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You may not know the term "chatoyance", but you've probably seen it. The term derives from the French word "chatoyer", which means "to shine like a cat's eye." If you've ever seen a the semi-precious stone tiger's eye, you get the idea. In woodworking, chatoyance is a similarly striking optical quality in which areas of light and dark grain shift and change position depending on the angle of view. The effect is most pronounced in burls and other wavy-grained woods, where abrupt changes in grain direction cause the concentration of reflected light to change dramatically based on the orientation of the surface of groups of wood cells.
Chatoyance is most often considered a desirable effect, and can be enhanced or diminished during the finishing process. There are any number of recipes for maximizing the chatoyance of a finished piece of wood. Most call for a dye stain or other translucent colorant – as apposed to a pigmented stain - and an oil or shellac finish. Here's one offered by finishing expert Michael Dresdner in answer to a question on producing a tiger eye finish on quilted maple:
"…Tiger eye is brown and gold, with loads of chatoyance. To do that on quilted maple, start with a dilute dark brown water soluble dye (van dyke brown will do nicely.) Flood it liberally onto the wood and wipe it off immediately. Although it is a dark color, a dilute or weak dye will mostly color endgrain. Let the wood dry. Then re-sand it with 220 grit paper to remove the dye from any flat grain surfaces. You'll find that leaves plenty of color in the pores, accentuating the figure. Now re-stain with a honey amber dye mixed to whatever color and intensity you prefer for the contrast color. This will tint the flat areas in between the dark figure lines, and you will have a tiger eye look complete with flip flop as you look at it from different angles. Top it off with a finish that accentuates the depth in wood -- shellac, lacquer, or oil."
From the Woodworker's Journal eZine archives
Sometimes, chatoyance is a nuisance. Veneers in some species will produce a striking and unwanted contrast at the intersection of two bookmatched flitches. In that case, minimizing chatoyance is the desired effect. Again, there are various opinions on the best way to achieve this. In general, the goal is to minimize the amount of light that makes it to the surface or the offending wood cells and straight back out to the viewer's eye. Pigmented stains and toners in the top coat are generally the recommended course of action.
There are, of course, other factors involved, including the way the veneer is cut, and the fact that many woods that exhibit a high degree of chatoyance are also very difficult to stain evenly with pigmented stain. "Lightness Variations in Bookmatched Veneers Panels" from the Woodweb Knowledge Base offers a good basic overview of the situation along with a couple of possible solutions. For an all-around education on the sometimes surprising relationships between wood, wood finish and light, we recommend a wood finishing book, like Jeff Jewitt's Great Wood Finishes or Michael Dresdner's The New Wood Finishing Book, and lots of experimentation.


