ArcaMax

DEAR DR. ROACH: My primary care physician has been using an AI-assisted device during our office visits that transcribes and records our visits. I receive an after-visit summary a few days later that contains minor errors at the least, but they're often blatant errors. For example, one problem was listed as "vasomotor symptoms due to surgical menopause." I have never had surgery, so this wouldn't be possible.

Another note stated that I receive significant relief for chronic right knee pain after starting a specific oral medication. Again, not true, as the relief was from a steroid injection to my knee. It seems to me that the medical notes should be accurate since other providers refer to them when planning their care.

Should I send a message to my doctor about the errors and ask them to be corrected? I wonder about all of the other patient charts that aren't accurate either. Thanks for your thoughts. -- D.H.

ANSWER: Let me first start by saying that these kinds of errors are not limited to AI. It is common that when I meet a new patient and go over their medical information, I find errors that have been passed down from physician to physician for years or decades. I teach my students that when there is a discrepancy between what the chart says and what the patient says, the patient is usually right.

When errors are found, I agree that they need to be corrected. However, you can't change information in a medical record, but you can write a new note with the correct information. Sometimes tracking down the correct information takes extensive time, but very occasionally, it's critical to the person's treatment plan.

The ability for patients to see their own medical records does have the potential benefit of making sure that these kinds of errors do not go uncorrected. You should let your doctor know about any discrepancies.

DEAR DR. ROACH: I'm a 70-year-old male who's having multiple issues with lots of prescriptions. I have high blood pressure and had a blood clot in the lung. My diabetes is under control. I take diltiazem, losartan, Lasix, glipizide ER, allopurinol, Jardiance, B12, D3, Xarelto, metformin, atorvastatin, doxazosin, famotidine and lorazepam (at bed). This is a lot!

My issue is that I am dizzy when I get awakened in the middle of the night out of a deep sleep. It's kind of like vertigo, but I'm OK after fully awakening and being awake all day long. Any guidance or directions? -- B.H.

ANSWER: I suspect your blood pressure is having a hard time adjusting to a change in your body position when you first awaken. Doxazosin is well-known to do that, especially in combination with diltiazem, losartan and Lasix. Your doctor might be able to try something else.

I tell all my patients when getting up to first sit on the bed and make sure you're OK. Then stand up and make sure you're OK again before you start walking. It takes the body more time to adjust to standing on these medicines, especially when we get older.

I also get concerned with lorazepam. This medicine becomes more problematic in older adults as we don't metabolize it well. It can damage the body's sense of balance and equilibrium, making falls (and car accidents) more likely. I don't prescribe this kind of medicine in older adults for daily use.

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Dr. Roach regrets that he is unable to answer individual letters, but will incorporate them in the column whenever possible. Readers may email questions to ToYourGoodHealth@med.cornell.edu or send mail to 628 Virginia Dr., Orlando, FL 32803.

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