Why I Read Charts (of my admitted patients)

I recently treated two patients, one with chest pain and one without.

The one without chest pain was much sicker with some dangerous arrhythmias, and while his initial cardiac enzymes in the ER were negative, the following morning his troponin was over 50. Yet he survives, so far, despite his advanced age.

The one with chest pain didn't seem particularly sick at all, and his Cardiologist was unimpressed with my presentation. Stable ECG, negative cardiac enzymes, and atypical features in an anxious patient with a previously negative workup suggests maybe he could go home, said he. Fortunately the Hospitalist agreed to admit him after some negotiation. This patient expired the next day.

Reading the electronic medical record of my admitted patients gives me perspective and feedback that is difficult to acquire in any other way. Apparently some HR departments frown on such intrusions into patient privacy, one more way that bureaucrats with good intentions sabotage the practice of medicine.

In my experience, patients are grateful that I care enough about them to learn how things went after our brief interaction in the ER.