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5 Keys to Victory for the Seahawks Against the 49ers …
After an emotional win on Sunday, the Seahawks have the gift of a short work week and a Thursday evening date with the San Francisco 49ers. The Niners, fresh off an embarrassing loss to the Giants, will surely come in to this game angry and looking to make an example out of our beloved Hawks. Before we get in to taking a look at this all too familiar foe … let's examine some of the numbers that these 2 clubs have put up this year …
Offense …
Points Scored …
Seahawks … 110 Points [Rank tied #23]
49ers … 152 Points [Rank #9]
Points Scored/Game …
Seahawks … 18.3 [tied for #26]
49ers … 25.3 [Rank #11]
Rushing Yards Gained …
Seahawks … 786 Yards [Rank #7]
49ers … 1061 Yards [Rank #1]
Passing Yards Gained …
Seahawks … 1018 Yards [Rank #31]
49ers … 1261 Yards [Rank #23]
Defense …
Points Allowed …
Seahawks … 94 [Rank #2]
49ers … 93 [Rank #3]
Points/Game Allowed …
Seahawks … 15.5 [Rank #2]
49ers … 15.7 [Rank #3]
Rushing Yards Allowed …
Seahawks … 420 Yards [Rank #3]
49ers … 556 Yards [Rank #12]
Passing Yards Allowed …
Seahawks … 1348 [Rank #17]
49ers … 1099 [Rank #4]
While there is some clear disparity between some of the numbers above … an overall pattern emerges that is all too familiar …
BOTH the Seahawks and the 49ers are teams that look to establish the run FIRST.
BOTH the Seahawks and the 49ers are teams that don't ask their QB's to win the game for them by throwing a ton -- simply be smart game managers and don't turn the ball over.
BOTH the Seahawks and the 49ers have great, fast, and very athletic defenses that are stingy as far as giving up points.
And as we already know, both teams have head coaches that are highly passionate and whose players emulate that exact same passion and tenacity.
In many ways, the San Francisco 49ers are a shadowy reflection of the essence of what the Seahawks are ...
So how do you beat the 49ers IN San Francisco?
The formula for how to beat the 49ers is relatively straightforward (though not necessarily easy). Here are some pertinent statistics from their games this season …
Key Numbers From San Francisco Wins ...
The 49ers had NO turnovers while forcing Aaron Rodgers to throw 1 Interception. The Niners rushed for 186 yards (Frank Gore ran for 112 yards on 16 carries [a 7.0 yds/rush average]) against the Packers.
The 49ers rushed for 148 yards against the Lions (Frank Gore ran for 89 yards and a touchdown). The 49ers and Lions each had 1 turnover, so no true advantage for either side there.
The 49ers rushed for an amazing 247 yards and 3 TD's against the Jets (Frank Gore had 64 yards and a TD and Kendall Hunter had 56 yards and a TD). The 49ers held the Jets to just 45 yards on the ground … held Sanchez to just 103 yards passing … forced 3 fumbles and an interception … and had NO turnovers themselves.
The 49ers rushed for an incredible 311 yards and 3 TD's against the Bills (Frank Gore had 106 yards and a TD and Kendall Hunter had 81 yards on only 11 carries). San Francisco forced both an interception and a fumble … and had only 1 fumble themselves. Alex Smith also passed for 303 yards, 3 TD's, and was not sacked.
Key Numbers From San Francisco Losses …
The Vikings forced 3 turnovers (2 fumbles and 1 interception) … sacked Alex Smith 3 times … and rushed for 146 yards (Adrian Peterson had 86 yards on 21 carries [a 3.4 yds/rush average]). San Francisco was held to 89 yards rushing (Gore had only 63 yards in that game).
The Giants forced 3 turnovers (3 interceptions) … sacked Alex Smith 6 times … and rushed for 149 times (Ahmad Bradshaw had 116 yards on 27 carries [a 4.3 yds/rush average] and a TD). San Francisco was held to 80 yards rushing (Gore had only 36 yards in that game).
Based upon the numbers from San Francisco's first 6 games, there are a number of keys Seattle will have to do if they are to win this game …
Hold the Line … Hold the Line …
In the War of 1812, the turning point of the entire war was the defense of Baltimore. One of the biggest keys to the defense of the city were the efforts of individual citizens of Baltimore, who not only erected barricades of earth, furniture, and whatever they could find on land … but also sunk many of their own ships in Baltimore Harbor in order to keep the British Navy out. That barricade of sunken ships proved to be an impenetrable barrier that made it impossible for the British Navy to enter … and ultimately was a large reason the Americans won the battle. Well if the Seahawks are to win on Sunday, they will have erect an impenetrable barricade of their own as well. They simply have to hold the line if they wish to have any chance of winning … and that battle for supremacy begins right up front in the trenches. San Francisco comes in to this game as the #1 Rushing Offense in the NFL, having gained an incredible 1,061 yards from scrimmage already. Joe Staley, Mike Iupati, Jonathan Goodwin, Alex Boone, and Anthony Davis have clearly been steamrollers up front. The Seahawks Defense doesn't look like one who's going to be easily steamrolled though, as they come in to this game as the 3rd Best team in the league against the run, having given up just 420 yards on the ground. They have been a virtual impassable fortress up to this point … and that can't change on Thursday if the Seahawks have any hopes of winning. Brandon Mebane is going to have to continue his Cortez Kennedy impersonation … Alan Branch and Red Bryant are going to have to continue damming up the river … and the rest of the defense shoot down Frank Gore and Kendall Hunter quickly like Patriot Missiles if they want to emerge victorious.
Like the Seahawks, the 49ers find themselves among the NFL's bottom feeders in terms of their passing attack (they rank 26th in passing yards gained) ... and 28th in Passes Attempted/Game (29.3). Alex Smith has passed for the exact same number of TD's as Russell Wilson (8) … and he has just 19 passes that have gone for 20 yards or more. In case you haven't figured it out yet, this isn't Tom Brady and the mighty Patriots passing offense the Seahawks are facing on Thursday.
As the 49er running attack has gone … so has gone the rest of the team. Seattle's Defense comes in to this game having allowed an average of just 70 yards rushing per game … which STILL ranks #2 in the NFL. If the Seahawks can continue to do that, I very much like their chances tomorrow. And there is real reason to believe that they can. Here are the defenses that the Niners have faced thus far …
Rushing Defenses the 49ers Have Faced in 2012 …
Packers … 661 yards (#19 in Rushing Yards Allowed) –Win for 49ers.
Lions … 482 yards (#7 in Rushing Yards Allowed) – Win for 49ers.
Jets … 903 yards (#31 in Rushing Yards Allowed) – Win for 49ers.
Bills … 1,041 yards (#32 in Rushing Yards Allowed) – Win for 49ers.
Vikings … 576 yards (#14 in Rushing Yards Allowed) – Loss for 49ers
[Vikings have #10 PASSING Defense in league … 1,306 yards allowed]
[Vikings have #16 PASSING Offense in league … 1,381 yards gained]
[Vikings have #8 RUSHING Offense in league … 760 yards gained]
Giants … 637 yards (tied for #17 in Rushing Yards Allowed) – Loss for 49ers
[Giants have #3 PASSING Offense in league … 1,738 yards gained]
[Giants have #9 RUSHING Offense in league … 750 yards gained]
So as you can see, while I believe the 49ers ARE obviously a good running team … some of the numbers they've been able rack up are undoubtedly the result of some of the defenses they've faced. In short, the 49ers haven't faced a team yet that has the caliber of defense Seattle has. The Vikings appear to be the best defense the 49ers have faced thus far … and they lost to them. They say that defense travels well and if the Seahawks simply continue to be who they've been so far … I like their chances tomorrow.
If I Could Save Time in a Bottle …
Pete Carroll is one who wants very much to establish the run in order to win the time of possession. After all, keeping your opponent's offense OFF the field is one of the best ways to ensure yourself of victory. Well 49ers head coach Jim Harbaugh wants to do the exact same thing. Just check out the Time of Possession numbers from San Francisco's first 6 games …
9/9/2012 – at Green Bay … (WIN)
49ers – 33:00 … Packers – 27:00
9/16/2012 – home against Detroit … (WIN)
49ers – 30:26 … Lions – 29:34
9/23/2012 – at Minnesota … (LOSS)
49ers – 26:32 … Vikings – 33:28
9/30/2012 – at NY Jets … (WIN)
49ers – 36:56 … Jets – 23:04
10/7/2012 – home against Buffalo … (WIN)
49ers – 36:17 … Bills – 23:43
10/14/2012 – home against NY Giants … (LOSS)
49ers – 27:45 … Giants – 32:15
As you can see, in those games that the Niners were able to control the clock … they won. In the 2 games they lost the TOP battle … they lost the game. So whoever ultimately controls the clock tomorrow … more than likely will walk away the victor.
The Running Man …
How do you control the clock? Ideally, you do it exactly the same way the 49ers would like to … having Beast Mode set off his own quake of the San Andreas Fault line. Beast Mode off left tackle … Beast Mode off right tackle… Beast Mode right up the gut for his 4.3 yards/carry average sounds pretty good, right? It does … except that as I mentioned above, the 49ers (like the Seahawks) are pretty stingy on defense …
Points/Game Allowed …
Seahawks … 15.5 [Rank #2]
49ers … 15.7 [Rank #3]
Rushing Yards Allowed …
Seahawks … 420 Yards [Rank #3]
49ers … 556 Yards [Rank #12]
The 49ers 3-4 Defense is stout up front with NT Isaac Sopoaga (6'2" 330 pounds) … DE Ray McDonald (6'3" 290 pounds) … and DE Justin Smith (6'4" 285 pounds) manning the line. The Linebacking corps behind them is extremely solid, as Patrick Willis (6'1" 240 pounds) and Aldon Smith (6'4" 258 pounds) are two of the best players in the game. Willis and NoVorro Bowman are both among the league leaders in Solo Tackles (Willis has 35 and Bowman is tied with Seattle's K.J. Wright at 33) … and since I fully expect the Niners to load up the box to stop Lynch, I suggest an entirely different strategy against them …
I Suggest a New Strategy … Let the Rookie Win …
Last week prior to the Patriot game, I said the following …
More than likely, New England will probably stack the box with 7 guys, trying to close down the running lanes, put pressure on Russell Wilson, and force the young rookie to beat them through the air. Carroll and the rest of the Seahawks know that as well ... which is why I believe that is exactly Seattle will look to do. The statistics appear to indicate that the Patriots secondary is a real Achilles Heel on this team, which is why I'd look for the Seahawks to look to exploit it. Don't be surprised if the Seahawks take some shots down the field, as Wilson hit Golden Tate for a 56 yard completion in the Carolina Game (which was ultimately called back due to a holding penalty on Giacomini). In that game, Russell Wilson showed some real promising glimpses that he may be starting to come in to his own. So personally, I'd look for Carroll and company to look to set up the RUN ... with the PASS in this game (not vice versa) in order to try get the defense back on its heels and to open up the ground game.
And I was absolutely right in that assessment, as Carroll DID open up the offense and Wilson passed for 293 yards and 2 scores in that game. While San Francisco doesn't have NEARLY the deficiencies in the secondary that New England clearly does … I'd look for Carroll to actually implement the same basic strategy in this game. Now I can hear some of the skeptics out there saying, "Why in the world you even want to attempt that against Carlos Rogers, Dashon Goldson, and the league's #4 Passing Defense? Here are a few reasons why:
1) As we talked about above, the 49ers will undoubtedly be looking to key on Marshawn Lynch, loading 7 (or possibly even 8 ) guys up in the box, forcing the young rookie to beat them. If the Seahawks just SHOW (even for a few plays) that Wilson's arm is a true threat … they might just back off a little and the lanes would then open up for Lynch.
2) Believe it or not … for all the hype that the 49ers Defense gotten, they have racked up just 9 sacks (only 5 teams in the NFL come in to this week with fewer). Getting consistent pressure on opposing QB's has been an issue for them.
3) The 49ers have only 4 interceptions (in the bottom 3rd of the league) … and have just 26 passes defensed (tied for 23rd -- the Seahawks have 40, which ranks in the upper 3rd of the league]. So, those teams that have taken their shots haven't gotten burned nearly as much as you'd think they should have.
In brief, San Francisco's defense may not be quite as good as the statistics might indicate. Just taking a look at Total Tackles, the Giants and the Vikings are the 2 teams that have beaten the 49ers thus far. Minnesota's defense has 454 tackles … and the Giants have 453 – which ranks #2 and #3 respectively in the league. The Patriots, by the way, are #1 in the league with 526 Total Tackles. Seattle comes in to this game as the #4 team in the NFL with 435 Total Tackles.
What about the 49ers? They come in at #17 with 387 Total Tackles.
Watch for Falling Rocks …
It's a truism in football to say that if you don't turn the ball over … more times than not you're going to win the game. And the 49ers are no exception to that old axiom.
In the 4 games that the 49ers have WON this year, they have …
forced a grand total of 4 fumbles
picked off opposing QB's 4 times
and had only 2 fumbles themselves.
[A Give Away/Take Away Margin of +6]
In the 2 games that the 49ers have LOST this year, they have …
forced 2 fumbles and
committed 4 interceptions
and coughed up 2 fumbles.
[A Give Away/Take Away Margin of -4]
Pete Carroll has preached the need to take care of the ball again and again. Going in to a hostile environment like Candlestick Park … for a team like the 49ers who know how to dominate the clock … it's never been more true. If the Seahawks take care of the ball … and simply BE who they were in the 2nd Half of the Patriots game … then I very much like their chances of going in to San Francisco and pulling off an upset.
The Vegas odds makers have the Seahawks as a 7.5 point underdog against the 49ers tomorrow. Though the Seahawks have lost the last 3 straight games to the Niners, you should go out and call your bookie right now because there is a whole lot to like in this game if you're a Seahawks fan. Just ask the Cowboys, Packers, and Patriots who were ALL considered favorites heading in to their matchups with the mighty Hawks. As the Dixie Dynamo Greg Roberts is fond of saying … I believe they've got the wrong team favored.
Seahawks 20 … 49ers 17

subset: commoncrawl


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|Wrightsville, Pa.
|High School:
|Eastern York
2010-11: Opens the season looking to secure the top spot at 149 pounds … possesses quality collegiate experience which should help him succeed … has shown steady improvement … has been a steady contributor during his time with the Green and White … will look to post a breakout campaign.
2009-10: Spent a majority of his time bouncing between 149 and 157 … wrestled in 15 matches … gained invaluable match experience … became a regular starter for the Green and White during the second half of the season … opened the season by wrestling two matches at the Monarch Invitational … picked up a 1-2 mark at the New Standard Corporation Spartan Invitational on December 5 … drew his first start of the year at home against PSU-DuBois at York's Quad meet on December 12 … wrestled in all four of York's matches at the North/South Duals on January 9.
2008-09: Began his collegiate career at the Monarch Invitational on November 8 where he wrestled in two matches … posted a 5-12 record as a Spartan rookie … drew his first college start against Lycoming at the Messiah Duals on November 22 … wrestled to a 1-2 record at the Spartan Invitational Tournament on December 6 …
recorded two pinfall victories in an exhibition matches on February 27 at York's Quad meet.
Personal: Is a sport management major ... is the son of Joseph and Victoria Giandalia ... born on July 2, 1990 ... voted most likely to succeed in go-kart racing ... names his father as the person he most admires ... favorite athlete is Tom Brady ... chose York because of the Grumbacher Sport & Fitness Center ... most significant athletic achievement is he "once pinned a kid who knocked out a tooth of his in the first period" ... most memorable athletic moment while with the Spartan program is when he walked on his hands across the room ... after graduation he plans on becoming an athletic director.


