Amphiboly: Why It's Important to Read Your Medical Records

I've (almost almost) got a BS in Philosophy, and one of the first things I learned in my curriculum were the logical fallacies. Logical fallacies are miscommunications which lead to an irrational argument. One of the most well-known logical fallacies is ad hominem, where in an argument, someone attacks a man, rather than that man's position. A less well known fallacy is amphiboly. Amphiboly happens when statements are overly ambiguous or too short to be logically meaningful.

Logical fallacies are found everywhere: news, marketing, books. But one place that they're found may surprise you: your medical records. Often, doctors fly through writing your notes after your visit, and sometimes, the results contained therein are shockingly different than what you reported. Symptoms may be listed in words that are vague or flat out wrong: "patient complains of pain" instead of "patient complains of aching and stabbing symmetrical joint pain." Doctors may also make character judgements (read: ad hominem) in your notes for other doctors to read: "needs psychiatric help," "catastrophizer," and "problem patient," are particularly damning. Unfortunately, when something gets written in your notes, it can affect the treatment you receive from everyone else in your healthcare team. There's not a whole lot you can do, but here are some tips on keeping your medical records free from fallacies. 

First, a confession: I'm not practicing what I'm about to preach. After round after round of horrible doctors notes, I've stopped being proactive about my medical records. But if you're just starting out your journey with chronic illness, keeping the record straight early on is of vital importance.

1. Read your medical records! That should go without saying, but oftentimes we don't. Many doctors offices don't make it easy to get a hold of your records either, sometimes charging fees and actively discouraging you from getting them. Don't be dissuaded! As GI Joe always says, "knowledge is half the battle."
2. Look for flagrant errors. Some errors are huge and easy to spot. One example: my mom had pain in her arm after radiation treatment for breast cancer. Upon talking to the oncologist, he wrote that she was having femur pain, and he called in orders to X-Ray her leg! These errors need plain-and-simple correcting. Talk to your doctor and let them know that you read your charts and there was an obvious mistake.
3. Check for amphiboly. Is your doc glossing over your symptoms, or using phrasing that other doctors won't understand? A good way to check this is to have a friend who doesn't know your medical situation read your charts and tell you what they infer from the notes. Could they describe your symptoms accurately? If they weren't anywhere close, there may be ambiguity at play. You can't just call your doctor and ask for this to be changed, but it's important to be specific about your symptoms at future appointments and perhaps mention that you noticed they were vague in their notes. 
4. Beware of Ad Hominem. Sometimes you think your relationship with a doctor is great...until you read their notes, and find out that they've labled you a "catastrophizer" and think you should get your head examined. If your doctor is saying things that question your character rather than your disease, beware. It may be time to find a new doctor. If you like your doctor and prefer not to switch, treat lightly when bringing things like this up. You don't want to make things worse.