Happens all the time. DH went to the ER some years ago for food poisoning. This is a man that would not go to the ER unless he thought he was knocking on death’s door. He came out much better with meds and hydration and his file in one of the main systems in the DMV now says he’s an alcoholic. He doesn’t drink much (2-3 drinks a month) and was most certainly not drinking that evening.

Many doctors are horrible.

—-
Signed,

Immigrants. We get the job done.

Anonymous wrote:Immigration is a highly stressful experience that is a potentially reasonable mention in a trauma-informed social history.

You have no clue what you are talking about. I am calling out xenophobia on your end.

Immigration is a highly stressful experience that is a potentially reasonable mention in a trauma-informed social history.

Anonymous wrote:

Anonymous wrote:Of course where people have lived is relevant.

People’s genetics and life experiences and habits and medicines (to include supplements) are relevant.

I am not deciding that. It is. When I ask people where they grew up or have lived or traveled, I explain why I am asking. Patients seem to appreciate that I am explaining the why of my questions.

I try to be careful with my wording. Based on symptoms, I will still ask the same questions. I will try to be more careful with my wording.

I wish there were more doctors who explain why they are asking certain questions. I don’t understand why some doctors get agitated when asked why do they ask, or why they are not willing to order certain relevant tests.
Could it be because they wrongly assume patients who speak with an accent are stupid?

The bolded. How did the question about place of birth come up? Noticed the accent? Would they have asked about the place of birth and immigration status if the patient didn’t have the accent?

Anonymous wrote:Of course where people have lived is relevant.

People’s genetics and life experiences and habits and medicines (to include supplements) are relevant.

I am not deciding that. It is. When I ask people where they grew up or have lived or traveled, I explain why I am asking. Patients seem to appreciate that I am explaining the why of my questions.

I try to be careful with my wording. Based on symptoms, I will still ask the same questions. I will try to be more careful with my wording.

I wish there were more doctors who explain why they are asking certain questions. I don’t understand why some doctors get agitated when asked why do they ask, or why they are not willing to order certain relevant tests.
Could it be because they wrongly assume patients who speak with an accent are stupid?

Anonymous wrote:Medically, I can't think of any situation where the word immigrant makes sense. A person's ethnicity matters in terms of disease risk and predisposition to certain gene variants. Where a person lived for most of their lives also matters, in terms of exposure to carcinogenics/pollutants and disease.

But doctors usually write, for example: South East Asian (Vietnam), exposed to Agent Orange as a child. THAT is a highly pertinent sentence, since you have the ethnic category and the mutagen that is Agent Orange.

"Immigrant" is a loaded word and there is no medically-sound reason to use it.

Most Americans f what you said about s not necessary. It’s enough to say “agent orange exposure”. Maybe use the chemical name. There are few diseases that matter wrt race. Age and gender matter the most.

Anonymous wrote:That’s valid info on a patient’s history

No, it is not.

Calling a patient an immigrant and writing place and country of birth is private information.

Unless you record place of birth and citizenship status of all of your patients, this is not a valid patient’s history.

There is also difference between stating “lived in country XYZ”, vs “immigrant”.

That’s valid info on a patient’s history

Did the doctor record it, or did the AI scribe record it?

Of course where people have lived is relevant.

People’s genetics and life experiences and habits and medicines (to include supplements) are relevant.

I am not deciding that. It is. When I ask people where they grew up or have lived or traveled, I explain why I am asking. Patients seem to appreciate that I am explaining the why of my questions.

I try to be careful with my wording. Based on symptoms, I will still ask the same questions. I will try to be more careful with my wording.

Anonymous wrote:Descent doesn’t tell you where people lived. For example, members and their families may have lived across the continent.

I agree there is bias. I also agree there is discrimination.

I don’t think everyone writing immigrant is biased or discriminating. I agree that wording is important. Sometimes things are worded in a way that is problematic and the writer had no intention to be problematic.

Unfortunately, I think you are coming from a place of ignorance. To make it simple, do not include personal patient information in their medical records unless you have a specific concern. If you do have a concern, you explain this clearly.

You don’t get to decide what “might be” relevant to someone else or shrug your shoulders if the patient ends up being discriminated against because you decided to include information they did not consent to sharing with everyone.

Descent doesn’t tell you where people lived. For example, members and their families may have lived across the continent.

I agree there is bias. I also agree there is discrimination.

I don’t think everyone writing immigrant is biased or discriminating. I agree that wording is important. Sometimes things are worded in a way that is problematic and the writer had no intention to be problematic.

Anonymous wrote:It is a loaded word, but that is political.

I sometimes write where people grew up for exposures and genetics that might be relevant. (GI)

Would you think it better to make it a verb instead of a noun? 64 you male who emigrated from …?

I also write BMI instead of obesity because that is also a loaded word.

I don’t think it’s discriminatory. It can be perceived as problematic. It is important information as described by many above.

To avoid being inappropriate you could say something like Northern European or South Asian decent. Best to be specific why you are including that information (vaccination, exposure, …). It is ignorant to say that there is no bias or assumption when it comes to certain regions of the world. As most immigrants will tell you, discrimination is sadly part of their reality. When you write specific information, such as city within a country, you are drawing attention to this info with every visit to any other medical professional who might ask additional questions or make assumptions that have nothing to do with a relevant medical history. So, this would be best to avoid. Just write down what to look out for from the medical perspective.

It is a loaded word, but that is political.

I sometimes write where people grew up for exposures and genetics that might be relevant. (GI)

Would you think it better to make it a verb instead of a noun? 64 you male who emigrated from …?

I also write BMI instead of obesity because that is also a loaded word.

I don’t think it’s discriminatory. It can be perceived as problematic. It is important information as described by many above.

If the physician notes the relevance of the remark it is perfectly fine. For example, need to verify vaccinations, monitor for exposure or anything similar, yes, it is a valid remark.

Otherwise, 100% discrimination and intended to create bias.

I doubt you can do anything yourself, but if you are in touch with the patient, you can gently explain patient rights to the patient if they ever see anything inaccurate or inappropriate in their records. Also, make a printout of the file without additional comments and let the patient decide whether it bothers them. They will now have a legal channel to have the information removed.