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PATIENTS DO HAVE A RIGHT TO SEE THEIR RECORDS

Question: I was at the desk waiting for the doctor's nurse to arrange an appointment for me. I happened to spot my own medical record open to view. I began to read notations the doctor had made. Suddenly, the nurse reached over and closed the record cover. I believe that trust is the very essence of a doctor-patient relationship. Otherwise, how can I follow the doctor's instructions concerning my health? Now I feel there are things he might not want me to know. Are doctors justified in keeping things private this way?

- M.P.

Answer: You have a right to know what's in your medical record, and in most states the patient can obtain a copy for the cost of copying. The original belongs to the doctor.

Some would view it as a good idea to have a copy of medical records, especially in view of the nomadic nature of our modern population, which changes residences - and doctors - with greater frequency today than years ago.

There is probably more to your story, though. The nurse might have been acting protectively, wanting to avoid any confusion. You have to concede that medical records can be couched in most unfamiliar language, some of it open to shocking misinterpretation by a layman.

You might be more than a bit surprised to find a woman's miscarriage referred to as "an abortion" in the precise doctor-to-doctor language of medicine. Mountains of lab reports are all but incomprehensible to anyone lacking medical training. And a patient might find unsettling the medically important, often utterly frank patient descriptions found in so many private medical records.

Why not ask your doctor about your medical record if you wish to? You can ask to read it and have it explained.

Question: I am 67 and am taking Mevacor to control my cholesterol. With it my total cholesterol number has gone from 273 down to 192 in a few months. But my triglycerides count has gone up from 77 to 190. My doctor says that is OK, that lowering the total cholesterol is more important. Should I be concerned about triglycerides?

- D.C.H.

Answer: Don't worry about that triglycerides level. You are doing great with your Mevacor. You are taking significant advantage of its cholesterol-lowering effect.

Your triglycerides are up a bit, but that increase still leaves you well out of the danger zone.

Your triglycerides level would have to get much higher before it became a concern. That concern would be for certain non-heart effects. In fact, at this point we cannot be sure about the influence, if any, of triglycerides on heart disease.

Question: Have you heard of removing gallstones with medicine? What about so-called silent gallstones?

- R.E.

Answer: Gallstones are being removed with medicine in situations that call for it.

One drawback is the length of treatment time; it can take many months. A patient faced with the need to take the dissolving drug for such an extended period might find it intolerable.

Many patients have silent gallstones, and they do fine just leaving things alone.

For more information, read my gallstones report. You can order it by writing: Dr. Donohue - No. 40, Box 5539, Riverton, NJ 08077-5539. Enclose $3 and a self-addressed, stamped (55 cents) No. 10 envelope.