The deluge of clinical information I face every day is littered with clinical junk mail.

No, I’m not talking about the advertisements from head hunting firms or the fliers from medical device companies suggesting I use their fancy new laser tattoo remover to retire a rich man in 6 months. These are all weeded out by my staff and never reach my desk.  I’m talking about clinical notes about real patients. Notes that are usually meant well but lack actual useful clinical information.

For example, the lab report that says the blood was drawn but does not give the result. Or the note from the pharmacist suggesting an increase in BP medication (lisinopril) from 20mg  to 40mg to ‘improve control’ in an 82 year old patient with early dementia, frequent falls, and  mildly impaired renal function where our records shows normal BPs at the previous four visits. His note did not include any clinical data to support his request. Specifically, he included no blood pressure measurements. Or the note from the pharmacy benefit manager pointing out that a patient is on thyroid hormone replacement and should have a TSH done annually, in a patient with regular annual TSH measurements, the most recent one just 6 weeks before the junk mail was sent.

I welcome legitimate feedback. I will read and consider your suggestion - but only if you have the courtesy, respect and professionalism to include pertinent and accurate information to support your comments.

Otherwise it is noise, takes time for me to review, and does nothing for the patient. 




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