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Tomaino Arm Care Network

Dr. Tomaino's Blog

It's Your Arm. You are Entitled to Know.

July 24th, 2011
I saw a patient friday for a second opinion about her clavicle fracture, which she sustained 1 month ago after being bucked from her horse. At her first appointment she was heavily sedated on pain medicine, told a sling would do, and asked to come back in another month.


When she returned to see her doctor she had a number of questions, and was understandably preoccupied with her injury because she works with her hands, and her ability to make a living revolves around regaining optimal function. When she asked to see her x-rays, however, her doctor declined--reiterating his plan to treat her nonoperatively. This patient's dissatisfaction prompted her toget a second opinion. In fact, her x-rays revealed a completely displaced and comminuted clavicle fracture, and I shared with her the pros and cons of surgically fixing it. She was pleased to see the x-ray (which she was entitled to see from the outset), and actively participated in her treatment plan--electing operative intervention.


This encounter reminded me of two conversations I have had recently with colleagues.

One mentioned to me that he does not think that patients should beable to watch surgical videos on YouTube or individual websites. When I asked why, he did not have a cogent answer, except to insinuate that he thought such videos for public consumption amounted to shameless self-promotion. I got the impression that he felt that seeing the surgical video,in his mind, was for "doctors only."

The other chuckled about a patient who sent him an email with a few questions after having seen him in the office. He seemed incredulous that a patient would actually have the expectation that their doctor would answer an email.


I find these 3 examples disturbing---and emblematic,I fear,of what is to come as "Health Care" becomes increasingly scaled up and institutionalized. As a patient myself, I don't think it's expecting too much to have access to information about my condition--including evidence-based articles, surgical videos, and x-rays. It does not mean that I don't trust my doctor. Simply put, we are entitled to have this access! Transparency should mean that we can use all and every bit of information tohelp us participate in our care.


What do you think?

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