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Difference between revisions of "Vancouver (Washington)"
Revision as of 06:58, 21 February 2013
Vancouver[25] is a city in the Southwest Washington region of Washington State, immediately north of the border with Oregon. Two bridges across the Columbia River connect Vancouver to the rest of the Portland metropolitan area. Vancouver is the fourth largest city in Washington (and is more populous than all cities in Oregon with the exception of Portland), but is obscured by its close proximity to and economic reliance on Portland, OR. It should not be confused with the larger city of the same name, Vancouver, BC (Canada) which is just under 300 miles (450 km) to the north.
Get in
By plane
Vancouver is closer to the Portland International Airport than most of Portland, accessible via Interstate 205 and five - twenty minutes away from most of Vancouver and its eastern suburbs of Camas and Washougal.
By car
Interstate 5 is the main freeway in central Vancouver. Interstate 205 is the primary freeway on Vancouver's east side crossing the Columbia from the Eastern Portland suburbs and eventually ending o Interstate 5 in northern Vancouver. Washington State Route (SR)14 follows the Columbia river from eastern Washington and terminates in downtown Vancouver, providing access to Vancouver's eastern suburbs including Camas and Washougal.
SR 500 and SR 503 provide additional routes through eastern Vancouver including Camas and Battle Ground.
By train
By bus
Get around
By public transit
C-TRAN[29] is Clark County's public bus system. Buses runs throughout the area, serving riders as far north as Ridgefield/La Center, as far east as Camas/Washougal and south across the river to Portland. Express buses and select routes allow connections and transfers to and from TriMet buses and MAX lines.
By car
By bicycle
The area code for Vancouver is 360. Seven digit dialing for all local calls, but note that the 360 area code also covers most of Washington west of the Cascades but outside the greater Everett-Seattle-Tacoma corridor, so 360 numbers outside of the local calling area may incur long distance charges, depending on where in the 360 area code you are calling. You don't need to use the area code when calling within 360.
Get out


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Hi, I have Tiscali Broadband and USB modem B-FOCuS USB 150, connected to my PC running Xandros 3.0. I'v been trying to set up Internet connection. I found a driver for my modem (http://eciadsl.flashtux.org/download/ec ... 1_i386.deb) and I have installed it via Xandros Network. So... my question is : What is the next step to get get that modem working.
THX for any help.
PS. Sorry for my EnGlish.


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Seagate: Investing In Future With DensBits
Seagate Technology, Cupertino, Calif., in June acquired an equity stake in Haifa, Israel-based DensBits Technologies, a developer of SSD controller technology that takes advantage of low-cost flash memory to develop SSDs. Seagate and DensBits will collaborate to develop the technology for future products.
The DensBits technology adds a level of robustness to the tri-level-cell (TLC) flash memory commonly used in consumer electronics products to make them suitable for consumer-grade SSDs. It also can be used with MLC flash memory for developing enterprise-grade SSDs, Seagate said.


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WEST, Texas—Residents displaced by a massive explosion at a fertilizer plant here will be allowed to return to their homes for the first time since Wednesday's blast.
Steve Vanek, a West City Council member, announced residents will be escorted to their homes within the five-block blast site beginning Saturday but will only be allowed into the area between 7am and 7pm daily.
The decision came just hours after fears of another explosion at the West Fertilizer Plant site, where officials say leaking gas tanks damaged by Wednesday's blast have been fueling small fires at the site.
On Saturday morning, local residents living just outside the perimeter of the five-block area closed off since Wednesday explosion reported that police asked them to clear back. Investigators combing the ruins as part of the search and recovery process were pulled away from the site for a brief time, the West Mayor's office confirmed.
Ron Price, who had been trying to access the site to check on the fate of his son's home, told the Associated Press that state troops "came flying down the road" and yelled at people to get back.
"It was pretty scary everybody just jumped and took off running," Price told the AP. "They jumped in their cars and we all started heading back."
Workers were allowed to return to the site a short time later, but officials remained concerned about the volatility of the area around the destroyed plant.
In an early evening press conference, Kelly Kistner, an assistant state fire marshal, said the state would begin to remove the remaining tanks from the site starting late Saturday night as officials continue to investigate the cause of the fire and subsequent explosion.
"We still don't know when the fire started, how the fire started or where the fire started," Kistner said. "Those are all things we are trying to determine."
A spokesman for the Texas Department of Public Safety, which is overseeing recovery at the site, said Saturday that the death toll from Wednesday's blast remains at 14.


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Optional data is everywhere. Databases almost always have a significant fraction of their fields as optional (that is, as possibly NULL). In addition, the forms submitted in web applications can contain absent parameters. All web applications must deal with such possibly-null data as part of normal processing.
For modeling optional data, wrapper classes such as Integer, Boolean, and so on, seem to have a significant advantage over primitives (int, boolean, and so on). This is because both NULL database fields and missing request parameters naturally map to null object references. With primitives, there is no such natural mapping.
For instance, how would you model a person's age as an optional number, with no reasonable default value, using an int? The only means is to use a magic value such as -1. This should likely be avoided, if possible.
JDK 1.5 introduced a language feature called autoboxing,
whereby primitives and wrappers are more or less interchangeable. However,
they are not entirely interchangeable, since wrapper objects can
be null, while primitives cannot.


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Johanna DeJong Collins
Johanna DeJong Collins, 96, of Sweetwater, passed away on April 10, 2013.Jo was born in Springfield, S.D. on Nov. 15, 1916. She graduated from Springfield High School and continued on to receive a teaching degree from Southern State Teachers College in Springfield, S.D. and a Bachelor's degree in education from Chadron State College in Chadron, Neb.A private family memorial service is planned with local arrangements by Cate-Spencer & Trent Funeral Home. Jo was married to Raymond Howe on July 4, 1936. They were married 48 years. She remarried to Richard Collins of Sun City, Calif. in 1986 and they were married until Dick passed in 1996. Jo worked as an elementary teacher at Martin Grade School in Martin, S.D. for 20 years. She enjoyed sewing, cooking, trail rides and keeping things well-organized. She was active in local churches.Jo is survived by brother John DeJong of Bellflower, Calif.; daughter, Joan Smola and husband Dr. Jerry Smola of Sweetwater; sons, Donald Howe of Carrollton, Texas and John Howe and wife Julie of Windsor, Colo.; and other family and friends.Jo is preceded in death by her parents, Morris and Jennie DeJong; sisters, Gertrude Orr and Bernice DeJong; and spouses Raymond Howe and Richard Collins.In lieu of flowers, memorial donations may be given to Nolan County-City Public Library, 206 Elm Street, Sweetwater, Texas 79556. The family of Johanna wishes to give a special thanks to Tammy Flores for her kindness and wonderful care.


