Electronic medical records have developed significantly over the past few years, but they are still in their infancy. Different electronic charting systems generally don’t talk to each other, and in many instances, records must be printed and then faxed from one physician’s office to another. Electronic communication between offices is improving, but there are lots of regulations which exist in order to keep personal health information confidential. Consequently, these regulations slow the speed of development.
To expedite your visit and improve office efficiency, it is best to check with the office a few days before your scheduled visit to verify that your information has been received by our office. If you like, you may bring paper copies of your records directly to the visit.
Thyroid Surgery
If you are visiting to discuss thyroid surgery, here is the important information to have available so that the best recommendation can be made at the time of consultation.
Most Recent Office Visit Note
If you have been sent by a physician for consultation, it’s helpful to have their last clinic note. Not only does it help us to understand why you are visiting, but it also has up to date contact information so that we can send them a note, pictures, and a pathology report if you have surgery.
Thyroid Function Tests
These are blood tests, and generally, a thyroid stimulating hormone (TSH) level is all that is necessary. This is generally drawn by your primary care physician or endocrinologist. A free T4 is also helpful, but not necessary unless your TSH level is abnormal.
Imaging Studies
These are generally ultrasound exams, but occasionally a computed tomography (CT) scan or positron emission tomography scan (PET-CT) has been performed. For any medical imaging study, there are two components: the images from the exam, and the report that the radiologist creates after viewing the images. It’s best to have copies of the report on paper, as well as the images on disk (CD). To a surgeon, a picture is worth a thousand words-the images themselves are more important that the radiologist’s interpretation (report).
Parathyroid Surgery
If you are visiting to discuss parathyroid surgery, here is the important information to have available so that the best recommendation can be made at the time of consultation.
Most Recent Office Visit Note
If you have been sent by a physician for consultation, it’s helpful to have their last clinic note. Not only does it help us to understand why you are visiting, but it also has up to date contact information so that we can send them a note, pictures, and a pathology report if you have surgery.
Bloodwork
Many times, a calcium and parathyroid hormone (PTH) level are all that is needed. However, it is also helpful to see an ionized calcium, and a 25-OH Vitamin D level. To be interpreted correctly, these values need to be drawn at the same time.
Urine
Physicians used to routinely order a 24 hour urine calcium level for the workup of parathyroid disease, but it is not necessary in most instances. If you happen to have already had one, you might as well bring the result, but it is not necessary and generally doesn’t affect the decision to proceed with surgery.
Imaging Studies
You don’t need any imaging studies unless the decision to proceed with surgery has already been made. If you have had an ultrasound, it is not necessary to bring the images. To an experienced parathyroid surgeon, looking at a few images or a report from a previous ultrasound just doesn’t cut it. Ultrasound is a dynamic exam, and therefore will have to be repeated at the time of your consultation by the surgeon who will be performing your operation. If you have had a sestamibi scan or a 4D CT scan, it is best to have both the images on a CD as well as the report. However, if these imaging studies were done in low volume centers, they may not be of adequate quality and will likely need to be repeated. Getting these studies done in low volume centers is generally a waste of time and money.