a few seconds to read it, and # 2, assuming that youve been to the same hospital previously, most of your medical history are probably already in the electronic medical chart.

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