考虑到此类潜在的困难,以色列堂-女执事医疗中心的心理医生初步只向10%的患者提供了病历。临床社工们正把病历提供给更多患者,但一些治疗师暂时选择了退出。妇科门诊部的社工尼娜·道格拉斯(Nina Douglass)担心,有些患者的伴侣言语恶毒。如果这样的人坚持要阅读病历,可能会将患者置于险境。
“I can imagine that our work can be deepened and enhanced through people reading their notes,” Ms. Douglass said. “But one size doesn’t fit all.”
“可以想见,通过让病人阅读他们的病历,我们的工作能得到深化和加强,”道格拉斯说,“但不能搞‘一刀切’。”
Mental health notes have very different readers: the therapist, who may use them as a memory prompt; other doctors treating the patient; insurers; and now the patient. Writing a note with necessary information for all can be daunting.
心理疾病病历有各种各样的读者:把病历当成记事本来用的治疗师;治疗该病人的其他医生;保险商;现在又多出了患者本人。书写一份包含各方所需信息的病历可能是一项艰巨的任务。
Mr. O’Neill, the social work manager, is pressing therapists to use straightforward descriptions. “I used ‘affect dysregulation,’ and a patient said, ‘What on earth is that? Are you saying I’m totally crazy?’ ” he said. “It just means they can get upset. So why not use the word ‘upset’?”
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