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Difference between revisions of "Ray Bulgarin"
|Line 18:
|Line 18:
|businesses = Human trafficking
Drug Trafficking
|businesses = Human trafficking
Drug Trafficking
|voice = Vitali Baganov
|voice = Vitali Baganov
}} '''Ray Bulgarin''' is a minor character in [[Grand Theft Auto IV]] and the main [[Antagonist|antagonist]] in [[Grand Theft Auto: The Ballad of Gay Tony]].
}} '''RayBulgarin''' is a minor character in [[Grand Theft Auto IV]] and the main [[Antagonist|antagonist]] in [[Grand Theft Auto: The Ballad of Gay Tony]].
== Biography ==
== Biography ==
Revision as of 23:14, 8 March 2010
|Ray Bulgarin
Bulgarin, as he appears in Grand Theft Auto: The Ballad of Gay Tony.
[[Appearance::Grand Theft Auto IV
Grand Theft Auto: The Ballad of Gay Tony]]
|Full Name
|Ray Bulgarin
|Date of Birth
|Place of Birth
|Date of Death
|[[Error: Invalid time.|2008 (aged 50)]][[DOD::2008 (aged 50)| ]]
|Age at Death
|Meadows Park, Liberty City
|Galina Bulgarin (Sister, possibly deceased)
|Main Affiliations
Tony Prince
Luis Fernando Lopez
Dimitri Rascalov
Giovanni Ancelotti
Blue Ghawar
Human trafficking
Drug Trafficking
|Voiced by
|Vitali Baganov
{{infobox character
|name = Ray Bulgarin
|image = RayBulgarin-TBOGT.jpg
|size = 200px
|caption = Bulgarin, as he appears in [[Grand Theft Auto: The Ballad of Gay Tony]].
|games = [[Grand Theft Auto IV]]
Rodislav "Ray" Bulgarin is a minor character in Grand Theft Auto IV and the main antagonist in Grand Theft Auto: The Ballad of Gay Tony.
Bulgarin is a Russian mobster who had immigrated to Liberty City in the 1980s, only to be deported after being arrested on human trafficking charges. At some point following his deportation he moved to the Mediterranean, where he lived in a large mansion overlooking the Adriatic Sea. He ran a smuggling operation from there, transporting both people and goods. He employed Niko Bellic, who smuggled people into Italy from Eastern Europe, until one run in which the ship sank, and Niko was forced to abandon ship. Bulgarin blamed Niko for this loss, and sought to hunt him down; Niko joined the merchant navy to escape Bulgarin's influence within Europe, and eventually escaped to Liberty City.
At some point, Bulgarin returned to America and met up with his old friend Dimitri Rascalov, who was at the time coincidentally an employer of Niko. Dimitri offered Niko to Bulgarin without hesitation, as a token of friendship; Niko escaped the ambush with the help of Little Jacob.
Bulgarin crossed paths with Luis Lopez and Anthony "Gay Tony" Prince, and hired Luis to assist him in acquiring Liberty City's professional hockey team, the Liberty City Rampage, but at some point they had a falling out. This lead to the demise of Marki Ashvilli, the hockey team owner and his private army when Luis was sent to eliminate them.
Finding out that the cook was part of the diamond deal, he beheaded him, leaving his head in a birthday cake box on a rooftop for Luis to find when he walked into an ambush Bulgarin had set up.
He later encountered both Niko and Luis for a final time (in GTA IV) when Niko and Luis were representing opposing parties (the McReary Family and the Ancelotti Family) in an hostage exchange. Gay Tony offered the McRearys a large quantity of diamonds in exchange for Don Ancelotti's daughter, Gracie, whom the McRearys had kidnapped. The exchange went as planned for Gay Tony, Luis, and Gracie, however when Bulgarin showed up and claimed that the diamonds were in fact rightfully his, he ordered his men to attack Niko and Patrick, though in the end neither sides got the diamonds.
When Rocco Pelosi revealed to Luis that Ray is at a sit down with Giovanni Ancelotti discussing the diamond situation, Luis dicided he had to kill Ray, before Ray killed Tony and Luis. Luis went after Ray's right hand, Timur, and the heroin left from Dimitri Rascalov; he destroyed the heroin and killed Timur, before heading after Rodislav, who was preparing to leave the city on his jet. With the help of Yusuf Amir, Luis managed to break into Ray's jet and face him after taking out several bodyguards. Despite threatening to destroy the aircraft with a grenade, Luis shot and killed him, causing him to drop the grenade and tearing off the cockpit. Luis retreated to the tail of the plane before the grenade detonated and escaped via parachute.
- Bulgarin's appearance has changed slightly from GTA IV to The Ballad of Gay Tony. In The Ballad of Gay Tony, his skin tone has changed to a more pale color and his hair color is much darker. More detail has also been added to his face and he wears a significantly different outfit.
- Ray is depicted in The Ballad of Gay Tony to be residing in a house in Meadow Hills
- Ray has a sister named Galina Bulgarin. Ray either kills, or seriously injures his own sister, when he shot up through the floor at her with an AK-47 after she was continuously annoying him in the beginning cutscene to the mission In the Crosshairs.
- Ray is revealed in The Ballad of Gay Tony to be collecting celebrity memorabilia (notably sports and rock band memorabilia) as a hobby.
- Ray has two cars, a black Marbelle which he drives in GTA IV and a dark blue Landstalker which he drives in The Ballad of Gay Tony. If you look closer, Ray is also driving a black Esperanto in the mission "Ladies Half Price".
- An easter egg in the original GTA IV is present if the player has choosen "Revenge" and is about to complete Out of Commission. When the player finishes off Jimmy Pegorino and the cutscene concludes the game, the player can spot a fireball-like explosion in the sky behind Niko. This would be when Bulgarin's plane is destroyed and Luis Lopez escapes via Parachute.
- Bulgarin used to wrestle and was in wrestling academy as a boy.
- Bulgarin supposed to be deceased in LCPD Database.
LCPD Database information
Surname: Bulgarin
First Name: Ray
Age: 50
Place of Birth: Unknown
Affiliations: Linked to Russian Organized Crime Syndicates throughout Liberty City
Criminal Record:
- 1989 - Human Trafficking
- People smuggler and high profile figure in global Organized Crime.
- Believed to be operating in Europe on the Adriatic.
- Deported after being caught receiving a shipment of Albanian sex workers at the Liberty City Docks in late 80s.
- Reports indicate that he may try to return to the US.
- Fire Ball Bulgarin.png
"Fire Ball Explosion" easter egg in GTA IV's "Revenge" ending.
Mission appearances
- Grand Theft Auto IV
- The Ballad of Gay Tony
- Boulevard Baby
- Going Deep (Boss)
- Dropping In... (Boss)
- In the Crosshairs (Boss)
- Ladies Half Price
- Departure Time (Killed)


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Eugene Onegin, ENO
Hellen Wallace reviews Deborah Warner's production of Tchaikovsky's opera
Eugene Onegin must be unique among opera plots in the catastrophic effect it had on its composer's life. Like Onegin, Tchaikovsky received an ardent love letter from a girl he hardly knew, Antonina Milyukova; horrified that he might be acting like Onegin in rejecting her, he felt honour-bound to enter a disastrous marriage. The challenge for a director is whether to identify Onegin with the estranged, artistic outsider, Tchaikovsky, or to make him more like Pushkin's depraved villain, and to backload all the characters with the poet's almost gleeful sense of irony.
Deborah Warner has taken the former approach in a largely traditional production which is skewed by its casting. Her Onegin (Audun Iversen) is no monster, but a nonchalant, solipsistic youth. In Act One, he lacks the snarl of real scorn, and comes across as a rational, self-aware commitment-phobe who lets her down gently with a chaste kiss. Amanda Echalaz as Tatyana, on the other hand, may act the part of melancholy young bookworm, but her singing was altogether on too big a scale to allow for real fragility. Sounding more mature than Onegin himself, her letter scene was shrill and loud, not helped by the vast barn in which this most intimate of scenes was set – neither apparently indoors nor outdoors, it only served to make a clumsy point about the rural setting.
It was hard to see how this neutral Onegin and belting Tatyana could make their dramatic transformations into deranged lover and sophisticated society hostess in Act Three, and certainly Echalaz had nowhere vocally to go. To their credit they created a final scene of great tension: if we believe the two actually might elope, they have succeeded, and this was almost the case here.
Still, the climax of the opera came in Act Two with Toby Spence's touching Farewell aria, beautifully paced and risking a wonderful range of timbres – the only pianissimo singing of the night. He makes a perfect Lensky, a bright, glistening stage presence with a youthful openness that at once gives him the vulnerability this Tatyana lacked. While his melodramatic petulance in the ball of Act Two is faintly ridiculous, by the fateful duel his sincerity is searing. Claudia Huckle's inimitably dark-hued mezzo made her an alluring Olga, while Brindley Sherratt was in sonorous voice as Prince Gremin.
Gardner delivered the score with taut verve, reminding us how close to ballet these lyric scenes are. There were moments, like the close of Tatyana's letter scene, where tautness became perfunctory and the upper strings needed more radiance, though the cellos lead the narrative with warmth. Couldn't the horns have lingered a little over their lovely falling melody? But the sense of disjunction that permeated the whole performance was not ultimately down to Gardner, but the curtain drops and long pauses between scenes that served no practical purpose since Tom Pye's sets remained unchanged. Jean Kalman's lighting worked its magic on two memorable winter outdoor scenes and a magnificent final ballroom, where Kim Brandstrup's elegant choreography was finally allowed to shine.
Eugene Onegin is on at the Coliseum, London until 3 December
Helen Wallace is consultant editor of BBC Music Magazine
- Article Type: | Blog |


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|Episode Description
|Tuesday, Apr 30, 2013 - 7:00 PM
This documentary looks at how nature - an increasingly rare influence on today's children - is essential to their health and development. The film focuses on ways that nature supports cognitive and physical development, creativity, emotional balance, and spiritual awareness - and to inspire action to get our children out of doors. G
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"Diwali is all about sparkle," says Krishna Sharma who celebrates the festival of lights with the same rituals he's been following in India. Krishna takes special pride in the fact that his better half, Shyama, creates artistic rangoli, (decorative floral art with petals, flour and coloured powder at the entrance of a home) lights oil lamps and prepares home-made Diwali sweets.
For the Sharmas, the preparations for Diwali started with spring cleaning and stocking up the pantry with ingredients that go in to creating the finest Indian sweets and savouries. Every year they religiously shop for silver coins to gift along with the boxes of goodies to their close family and friends. The silver coins signify health, wealth and prosperity.
"We treat our guests like God. Hospitality is the mainstay of Diwali," says Krishna, talking about the Indian custom of welcoming people home and feeding them up.
"In New Zealand we tend to celebrate Diwali over the weekend and spend all our time visiting friends, except on the day we pray to Laxmi, the Goddess of Wealth."
While celebrations have already been held around the country, today is Diwali. During one of today's celebrations - Laxmi Poojan - it's believed that the Goddess of Wealth gets attracted by the flame of decorative oil lamps and twinkling fairly lights that roll out a warm welcome. The entire family will wake-up before sunrise, shower and pray. This is followed by the ritual of washing the family jewellery and heirlooms in milk and honey. According to popular belief, Hindus do not step out of their homes because it could deter the Goddess of Wealth from entering.
Krishna dutifully follows the rituals in the hope that his 12-year-old son Abhishek will not lose touch with his culture and background.
For Vinod Mistry, director Surti Indian Samosa, Diwali is quintessentially about throwing light on the inner self. Vinod is happy that there are so many initiatives by the Auckland Tourism, Events and Economic Development (ATEED), like the 'light up your home' competition and a restaurant vegetarian food challenge being organised to celebrate the biggest Hindu festival.
Rina Tagore, a keen observer of the social and cultural landscape of the city is delighted that Diwali is celebrated as a big public event in Auckland.
"The opportunity to experience the lights, the colour, and the buzz, the display of popular and traditional culture shows the growing diaspora of the sub-continent in Auckland," observes Rina who believes that the support from the local government for the events speaks of the value placed on community wellbeing.
In comparison to other OECD countries, New Zealanders are far more open to ethnic and religious diversity according to Mervin Singham, director at the Office of Ethnic Affairs
"It may have something to do with the growing relationship between India and New Zealand, particularly in the areas of tourism, education and trade. Our inclusive society is the envy of many and a true example of how New Zealand can be a leader in developing peaceful co-existence of people from all ethnic backgrounds," he says.
"Traditionally, Diwali is a festival of peace, harmony, brotherhood - the need for which is particularly relevant in today's world marred by violence and acts of terrorism," says Avanindra Kumar Pandey, High Commissioner of India, New Zealand.
"Diwali offers an opportunity not only to celebrate but also to strengthen the bonds of friendship between all communities in New Zealand, as also between the two countries."


