The patients of Dr. Hugh Schade of Los Gatos and San Jose, Calif., have no problem getting their medical records.
He gives them the full records, with X-rays, test results, his observations and prescription orders. He has been doing this for 11 years and is convinced it is healthy for doctor and patient.
When his patients return, he adds to their records, but they keep them. They are free to take them with them if they go to another doctor or go on a trip.
One traveler, recently recovered from a heart attack, carried his records in his camper. He had an abdominal pain but wasn't sure if it was "gas" or a heart attack, so he drove up to a hospital. A doctor took an electrocardiogram, checked it against a previous ECG and said he was probably all right. The doctor told the traveler to camp overnight in the parking lot while his blood chemicals were checked, then gave him an all-clear.
"If this patient hadn't had his history and ECG, that doctor wouldn't have taken a chance," Schade said in an interview. "He'd have admitted him to a coronary care unit for three days and taken serial ECGs and blood tests every day. Having those records saved him a hospital stay and the worry."
It also saved him or his health insuror several thousand dollars.
Schade decided in 1974 that his patients' bulging records were eating space and hardly benefiting him or his patients. He started keeping only a concise chart for his own files and giving the full set of records to most of his patients.
"Other doctors warned me against it," he said. "People said I'd create lawsuits. But it just seemed logical to me. It's never led to a suit. It's had a lot of advantages.
"When I refer a patient to a specialist, it doesn't take him so much time to take the history. Tests don't have to be repeated. Everyone knows all there is to be known."
Also: "This educates the patients. I include instructions for them. They read the record, they ask questions, they learn. They start keeping their other health records and receipts in their folders, so I learn more about them when they come back.
"And they start keeping track of their cholesterol and so on. They learn about prevention. That's really what will save us money in the long run -- they take responsibility for their records and their health, too."