Michael Meltsner

US Experience with Doctors and Patients Sharing Clinical Notes

The move to offer patients online access to their clinicians’ notes is accelerating and holds promise of supporting more truly collaborative relationships between patients and clinicians, say Jan Walker, Michael Meltsner, and Tom Delbanco

A Patient's View of OpenNotes

In this editorial the author comments on the arguments for and against easy access by patients to their doctors notes, as well as reflecting on his familys experience with a lack of transparency between doctor and patient. The author argues that OpenNotes can stimulate a flow of information that leads to greater accountability on behalf of health care personnel, a development that in the end can only improve the quality of patient care. The same issue of Annals of Internal Medicine reports on an extensive, three facility trial of OpenNotes that concluded it was an overwhelming success with patients and that doctor fears were not realized.

Equality and health

This article describes civil rights litigation over discrimination in health care in the 1960s. As a consequence of Title VI of the Civil Rights Act of 1964 enforcement shifted to federal regulators whose performance is measured and evaluated.

The Jagged Line Between Mediation and Couples Therapy

ConclusionMediation of conflict in couples has emerged as a hybrid discipline blending theory and practice from psychology, law and other disciplines. In attempting to orchestrate a successful negotiation, mediators engage the couple in problem solving over concrete issues and workable alternatives. While the healing aspirations of couples therapists transcend the narrower focus of mediation, clinical practice is enriched and informed by facilitating a negotiation that provides valuable data in an economic manner and a rich context for therapeutic intervention.

The Future of Correction: A Defense Attorney's View

The author, former legal director of an organization conducting a national program of test litigation in the correctional area, describes a variety of cases that have led him to take a pessimistic view of the future of correction. He states that (1) a defendant cannot put much faith in a criminal justice system which makes his pretrial freedom dependent on the amount of money he has; (2) considering the lack of resources provided for those in jail but presumably innocent pending trial, one can expect little in the way of correctional resources for convicts; (3) longstanding prison abuses are still widespread; (4) judges and administrators ignore the failures of experimental programs in order that they may continue to require inmates to participate in them; and (5) the correctional process is perhaps most dangerous when it justifies itself as acting in the defendants best interests. In conclusion, the author suggests that correctional personnel should play a more active role in exposing negative aspects of imprisonment to the public.