HEALTH FEATURES^TM
OFFICIAL PUBLICATION OF THE
AMERICAN FOUNDATION FOR HEALTH

Medical I.D. Card:

A Matter of Life

EDITOR: Doctor, in your ten years of emergency work dealing with total strangers, what has been the biggest problem you've encountered?

DOCTOR:  I have often had to make a quick diagnosis on a patient I've never seen before.  Quite frequently, a patient is brought to me with very little information.  I might be told only that the patient suddenly collapsed at a supermarket, and that the patient was alone.  The emergency room clerk may also inform me that they've searched the person's wallet and found his name, address, and maybe even a telephone number of a relative.  Unfortunately, I'm often told that the relative doesn't answer the phone.  By this time, the emergency room nurse will tell me the patient is in physiological shock, close to death.  At times like that, I've seen the most experienced emergency room physicians sweat a little.  You have few seconds to waste on an emotional response.  The doctor has to function more like a computer.  I must rely on everything I've learned and consider perhaps a dozen possible diagnoses.  In this particular example, I might consider a heart attack, ruptured abdominal or intracranial aneurism, stroke, or cardiac arrhythmia.  A wrong diagnosis can be fatal for a patient.  There is a different medication and treatment for each possibility.  A medication that can be lifesaving in one instance can be outright deadly if used in another.  What would be the most helpful to the doctor would be some information about the patient's past medical history.  Perhaps this is a patient who has never before been seriously ill.  This would make one diagnosis more likely than another.  Or perhaps the patient has already had two heart attacks in the past two years.  The point I'm making is, if I had access to the patient's history, I could begin ordering tests or examining specific parts of the patient first to make a quick and correct diagnosis.  The lack of a patient's past history can be particularly serious if the physician is less experienced.  Every clue given the emergency physician reduces the chance of an incorrect diagnosis.

EDITOR: Doctor, what do you think should be done about the fact that most of us are like the patient you describe, someone who carries no medical information about oneself?

DOCTOR:  I believe that we would save lives, reduce pain and suffering in the emergency room, and speed up treatment if all of us carried some form of medical identification.  If your problems are minor, you can even jot down some basic information on a piece of note paper, and put it in your wallet.  There are other I.D. cards and bracelets.  One is called LIFEDATA^TM card.  It measures about 3-1/2 by 6 inches and folds in three to fit into a wallet pouch.  On the front a noticeable red medical symbol alerts medics that the card contains emergency medical information.  The card has a health questionnaire which is filled out by the person who will carry it.  Once it's completed, the card contains an amazing amount of detailed information about one's personal medical history – just about everything an emergency physician needs to know.  It's even better than carrying your doctor's medical record because it is so organized to allow any doctor to quickly scan the card to become familiar with your medical problems.  Inside the fold of a LIFEDATA^TM card is an insert which serves as a log of each doctor visit so that the card can be updated every time a new diagnosis is made or medication is changed.

EDITOR:  Isn't it enough to carry a simple I.D. card that has your doctor's name and phone number?

DOCTOR:  No.  Frequently, the emergency room cannot reach the doctor.  Instead, we may end up talking to another doctor who is taking call that night and doesn't know the patient.  Also, even if the patient's doctor is available, it may take ten to twenty minutes to reach the physician; those may be critical minutes for a patient whose life is in the balance.

EDITOR:I understand now why carrying a comprehensive medical I.D. can save lives, but you also said it can save patients pain and suffering.  What do you mean by that?

DOCTOR:  First, a medical I.D. card like LIFEDATA^TM contains information that will speed registration at an emergency room.  Questions that the hospital has about your insurance and employment can seem endless when you're sick; it's nice to be able to let the card speak for you.

Second, I can remember a patient I treated in the emergency room for an abdominal pain.  He tried to cooperate but he was in too much pain to coherently describe all the abdominal surgeries he had undergone.  He said that he had a colic, then he said he had colitis, then something about an ulcer.  This poor man got more flustered as we pursued the confusing story and he knew he was not making sense.  We had to call his doctor but the doctor did not answer her cell phone (the cell phone waves don't reach inside some steel buildings.)  The patient had come in at eight in the evening and it was after eleven when we finally reached his doctor.  But because we weren't sure if we would ever reach his doctor, we had begun diagnostic blood tests and x-rays.  When we got the history from the doctor, it turned out that half of those painful tests were unnecessary.  We were able to resolve the patient's problem with a simple injection and a renewal of a prescription medicine whose name he had not been able to recall.  By the way, until that night, his doctor had been one of the fastest to answer our calls.  It turned out that a new operator at her answering service had been calling the wrong number all evening.

I also remember a man we had to put through numerous tests because his doctor was off call to another doctor who didn't know the patient.  Sometimes we call a doctor and the doctor can't recall all the medications the patient is on.  How could doctors remember the medications of all their patients?  One conscientious doctor got up in the middle of the night and drove 25 miles to his office to look up a detail of a patient's record because we just had to have it.  I think that was almost beyond what we should expect from doctors.  They have personal lives, too.  What if the patient got billed for the trip the doctors had to make?  All this unnecessary cost and effort – just because people don't carry enough medical information with them.

You know, this country has one of the best medical care systems in the world and we spend the most amount of money for medical research.  It's hard for me to believe that this country as a whole has not taken simple steps to have our citizens carry medical information.  The cost to the patient is so negligible, and it can save so many lives, I once calculated that it could reduce the cost of medical care in the U.S. by several hundred million dollars annually.  Remember, when it takes more time and effort of the emergency room staff to treat a patient, somebody pays for it.  Even if the insurance or Medicaid paid, that's really us.  Our insurance rates go up.

EDITOR:  Doctor, has any responsible organization endorsed the concept of carrying medical identification?

DOCTOR:  Oh, yes, for instance, the American College of Emergency Physicians and the AMA.

EDITOR:  Thank you doctor, for a most enlightening interview.

(Editor's note:  The physician interviewed above is Kenneth N. Matsumura, M.D., who worked for many years at a metropolitan hospital emergency room in the San Francisco Bay Area.  He has also served as chief of urgent care service for a federally funded health center.  He is internationally known as the developer of the bio-artificial liver and pancreas.)