"But Dr. Thomas Lee, head of Partners's physician network, said segregating psychiatrists' notes fosters that stigma. "Schizophrenia and Parkinson's disease are both biochemical disorders of the brain. Why is one considered mental health and the other medical?'' Apparently Dr. Lee flunked his psychiatry rotation in medical school. Or at least he should have. It is positively frightening to see such a lack of awareness in someone who has entirely too much power to impact the course of the conversation. The conversation with business oriented insurance people is a constant battle with neanderthals who simply don't get it. The real tragedy is to have trained health care providers who are demonstrably brain-dead about the full meaning and impact of certain points of view. This situation has been getting out of control for over two decades. This is another escalation of a cultural and social travesty. The battle for individual integrity, and the integrity of good mental health care, is being lost by the advocates of good sense, and being won by the forces aimed at saving money. Dr. Lee his a hapless puppet for the MBA's who are looking for ways to cut down on mental health related payments. This is a perfect way to do it.

I am a clinician and someone who has a close family member struggling with mental illness. A clinician treating a patient needs access to these records.In the case mentioned in the article the patient wanted the physician to manage the patients psychiatric meds until she found a therapist. Of course he needed to know the patients history. The fact that the doctor felt uncomfortable managing her meds is irrelevant. The physician's last experience with these meds was most likely during a psychiatric rotation in medical school. I am sure a psychiatrist would feel uncomfortable managing cardiac meds. Because of of the stigma society attaches to mental illness patients are reluctant to divulge information that is very relevant to patient care.

Of course a qualified care giver needs good information to provide good care. That is not the issue. There are too many bigger issues to neatly list. Include among them: 1. the problems associated with very personal information being stored in a computer and available to too many people who have no need for or understanding of the information, 2. The impossibility of succinctly documenting highly nuanced information about the emotional lives of people in distress, 3. The background of the insurance industry acting as big brother, and being intent on interpreting information in a way which facilitates the refusal of payment. Those points are just the beginning of a very complicated conversation.

as someone who had a radiologist mistake a metal marker put on by an xray technician to orient a chest x ray as bb gun shots left in the stomach. it took 5 phone calls to have the radiologist amend the medical record but still he did it in a way that said that " patient said they never got shot with a bb gun" instead of taking out the wrong reading in the electronic medical file, so I can truly understand that these records are dubious and full of errors and wrong judgements. We should listen to Jerome Groopman when he says that doctors have preconceived notions as to how to treat two minutes after a patient presents himself. It is very sad.

Why not add a non-overridable feature to the medical records software that automatically sends the patient an email notification every time his/her psychiatric record is accessed (identifying who did it)? That would at least make clinicians (and support staff) think twice before looking at highly sensitive narratives out of mere curiosity.

It is worth noting that the conference where patient Julie and Dr. Scott Monteith aired their views was the second annual Health Privacy Summit in Washington, DC on June 5. The annual summit explores problems and solutions related to protecting patient privacy and trust in health care practices and technologies.

There are reasons for keeping mental health issues private.....once disclosed everything is attributed to them. I have be an RN for 41years and have seen first hand what disparate treatment known psychiatric patients get. I myself,who has anti anxiety medication to take when I need it, was made to feel like a drug addict when discussing sleeping issues with my physician.If you admit to any mental health issues, substance use issues or are overweight be prepared to have all of your ills attributed to it. So while I believe having a universal medical record would be great, caregivers are not yet unbiased enough to use it it without prejudice.