Take 1.

Doctor, I think you misspelled abdominal. 

Open Notes, which began in 2010, is a national initiative that gives patients access to read their doctors’ and nurses’ notes about their appointment.

A little history here. Before the Health Insurance Portability and Accountability Act (HIPAA) was enacted in 1996, patients typically had to sue to see their records. Even now, the process can be difficult in many organizations.

How’s it going? Results of the first year are positive. Eighty percent of patients who saw their records reported a better understanding of their medical condition, and two-thirds reported they were better at sticking with their prescriptions. Even though many resisted initially, providers saw the benefit too. None withdrew from the pilot, and participation is growing.

Who is participating? The results started a movement to bring more transparency to medical records. Three million patients now have access to their providers’ notes. Participating sites include MD Anderson Cancer Center at the University of Texas; Beth Israel Deaconess Medical Center in Boston; Geisinger Health System in Danville, PA; and the U.S. Department of Veteran’s Affairs (VA).

 Drug tests for doctors in CA.

If passed, California Proposition 46 will require doctors to undergo random drug and alcohol testing and report positive results to the state’s medical board. It’s on the state ballot on November 4th, and a recent poll suggests it has support. This type of screening does not happen anywhere in the U.S., so CA would be the first state to implement.

Why screen doctors? Other industries, like airlines screen their pilots for drugs and alcohol as a way to keep passengers safe. Doctors have the same rate of abuse and addiction as the rest of the population. The proposition is intended to keep patients free of unnecessary harm. Critics argue that it’s costly and an invasion of privacy. Voters will decide in November.

That sounds familiar.

The July effect. A perceived increase in the risk of medical errors and surgical complications that occurs when U.S. medical school graduates begin their residencies. Usually July 1. A similar period in the United Kingdom is known as the killing season. Ours sounds less dangerous.

Your health matters too.

Smart start. Breakfast has long been considered the most important meal of the day. Until now. New research questions the idea that people who skip breakfast eat more or less healthy foods later in the day. A meta-analysis of studies published last year shows that skipping breakfast doesn’t necessarily lead to weight gain. The conclusion: Don’t force yourself to eat breakfast if you don’t enjoy it.

Is that right?

 200 times.  The August issue of the journal BMJ Open published a study that examined list charges for blood tests in 2011. The average cost for a basic metabolic panel was $371, but prices ranged from a low of $35 to a high of $7,303 (200 times more).