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Steven Taylor has vowed to stay with Newcastle and lead the club back into the Barclays Premier League.
The highly-rated 23-year-old defender has been linked with a move away from St James' Park this summer following the Magpies' relegation last term, with Everton and Aston Villa among the reported interested parties.
But Taylor told the Daily Express: "I was part of the team which was involved in taking Newcastle down and out of the Premier League and I want to put it right by being part of the side that takes us back where we belong, in our rightful place in the top flight."
He added: "I have never swayed from that aim. There has been interest but I want to make very clear that I have always wanted to lead Newcastle back to the Premier League. That has always been my main wish."
Newcastle have already lost key players in Sebastien Bassong, Michael Owen, Damien Duff and Habib Beye since slipping out of the Premier League but can claim top spot in the Coca-Cola Championship standings by beating Leicester on Monday night.
Copyright (c) PA Sport 2009, All Rights Reserved.
Do YOU want to write for GiveMeSport? Get started today by signing-up and submitting an article HERE: https://www.givemesport.com/writeforgms


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Finished in that shade of Old English White with whitewalls, we can't help but think of Mark Twain when we see this 1954 MG TF for sale on Hemmings.com. It needs a bushy white mustache to go with it, which wouldn't distract at all from what looks like a spectacular restoration on the car. From the seller's description:
Recently completed ground up nut and bolt restoration. No expense was spared. It was bought in 1993 as a very solid show quality driver for $12,000, then driven, shown and enjoyed for several years. Than the owner started what would become a 10 year, professional concourse quality restoration. Every inch of the car had to be as new or better. Anything that was not perfect was restored or replaced. This restoration was completely documented with photos and receipts for every step along the way. Originality was painstakingly researched to assure the car would meet the highest standards. A total of over $60,000 invested, resulting in this amazing MGTF. You will search a long time and never find a better more completely restored TF. Regrettably the gentleman who spent his time and money to have one of the finest MGTFs in the world never enjoyed the fruits of his labor. He passed away shortly after finishing the car. He did have time to drive it a few times and to sort out all the things to make it 100 percent ready to enjoy. It has had approx. 200 miles driven since completion.
This is one of those rare oppertunities to buy a completely restored car at fraction of the cost to restore one yourself. Obviously the owner got cought up in the restoration process and obcessed about creating the perfect MGTF. Im sure he never intended to spend so much but what a great oppertunity for the next owner.
The next owner will have to choice as to whether it becomes an trailored show car or is enjoyed as a show quality driven car. It is the perfect choice for both.
It is finished in the correct TF colour, Old English white with correct red leather interior. It looks as nice underneath as it does from the topside. The level of detail is unbelievable. It runs as good as it looks with every mechanical system completely rebuilt to be as new. It starts runs, tracks and brakes as new or better. I have every receipt and a complete photo record of every aspect of the restoration.
See more MGs for sale on Hemmings.com.
I would say that "invested" is not the same as "spent".
Very nice. One question: were wide whitewalls commonly used on TFs back in '54?
Final invoice is probably what ki8lled him and white walls do not belong on aq sports car
I always liked the TF, even moreso than the TC or TD. Strangely enough in our neighborhood, a TF was scarce as the proverbial hen's teeth. Nice to see a fine example of a TF here.
So sorry for the owner who had gone to such great pains to do the job and not get a chance to really enjoy it. I hope that where he is now, he has his choice of rides.
Can you say "over-restored"? And the white walls are a joke.
I don't know about the whitewalls, but this is another car I would like to have in my (still non-existent) collection.
I can just picture the Great Leslie looking in the rear view mirror for Professor Fate.
Glad to see that I'm not the only one to put whitewalls in the same category as ear-rings on men!
The American journalist Henry Manney III, writing, I think, in Road and Track, described the TF on its introduction as "Mrs Casey's dead cat warmed over". The press were expecting something a bit more radical, which came later as the MGA.
Back in the day, the conventional wisdom was that Americans loved whitewalls, so many importers put them on cars that would never dare show them in their home markets. I think you'll find photos of US auto shows with white-shoe TFs, and perhaps some ads, though most cars I remember seeing in New England showed better taste.
Pardon me, snobs, but I absolutely love it! For a stopgap auto, abdington did an awesome job!
Almost 40 years ago I was given a 1954 MGTF when I graduated high school. I helped my father restore the car buying parts from Whitney and Moss Motors and even did some body work. I am female by the way. Also, I was born in the UK and my dad was in the USAF. What wonderful memories. I loved that car more than just about anything. I remember cranking it when it wouldn't start with the electric starter and choke. It had spoke wheels and the worst thing I did was loose the original owner's manual. I loved the way it hugged the road and couldn't wait each day to drive it—anywhere. I sold it to someone in Texas in 1975, I believe. I still have the original key somewhere.
I've had several TD's, a TC and a 54 TF, but through bad luck and my own stupidity, I have none. I am trying to find a 55 TF 1500 that needs lots of love. I'm really far too old now to try this, but it's the only car I've had a lifelong love affair with and I do not wish to die without trying to find a '55 I can nurse back. Unfortunately, prices have reduced my chances, but I still hold out hope of finding something under the 15,000 range.Does anyone know of any '55 TF 1500 that is not already destined to be shipped back to the U.K. and resold at inflated prices?


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Valdosta, GA - The papers have been served. The Valdosta-Lowndes County Industrial Authority is moving ahead with a lawsuit against 'Wiregrass Power, LLC'.
They're suing for land that was once planned for the Biomass Plant which was later scrapped. The Industrial Authority owns the land and contracted Wiregrass to run the plant.
The Authority says the extended lease agreement ran out in June of last year, so that should put ownership of the land back in its hands.
Valdosta, GA - The vocal protests in Valdosta are long gone, but the controversy over the proposed Biomass plant lingers. This time not for concerns of health safety, but over the land.
The Valdosta-Lowndes County Industrial Authority plans to sue Wiregrass Power LLC to end its contract.
"The Industrial Authority has taken this action to ensure that we have a clear title to the land that was originally proposed to Wiregrass Power," said Allan Ricketts, Project Manager for the Industrial Authority. "So that we can pursue economic development opportunities to create jobs and capital investments in Valdosta and Lowndes County."
The Industrial Authority owns the land and contracted Wiregrass Power to run the plant, but the biomass plans were scrapped and a Solar Plant was built instead.
The Authority says the extended lease agreement ran out in June 2011, so that should put ownership of the land back in its hands. Wiregrass tried to buy the land from the Authority in May 2011, just five days before the deadline. The Authority denied Wiregrass the purchase, saying the company was already in default because a "failure in performance."
Wiregrass denies any allegations the Authority has made regarding the agreement. Their attorney says they were not in default and they complied with every deadline.
The proposed Biomass Plant was supposed to be a low-cost source of efficient energy. Supporters say it would have created hundreds of jobs. But opponents say the health risks include cancer, lung disease and respiratory disease.


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By Avi Salzman
Investors took off early for Thanksgiving vacation, as composite volume on the NYSE fell to its 10th lowest level of the year on Wednesday.
The Dow rose 48 points, or 0.4%; the S&P 500 rose 3.2 points, or 0.2%. Both indexes registered their highest closing prices since November 7.
Consumer stocks wre among the best performers, with Skechers (SKX) rising 10% after an upgrade and Movado Group (MOV) up 7.6%.
On the downside, Deere (DE) fell 3.7% after posting disappointing earnings results. Read our take on the results here.


