Why sharing your complete medical history matters

September 13, 2022 in Health Risk Management  •  By Miles Varn, MD
medical history

It’s your first visit to an orthopedist for knee pain. As you complete your pre-appointment paperwork, you focus on the symptoms you’re experiencing and the treatments your primary care physician has recommended before referring you to a specialist. You don’t mention that you had surgery on the ankle on the opposite leg a few years ago because that doesn’t seem relevant.

But that information could be very relevant and shape both your diagnosis and treatment plan. The surgery could have affected your gait, causing extra strain on your knee, for example. Without a complete picture of your medical history, your doctor does not have all the information needed to make the most accurate diagnosis and create the most appropriate treatment plan.

An up-to-date, comprehensive medical record can lower the risk of misdiagnosis

Without your complete medical and family history, healthcare providers lack the information needed to reduce your risk of experiencing a misdiagnosis or medical error. A secure, comprehensive electronic medical record allows you to share this important information with every healthcare provider who treats you. That can be even more important in an emergency or if you get sick or injured while away from home and the care of your usual doctors.

When you don’t share your complete medical history with healthcare providers, you’re a greater risk for a range of issues, including:

  • Medication errors and interactions: Without a complete list of all the prescription and over-the-counter medications and supplements you take, you’re at risk for medication errors, some of which can have serious consequences. For example, if your doctor does not know that you take Prozac for depression and prescribes Imitrex to treat migraines, the combination of these drugs, which both affect serotonin levels, can cause a potentially serious condition called serotonin syndrome. Or if you regularly take acetaminophen for arthritis pain and are prescribed another medication that contains the same drug, your liver could be damaged.
  • Misdiagnosis: An incomplete medical record can increase the risk of being misdiagnosed or can delay your diagnosis. Your doctor needs access to the results of previous bloodwork and imaging studies to compare the results with any new tests. It’s also important for your doctor to know your family history, for example if a family member was diagnosed with cancer or had a heart attack at an early age, information that may indicate you are at a higher risk for these conditions.
  • Duplicate tests and missed follow up: When a healthcare provider doesn’t know what diagnostic tests you’ve already undergone, you’re a risk for being sent to get the tests again. This not only can this slow the process of diagnosis, it can also expose you to additional radiation if you undergo repeat, unneeded imaging, and it can increase your healthcare costs. Having access to your previous test results is also important if the results suggested that you needed additional testing or follow-up care. Without this information, you may not get the care you need.
  • Inappropriate treatment: Lack of access to your complete medical history may also increase your risk of receiving inappropriate treatment. For example, if you have chronic back pain but your doctor does not know that no previous doctor recommended physical therapy, he or she may recommend more intensive treatment like prescription pain medication or surgery.

A health advisor can help you gather your complete medical history so you can share it with any healthcare provider and can also keep your record updated and share the information with providers instantly in an emergency.