The COSTS of Medical Records Errors and Lies

Sometimes my radio show conversations take a very unexpected turn — and yesterday’s post-air chat was no exception, although I have to say, this one surprised even me. I’ve been hearing stories from the dark side of medicine for more than 2-1/2 years, ever since I started by advocacy work. I thought I’d gotten a taste of almost everything. But this one…

Yesterday’s radio interview took place with Dr. Robert Carhart, a cardiologist from University Hospital whom I have mentioned previously. He has a knack for explaining things to those of us who don’t know medicine so we can understand them . Yesterday’s topic was heart attack — just the basics — and what patients or their loved ones need to do when/if even the vaguest of symptoms rear their ugly heads.

Once the mikes were turned off, we began talking about what happens when a heart attack victim is taken to the hospital, and what problems patients need to be aware of. We weren’t talking about the patient’s health at that point. We were talking about the behind-the-scenes, little known “tricks” used by hospitals that can have longer term ramifications should the patient survive.

What I never knew: reimbursements for heart attacks are higher than those for most other emergencies. That means when the hospital (emergency room) sends their bill to medicare or insurance, they make more money if they document a heart problem. As a result — think about this — if they can make any suggestion whatsoever on someone’s record that there was an erratic EKG or any other test they might run for heart problems, then they make more money.

Dr. Carhart told about a story he had heard (NOT in conjunction with his own hospital) about a man who had been taken to the hospital for vague heart attack symptoms (a very smart thing to do, by the way — even if you aren’t sure you’re having a heart attack, err on the side of caution!). They ran an EKG and other tests, then put him in a room to wait to be seen by the doctor. Every 20 or 30 minutes, a nurse would drop in to tell him they were still checking on his heart attack — but — it was very clear there was no emergency! If he had really had a heart attack, he would have been treated immediately and sure enough, when he was discharged several hours later, the information he was given reflected nothing about heart problems. HOWEVER….

(a big however)…. when he received the paperwork from his insurance, and looked up the code numbers on what payments had been sent, they all indicated he had been treated for heart problems, and the hospital was reimbursed for such. Now heart problems, which he does not have, are recorded on his medical records, and the hospital is so much the richer.

That may not sound like such a big deal…. except for part II of this expose — the down-the-road problems that can possibly occur as a result.

And this I tell you from first-hand experience….

When information is put into your medical record incorrectly, whether intended or not, it can have a huge ripple effect. In my own case, I believe my misdiagnosis may have partially resulted from an error in my records. When I first visited my family doctor with a golf-ball sized lump under the skin on my torso, it got recorded (unbeknownst to me) as being painful. It wasn’t! It didn’t hurt at all…. it was just there. Once my misdiagnosis debacle ended, and I looked back at all the records, I saw that the word “painful” had been carried on throughout all the reports, including the pathology reports from the biopsy from the lump.

I wonder if I would have been misdiagnosed if that word “painful” hadn’t been part of the records? Which begs the next question — what if that error had resulted in chemo treatments?

Fast forward to today — almost three years later. I have applied for life insurance, and so far, cannot get it approved. Never mind that I am healthy, and always have been. I’m a perfect candidate for health insurance, but since there is evidence in my medical records of a cancer diagnosis — argh — it’s been very frustrating. And why? Because of of a misdiagnosis, probably resulting from an error in my medical records.

But who cares? I’m the ONLY one who cares! The insurance companies don’t care, the doctors who made the errors don’t care. I’m a very small voice and they have no reason to listen to me. And if they did pause to listen, it would just cost them money. And as we all know, as you’ll find repeated in so many of my posts:

Health care is not about health or care. It’s about MONEY.

Today’s piece of advice is simply to double check your records. Make sure they are correct. Don’t let anyone — the doctor or anyone on his/her staff — make any kind of error, no matter how small. Beyond checking the spelling of your name or your zip code, check to be sure that what they have recorded is REAL. Because you never know how any error — whether or not it was recorded intentionally — may come back to haunt you.


(Added, Spring 2008):  Here are some tools for correcting those medical records:

How to Get Your Medical Records

How to Review Your Medical Records for Errors

How to Correct Your Medical Errors

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Trisha Torrey
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