Dr. Boles does not perform medical records reviews because he finds that talking to the family gives him far more clarity than even the most extensive medical records. Per Dr. Boles, “A medical records review by itself often only perpetuates the incorrect assumptions of others. In my opinion, you need new thinking, not the rehashing of old thinking.”
However, a review of some of the medical records is an important part of a comprehensive evaluation. The medical records that Dr. Boles finds to be the most helpful are as follows:
- Sub-specialist evaluations (e.g. neurologist, gastroenterologist, geneticist)
- Certain hospital records (e.g. admission, discharge, operative, sub-specialist consultation)
- Specific testing (e.g. DNA/genetic, biochemical/metabolic, biopsy, MRI, endoscopy)
- Most-recent laboratory results (e.g. CBC, chemistry panel, coenzyme Q10, carnitine and/or amitriptyline blood levels)
- Growth chart for height and weight
Send the medical records, preferably by email, and at least a week ahead of the visit. Mailing a DVD is also a good option. Dr. Boles has a tree-friendly paper-less office. Paper records can be reviewed at the visit, but will take time away from the visit. In regards to imaging studies like MRIs, please do not send the actual films, but instead sent the written interpretation.