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GREENVILLE, Ill. -- Greenville College has announced the hiring of its next head men's soccer coach. Following the April resignation of Bobby McColl, Chris Swift, a native of southern California, will assume the reigns of Greenville's three-time NCAA national tournament participant men's soccer program. Swift will also serve as GC's assistant women's soccer coach.
Coming fresh from a stint as an assistant women's soccer coach at two NCAA Division I institutions (Eastern Kentucky and Lamar University), Swift brings 11 years of coaching experience -- five at the collegiate level and six in high schools.
A 2006 graduate of Vanguard University in California, Swift holds four coaching certifications -- USSF "C" License, NSCAA National Diploma, USSF National Youth License, and NSCAA Regional Goalkeeping Diploma.
Swift joined the Eastern Kentucky Colonels after spending three seasons as an assistant coach at Lamar University in Beaumont, Texas. In his first year at Eastern Kentucky, the team finished 10-7-3, posting the first winning record in program history, and setting school records for overall wins, conference victories (six), goals, assists, points and shots. The Colonels went undefeated at home for the first time in program history, posting a home record of 8-0-1. The 2012 team also earned a fifth consecutive berth in the OVC Tournament, the longest active postseason streak in the conference.
Lamar improved all three years that Swift was a member of the coaching staff, culminating in 2011, when the Lady Cardinals enjoyed the most successful season in the five-year history of the program, setting school records for victories (eight) and conference victories (six) while earning the No. 3 seed in the Southland Conference Tournament. Six Lady Cardinals earned all-conference honors following the breakout season.
Swift used his connections in California to recruit several key members of Lamar's record-breaking 2011 team, including two all-conference selections.
Swift was also instrumental in Lamar's high academic standards while he was there, resulting in two Lady Cardinals being named second team Capital One Academic All-District in 2011.
Aside from recruiting and academics, Swift was also in charge of training, video breakdown, camps and community service while at Lamar.
Before arriving at Lamar, Swift was an assistant coach/goalkeepers coach at his alma mater, Vanguard University in Costa Mesa, Calif., from 2008-09. Swift played goalkeeper at Vanguard from 2002-06 and recorded 138 saves and four shutouts during his career. He earned his bachelor's degree in history and political science.
Swift also possesses several years of club coaching experience, serving as an assistant coach for the Slammers Football Club from 2004-06, the United Futbol Club from 2006-09 and as the goalkeepers coach for the Los Angeles Legends Football Club in 2009.


text: I agree. A simple "I've been offered an opportunity and I feel it's in my best interest to take it" is fine. No details. If you are valued, she will offer to negotiate but I doubt it. $.05 raise is an insult. I know, it's happened to me. She's essentially telling you that your time is worth five cents an our more with all your schooling, training and loyalty? Would you leave a nickle tip @ a restaurant? Better to say it just isn't in the budget and show appreciation in other ways? Thank you note, gift card occasionally? Your first responsibility is to yourself. You owe her nothing. Everything ES said comes from alot of knowledge and experience. Good luck! It's nerve racking I know but this too shall pass!


