Thanking The Doctor, Not The Chart

Part 4 of How to Thank A Doctor:

"How do I avoid my thank you note being scanned into my medical records?"

Doctor D recently got an email from a patient who was horrified to find that a thank you note she wrote her doctor had been filed in her chart. WTF? Why the heck would a doctor stick a personal display of gratitude in the chart with a bunch of lab results?

Yes, we doctors are kind of obsessive about our records. The record is supposed to log every interaction we have with our patients. Most docs don't count a thank you note as a medical encounter, but some docs are just going to err on the side of being anal and put anything in there. (It's not our fault that we are meticulous about records. We live in constant fear of lawyers who are out to use medical records to destroy us.)

One question you may want to ask yourself:
Is is so bad to have your thank you note on the medical chart?

It may be odd, but it usually isn't a real problem? Unless your note is creepy, having a note on the chart makes you look like an awesome person to anyone who sees the chart later.

But if you are a private person who doesn't like your feelings being preserved in a permanent record there are a few strategies you can use to keep that Hallmark card out of your chart:

• 1) Don't mention details of your treatment or symptoms: Just stick with your feelings of gratitude. If you say, "Thank you so much doctor, but I just wanted you to know that since my treatment I've had this funny tingling in my fingers..." then you have just asked about your medical symptoms and therefore an MD is legally bound to keep record of these symptoms—usually by scanning the entire note into the chart. Keeping off the medical stuff will avoid forcing your doctor's hand on this.

• 2) Ask to keep it off your chart: Most doctors want to respect your wishes. If you say "don't file it" then as long as it isn't very medical in nature we will try to leave it out of the chart. Of course, there are some anal doctors that just can't help but stick everything in the chart, and for those doctors there is always option #3.

• 3) Ask the doc, "If I send you a thank you card will it end up in my chart?" If doc says "Yes" and you feel strongly about your card not entering the record, then express your thanks verbally. Despite what the gift card industry would have you believe, you can sometimes say it just as well without a card.

• 4) Say "Thank You" with an interpretive dance. There is absolutely no way to enter dancing into the medical record! On second thought, don't do that—it might come across as creepy.

Have you ever been frustrated to find you doctor charting personal communications that you felt shouldn't be in the medical record? Have any of you health professionals felt like you had to file a thank you?

As always Doctor D loves to hear your thoughts and stories in the comments!