At Harvard University’s Beth Israel Deaconess Medical Center in Boston, mental health patients are given access to their therapists' notes, as part of their innovative Open Notes program. Dr. Michael Kahn, a psychiatrist at Beth Israel wrote about why the program was launched in a recent JAMA article. Here, he reflects on what clinicians are learning from it.
Knowing that patients may read their notes, encourage doctors to use less jargon.
“For those clinicians who haven't done [this], I think it does require a kind of readjustment. For some clinicians who are used to using more jargon in their notes (there's certain jargon terms within medicine, in general, and psychiatry, in particular, that are often used to describe patient behavior that can have a more critical or judgmental cast to them), I think there are better ways to describe behavior with more generous and accurate terms.”
Some clinicians worry that making notes available to patients could cause problems.
“Typical reactions are that it will upset patients too much, patients won't understand what I'm writing, it will inhibit my communication with other providers because I'll have to use inaccurate terms.”
For patients with addiction, reading these notes can provide additional therapy.
“Some patients will readily acknowledge that they have a problem with addiction, and many patients don’t, and there’s patients in between of course. For those patients, it’s interesting that the fact that something is actually written down—that they can read and reflect on by themselves; not in an office with another person—can have a very powerful effect.”