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What could possibly be in my medical records that they don't want me to know about?
The price tag
The price tag isn't part of your Medical Record. However you do get a lit of Procedures which you may be able to cross reference to see what the price of them are... However you normally get the price when they send you the EOB (Explanation of Benifits)
Most Patients think Doctors and Hospitals should charge less.
There are way more patients than doctors so if we are going to get into this bullshit of setting policy by taking fucking polls, then I think the Doctors will be fucked over well and good.
The mistakes
For example:
"Patient responds well to placebos"
"Patient is a looney hypochondriac, but has lots of money. Recommend all possible expensive tests."
"Patient is an addict, faking symptoms in order to get painkillers."
"I'm not going to do test X because the lab I own doesn't sell that service, but I'll send him for an extra MRI because I've got a boat payment to make".
"Patient is an addict, faking symptoms in order to get painkillers."
This one actually happened to an old friend of mine. He had in the past had issues with substance abuse and it had made its way into his medical records. Fast forward a couple of years and shows up at the ER with a pretty nasty injury after chopping wood and they outright refuse to give him any painkillers except ibuprofen...
Took 24+ hours before he and several others were able to convince the doctors that he needed real pain relief.
"Patient is an addict, faking symptoms in order to get painkillers."
This one actually happened to an old friend of mine. He had in the past had issues with substance abuse and it had made its way into his medical records. Fast forward a couple of years and shows up at the ER with a pretty nasty injury after chopping wood and they outright refuse to give him any painkillers except ibuprofen...
Took 24+ hours before he and several others were able to convince the doctors that he needed real pain relief.
A number of states now have databases of patients that doctors label as such for other doctors and pharmacies to watch out for.
Unfortunately, doctors are generally woefully unequipped to treat pain, particularly long-term pain. Plenty of addicts are made by the medical profession, something they don't like to admit.
Unfortunately, doctors are generally woefully unequipped to treat pain, particularly long-term pain. Plenty of addicts are made by the medical profession, something they don't like to admit.
Posting as AC for obvious reasons but... Yes I would agree that a lot of addicts get their drugs directly from a doctor. It just takes one injury that causes chronic pain and you're often left with two choices in the end: Try and live with the pain, or become an addict. I don't necessarily mean mental addiction, but there is no way to avoid the physical addiction. I was hurt, and was on narcotics for years. They finally were able to perform a procedure that didn't remove the pain, but got it down to the bearable level it was at when I was medicated. I was virtually pain free, even at the lowest dose of my medication. I asked the doctor to take me off completely and we spent months and months weening me off. Within 3 days of taking that last dose, I thought I was dying. It was the most miserable experience in the world. At least, I thought so at the time. It's been almost a year since I've touched the stuff, but the first few weeks were the only time in my life where I ever thought I needed a drug to live. I had to flush my stockpile of medication down the toilet for fear that I would, in my weakness, use it.
Unfortunately for me, the procedure was only a temporary fix. It will help me for 6-24 months. I've also discovered that I still have bad days. Days where I can't get out of bed in the morning due to pain. So, now I find that I am going to have to ask my doctor for a limited supply of meds anyway, just to deal with this occasional issue. I could have gone on long term disability years ago, but I prefer to work. I can't keep a job if I can't get out of bed, however. It's a terrible situation to be in, and I would never wish it upon my greatest enemy. I wouldn't even subject the man who did this to me to this kind of life.
Disclosure: I'm married to a doctor. A pain doctor, no less.
Doctors go to jail for prescribing painkillers that are later abused, so they err on the side of caution. Your friend is a victim of the drug war. My wife has "fired" many a patient - most of them quite deservedly. But people are very good at saying what they need to say, so she has to be over-cautious.
I worked in the medical industry, handling medical data. This is exactly what they don't want you to see.
Patient records are riddled with notes intended only for internal use. To a doctor, it's nothing special that you suffered explosive diarrhea in the middle of the hospital elevator - that happens once a week, and it could be medically important. To a patient, that's a terribly embarrassing episode that shouldn't be in records, and even considering storing such a thing is grounds for a lawsuit. That lawsuit would be argued in front of people outside a hospital setting, who would be biased in favor of the patient. In front of a hospital ethics board, tthe incident is just another bad day for the janitor.
To use the traditional car analogy, hospitals are much like body shops. You really don't need to know every point that was inspected, every noise source that was considered, or the internal notes from the mechanic about how you question every repair so he should make sure to only finish work on days the manager's available. Most of the information is obvious to someone knowledgable, useless to someone who knows nothing, and ammunition for someone who knows just enough to be dangerous.
On the other hand, what does the patient need to see? Doctors know that old records are unreliable, so history beyond a few years old doesn't really matter if it's slightly inaccurate. Current treatment is usually handled by a single primary doctor, who knows what makes sense for a particular patient, so inaccuracies there don't matter either.
Sure, it's information about the patient, but giving out all the details just causes more trouble than good.
To use the traditional car analogy, hospitals are much like body shops. You really don't need to know every point that was inspected, every noise source that was considered, or the internal notes from the mechanic about how you question every repair so he should make sure to only finish work on days the manager's available.
True, but I'd expect to get that information if I ask for it. Same with medical records.
I observe every single thing done to my car. I am there in the shop as they do them; not in the waiting room. I have seen belts put on backwards, i have seen a mechanic raise my hood into the ceiling. I also come out with a full understanding of what needed to be done on my vehicle and why. Healthcare is the same. You should have full access to YOUR records.
Sure, it's information about the patient, but giving out all the details just causes more trouble than good.
You miss the point... it's ALL discoverable in a lawsuit. And not just the patient's internal records - everything the hospital did anywhere near the case. Emails, internal mail, policies, meeting notes, texts, call records... you name it. Discovery alone can cost the hospital a small fortune. People in general - not just doctors - are under the impression that secrecy prevents problems, but making a patient feel like there are secrets to be discovered only leads to more trouble. Even if the hospital makes
In a lawsuit, the trouble's already arrived, and the records can do more good than harm.
The real problem isn't really patients knowing their records, but rather patients taking their records out of context, without understanding what each note means. Ten minutes on the Internet, and patients get a huge list of questions about every trivial detail in their records, and they'll be sure to waste the doctor's time with them at the next appointment. They'll think that a noted tiny chance of a problem is a major issue, They'll see every mistake is a gamble with their life.
Not every patient, of course... but just enough to make medicine even harder than it is.
An interesting anecdote: About two decades ago, my father developed cancer. He had surgery, which went well and led to a complete recovery. At one of his follow-up appointments, his doctor told him something from his record, that he'd kept secret. As it turns out, my father had actually died on the table. He's always known he was allergic to all seafood (and that was noted in the record), but it's actually a particular iodine compound that's the culprit. That compound was used in the normal surgical antiseptic, and was never before thought to be an allergen. During surgery, he had a severe reaction and had a severe heart attack.
The surgeons of course noticed immediately, treated the heart attack, then finished the cancer surgery, then the doctors included treatment afterward to clean up the mess. It was all detailed in the record, and any inquiry (or future surgical plans) would have clearly seen it, but it wasn't something my father needed to know in the months after surgery. After such an ordeal, the extra stress of knowlege would have only hindered recovery. Ignorance can indeed be bliss.
Patient records are riddled with notes intended only for internal use...could be medically important.
Not all of those notes are. Friend of mine got access to her medical records. One of the notes was, "pleasant young female."
I've read notes on me that said the same, but I'm also in a health profession, so I read the importance a little differently.
"Pleasant" indicates that the patient is not showing undue signs of stress, depression, altered mentation, or hostility. A "pleasant" person is more likely to follow medical advice (i.e. comply), and therefor more likely to actually get the treatment as prescribed by the doctor. Depression, altered mentation, or hostility indicate more care needs to be taken, or might indicate pain,
"Patient responds well to placebos"
"Patient is a looney hypochondriac, but has lots of money. Recommend all possible expensive tests."
"Patient is an addict, faking symptoms in order to get painkillers."
My knee-jerk reaction to this is of course "there's NO good reason to withhold my medical information from me!", which was only made worse by the surprising statistics of doctors that wanted to keep it hidden from my view. But you raise some very good points.
Perhaps what's needed here is a two-section medical record. Things that should be shared with the patient, (which should be the default behavior) and things that should NOT be shared with them, for their own benefit. The patient should not be able to determine if the "not to share" section contains information or not.
But as for the 2nd of your examples, yes a hidden feature is abusable. But this is your DOCTOR we're talking about. They are in a position of trust. If you don't trust your doctor, you need to find a new one. If you're a doctor and you've proven yourself untrustworthy, you need to be delicensed. It should be safe to assume you can trust your doctor. Given that, they should be allowed to selectively hide information from you for your benefit.
Like the old saying goes, there are two people in life you should never lie to: your doctor, and your lawyer. Because it's their exclusive job to represent and protect your best interest. And you need to be able to completely trust them both, because your health and your freedom are on the line, and they're the ones you're relying on to protect that.
Well... what they did
I guess doctors make wrong or let's say suboptimal decisions all the time, it's just that rarely people get so bad or die because of it so you actually get into malpraxis discussions. They want no patient oversight of what they are doing because a 5 minutes google search might convince you they are not doing a stellar job after all.
In Romania we have a law, that they "forget" to change every year, stating that the dead guy (and only him) must personally ask in writing for the medical records. In case someone dies from malpraxis no-one has access to that anymore so basically you can't argue malpraxis for people who died (therefore we have a statistically excellent medical system).
So yes, I'd go with conspiracy.
I guess doctors make wrong or let's say suboptimal decisions all the time, it's just that rarely people get so bad or die because of it so you actually get into malpraxis discussions.
Doctors do make mistakes just like any human. The human body is a complicated thing and doctors are nearly always working with incomplete information. Mistakes are unfortunate but also inevitable. The most you can and should ask for is that the doctor treated you with the appropriate standard of care [wikipedia.org].
They want no patient oversight of what they are doing because a 5 minutes google search might convince you they are not doing a stellar job after all.
It is terrifying that some people think that 5 minutes on google somehow will make them more informed than 10 years of medical training plus years of actual medical practice. Self diagnosis via google is a
5 minutes on google will tell me that the self-protecting asshole doctor prescribed a relative of mine a drug containing paracetamol, which google helped me learn was a synonym for acetaminophen.
What's the big deal? Well the relative had knee replacement surgery, so painkillers were necessary. The asshole doctor ignored the fact that he was explicitly told not to administer anything containing acetaminophen because the patient had liver disease and explicitly stated such on multiple occassions. The doctor didn't want to go through the hassle/overhead of dealing with a schedule 2 drug, and just prescribed the drug containing acetaminophen.
Even after explaining to him that 'No, this person really needs to not take acetaminophen/paracetamol/tylenol/etc' we still discovered that they kept 'resetting' and going back to giving him the drug.
So you will have to forgive me for not trusting 10+ years of experience vs google when the asshole kept giving tylenol to a guy with liver disease.
So you will have to forgive me for not trusting 10+ years of experience vs google when the asshole kept giving tylenol to a guy with liver disease.
It's appropriate to check on what is being prescribed and be involved in your care when you have the ability. Even well intentioned doctors (and pharmacists) make mistakes. Odds are that there was a problem with communication and that it was an honest mistake. Doctor's that would intentionally or negligently harm a patient are quite rare.
That said, if you felt the patient was being intentionally mis-treated or incompetently treated then one has to ask why you continued to let this doctor treat the patient? If this guy was such an "asshole" then you can and should demand a different doctor be involved. You always have that right and you should exercise it if needed. What you are describing is grounds for a lawsuit. Did you bring one or are you just trying to bash doctors in general based on one anecdote?
That said, if you felt the patient was being intentionally mis-treated or incompetently treated then one has to ask why you continued to let this doctor treat the patient? If this guy was such an "asshole" then you can and should demand a different doctor be involved. You always have that right and you should exercise it if needed. What you are describing is grounds for a lawsuit. Did you bring one or are you just trying to bash doctors in general based on one anecdote?
It was the non-surgical doctors/staff
Agreed. Whatever their reasoning is, you can bet that it isn't for your benefit.
Doctors are human beings just like the rest of us, and driven by self-interest just like the rest of us. I've always found it strage that people are so willing to put their undivided trust in doctors -- when those doctors are ultimately driven by self-interest and theferore should be regarded as no more or less trustworthy than any other human being.
In fact, I've noticed that doctors are every bit as susceptible to "material dri
What could possibly be in my medical records that they don't want me to know about?
20 years ago my 35 year old friend died from stomach cancer. 8 years prior a radioligist failed to do his/her job correctly by not noticing a tiny white dot, so for 8 years the cancer grew until any swallowed food was blocked from continuing on into his body. Coincidentally, my friend's wife happened to work in the records room of his HMO (it's name rhymes with 'gyp'), and snuck his medical records out. The widow received a large wrongful death settlement only because of her having physical possession of his records, else no one would have known the true cause of his provider's negligence.
That's one reason why you would want full access to your own records.
I type medical transcription. Doctors can and do insert personal opinion into their notes, make mistakes, misstate facts, and other things that might lead to malpractice suits and other legal problems. This is called ass coverage.
I was surprised that in the article and in the linked survey article there was no mention of WHY a doc would want to restrict information.
Because you don't need it; now stop acting like a 3 year old with all this 'why' nonsense!
We had to take out a feature that let patients update their medical history online (which is a great feature because then the patient isn't be forced to memorydump in the clinic, there's a reason they tell you to write all this down and bring it a notebook when you see the doctor) because they were trying to removing items from the medical history in order to get claims paid that were rejecting for pre-existing conditions.
Now that obamacare is putting an end to the pre-existing condition thing, we may put it back, we'll see if the docs want it though. I believe the 65 percent is right though. On the other extreme, my boss believes that the patient should own their own medical record as a file they carry with them everywhere on a thumbdrive, I see that as a recipe for lost records and forgotten passwords. The alternative to having it on your person being Microsoft HealthVault still doesn't exactly make me tremble with joy.
Like most things, it would benefit from being managed by Git
You see a simple folder full of your medical history.
Your doctor sees it as a book of half-truths that can be twisted to create liability in a multitude of ways.
Remove the liability here, and these results would change.
Yes. Remove the liabllity.
Improve professional standards.
If doctors think they are vulnerable to malpractice suits then clearly they are aware that their house needs to be cleaned. You can either put up with the dirty house (tort reform), or you can actually clean house and improve medical standards.
Of course doctors don't want their misdeeds and incompetence on display for all to see.
John Edwards and his kind are the reason. Many malpractice suits don't have any scientific basis, it's just a matter of running a sympathetic "victim" in front of a jury.
http://www.washingtontimes.com/news/2004/aug/16/20040816-011234-1949r/?page=all [washingtontimes.com]
Information != Knowledge. It's already a big problem for doctors that patients come in demanding this or that treatment that they've read about on the internet, often with no real understanding of whether it's appropriate for them, or whether it's actually an effective treatment at all. I would imaging this is what is behind the doctors attitude in this study; full access to medical records will probably only increase that trend, with people trying to interpret their own records, and saying why did I not get such and such a treatment that I found on Google. That's not to say I agree with the doctors stance, but I can see where they're coming from.
Doctors don't know everything. They're trained to spot the most common problems, but it's really, really easy to stump a doctor. My GF has been having dizzy spells. She went to her GP, who sent her to an ENT, who sent her to an audiologist. None had any ideas.
So she spends some time on Google, and finds out that dizziness can be a side effect of gall bladder attacks(through over stimulation of the vagus nerve which causes a sudden drop of blood pressure). And she had seen the same GP a year earlier about her gall bladder problems. Why didn't the GP pick this up?
No, patients should be encouraged to do as much research as they can. You as a patient care more about your issue than anyone else. You know more about your body than anyone else. You should be a partner with your doctor in your own health care.
With my ex-wife, we only managed to get a (now-multiply-confirrmed) diagnosis of her inherent genetic condition after 30 years of misdiagnosis by dozens of doctors. With the help of Google. Yes, I'm sure lots of people waste their time and it's a haven for hypochondriacs but it's also an invaluable resource when doctors are as overworked/lazy as they are.
Her condition is JHS - joint hypermobility syndrome (also called HMS) that can come from over-extending joints (e.g. ballet dancers, gymnasts) or - in her case - from a genetic predisposition to a collagen deficiency. It was almost unheard of until a decade of so ago (and I've since seen another diagnosis of it in the school I work for) and there is little research on it - it's one UK doctor's pet research project, but by all accounts he's a bit of an arsehole.
It's misdiagnosed by most doctors as arthritis because the chronic joint pain associated with it is easier to write off as that than anything else (even in 20-30 year olds). In fact, it's the exact opposite - sufferers can do the splits and bend over backwards to rival the best contortionists but have chronic pain, whereas arthritis LIMITS joints movement and have chronic pain.
There's a simple ten-point test that's taken as official diagnosis, one point if you can place your hands flat on the floor without bending your knees, for example. Everyone in the world scores about 2-3. Flexible people can score 3-5. JHS sufferers score 8-10. My ex- scored 10 and always will, even when she's 80. It's the prime diagnostic for it, as they don't even have isolated genetic tests for it yet.
The process to find out what the condition was (from just 30 years of constant arthritis diagnoses and treatments to help loosen joints, etc.) was:
a) I had to explain to her that normal people AREN'T in pain 24 hours a day (when you live with it all day, every day, you just assume everyone else does but keeps quiet and soldiers on) and that your shoulder/hip shouldn't just "fall out of the socket" once a week or so (I became expert at putting them back in).
b) I collected her symptoms, went on Google, found this (rare, genetic) condition that matched. There was precisely one doctor actively researching it, but it was in all the medical textbooks. Arthritis wasn't even close to matching the symptoms, but it was listed under the arthritis departments and diagnoses every time because it's SO often mis-diagnosed (which makes you wonder how 20+ doctors missed it).
For instance, one of the symptoms is a reduced effectiveness of anaesthetics, and my ex- had a chronic fear of dentists because - even when anaesthetised - it hurt her too much. That's too simple to be a diagnostic on its own, but after 20+ such odd foibles of her health explained within 10 minutes of reading, things started to click (and not just her joints!).
c) We took it to our doctor. He was overjoyed and keen. He had a diagnosis that he'd never seen before, it fitted the symptoms he had recorded in her notes perfectly, it was commonly mistaken for the arthritis that doctors before him had diagnosed. He was able to say that 20+ doctors before him were wrong, that "he'd" spotted the problem, and prove it. He ran off, researched it himself, and said he thought we were right.
d) He sent us to a specialist (ironically, an arthritis consultant). They confirmed the diagnosis in seconds, and said they would have been able to in seconds for the previous few decades as it was well-known to them even if there was little they (or anyone else) could do to treat it.
e) She received treatment (physio, painkillers, etc.), an official diagnosis, found support groups, was made aware of the chances of passing it on to our daughter (who has a much milder form, that isn't pain-associated, which probably means she'll be good at ballet and gymnastics and not suffer like her mother, but she'll still carry the gene and needs to know that when she gets older), got on with her life, and hasn't been back to a doctor for anyth
Some doctors will argue that by allowing the patient full access to the notes in the system, a doctor may be less frank about the mental condition of the patient or be reluctant to place information in the record which reflects poorly on the patient's demeanor, such as cooperativeness, a tenancy toward hypochondria, or just plan belligerence. In their defense, this honesty could lead to lawsuits (in the worst cases). Even in the instance where it's a simple difference of opinion, some patients are going to be fairly vocal about having the records changed or modified to suit their version of reality (correctly or not), resulting in more time spent by the doctor and administrative staff on uncompensated work.
Now, the best way to combat this is to allow comments on the records by patients. It will keep some of the sillyness out of records (http://www.smithsonianmag.com/arts-culture/The-Last-Page-UBI-in-the-Knife-and-Gun-Club.html) and will allow legitimate differences of opinions. A chart which is riddled with patient comments contradicting past providers will be just as valuable to a future provider as a note that the patient is difficult or uncooperative in treatment decisions.
Another item of concern is from the insurer's side. There will be people who attempt to expunge their records of items which decrease their insurability or increase their rates (and this will only get worse with mandatory insurance without cost caps or guaranteed rates). The way the questions were worded wasn't mentioned in the fine article, so if write/erase access was included in "full access," then continuity of care may be jeopardized by those seeking to minimize the impact of previous conditions on current health care rates - or simple embarrassment.
Some doctors will argue that by allowing the patient full access to the notes in the system, a doctor may be less frank about the mental condition of the patient or be reluctant to place information in the record which reflects poorly on the patient's demeanor, such as cooperativeness, a tenancy toward hypochondria, or just plan belligerence. In their defense, this honesty could lead to lawsuits (in the worst cases).
If they are less frank, then doctors are adding opinions and personal biases, not facts.
I'm an attorney, so I know a little bit about arrogance, but we're patzers compared with doctors. Many truly have, if not God, then Emperor complexes, with their wisdom received without question by their subjects.
But that's probably not the real reason they don't want patients to have access to their complete medical records. It's all about avoiding medical malpractice claims (and annoying phone calls from patients asking questions).
So blame the lawyers.
I have seen my entire medical records. Everything that a doctor has access to about myself. They were handed to me while I was at my doctors once and left alone in the room for several minutes while they arranged something. This was pre-computerisation, and they were my damn records, so I sat and read through them all.
Most of them were boring. Most of them related to childhood reports that were ultimately no-diagnosis because it was a cold or sniffles or whatever. One of them relating to my birth describes sub-conjuctival haemorrhaging (bleeding behind the eye) - today my birth would have resulted in compensation and investigations as they damaged my eyes pulling me out.
Apart from that, it was not interesting. Hell, they didn't even have my blood type, because they don't test for it unless they need to. And I haven't been to the doctors in YEARS except to register with a new one. I'm in the UK so there's no "cost" involved in treating me that I shouldn't know, as such.
That said, why would you not want me to see them. If I have a condition, can you really hide it from myself? Seems like nothing more than an arse-covering exercise and - if that's so - why do you have to cover your arse? Why should you care that a previous doctor might have to cover their arse?
Don't let me delete them or modify them, but I should at least be able to view them on demand and provide notes/comments as necessary if there's a dispute. How else can I be assured that the data you have is accurate? I can even query my entire criminal record and have it corrected if necessary (e.g. if someone falsely used my identity to commit a crime, which is quite a common thing), so why can't I do the same for medical records?
In the UK, the PNC has an access and appeals process because there are recorded instances of someone being refused a job only to discover that the things on their record WEREN'T THEIRS - computer error, deliberate fraud, etc. is quite common - enough that there's a procedure to identify you with fingerprints in that case and modify criminal records accordingly, and have an appeals process.
You're not telling me that medical records can't have exactly the same problem and solution, especially in countries where that person's insurance is going to be paying for that medical treatment?
Hell, in the UK, even the Data Protection Act can be brought in here - you're storing data concerning my personal details on a computer system - that's automatic right to query, appeal, correction, etc. before you even start whether that's your image on CCTV (yes, under the UK DPA you can ask for all 'personal data' about yourself, including CCTV of you, from anyone who records it and stores it - there's even an official FAQ about it and they have 40 days to respond, so long as you provide enough details to isolate the data you require), the details your employer holds, or what a certain website holds on you in terms of cookies and stored data on their systems.
It's entirely a malpractice cover, from what I can see. And if you're scared of someone potentially discovering malpractice, then maybe you should deal with your patients more carefully, not try to hide your tracks. And, honestly, that would be #1, top-of-my-list reason for records TO be opened, if that's the case.
Brokers don't think you should have full access to your investment account (after all THEY are professionals and you are too stupid to understand what they are doing).
Mechanics don't think you should have full access to your car's maintenance record (see above).
file this under ruductio ad absurdum [wikipedia.org] - I can understand the physicians point of view. I simply disagree...
"sed quis custodiet ipsos custodes"
Split the record into a "data" section and a private "remarks" section. Patients get unrestricted access to their own data sections, but require a court order to see the remarks. Establish clear rules for what can go in the remarks section: everything else must go into data, and inappropriate use of the remarks section itself counts as a minor form of malpractice.
This should strike an appropriate balance. Patients can still get at the significant stuff, and they have recourse to get the rest if it's truly necessary. Doctors can continue to comment frankly about patients-from-Hell, without having to worry about being embarrassed unless they already have much bigger problems.
I think one reason why medics might have a problem sharing is that there are issues if there are suspected psychiatric issues. Imagine a situation that a patient is prone to aggression and the doc thinks this might be related to schizophrenia or something along those lines. In my experience, anyone dealing with patients like this really try hard to keep themselves distant from the patient, in case they turn up on their doorstep... and this does happen. So I would look closely at how the question was worded in this survey. I would imagine most medics can think of at least one person who they would prefer didn't see their notes and for very good reasons. So if the question was along the lines of "should all patients" have access then the answer must be no.
My mother has worked in the medical industry her whole life on the administrative side. Since I was a kid, she would always go on and on about "always get your full medical record, check it for errors. Always ask for an itemized bill and check it as well." Then, a few years ago she got cancer, and thankfully survived and is cancer free after several surgeries and radiation treatment. And guess what... her persistence paid off. She again asked for an itemized bill, something that, over the years they've gotten more and more reluctant to give us... and the hospital had literally double charged her for everything. 2 pillows, 2 blankets, 2 room stays. They tried to argue this with her, but she had experience in the medical field and pointed out to them that if she had received the dosage of general anesthetic listed on the bill she'd be dead. The insurance company hadn't even caught it. She saved them hundreds of thousands of dollars, and they sent her a letter thanking her for her diligence. She only saved herself a few hundred dollars in co-pays, but she was proud none-the-less. Your medical record is yours, not the doctors. You should have full access to everything in it, and should be able to remove anything that you feel is inaccurate at will.
.... proof of that service rendered.
It is absolutely important for a doctor to understand the medical history of a patient and it is very beneficial to the patient, because frankly, every patient is different. I also believe it is important for a patient who is seeking medical services to be fully informed of what doctors prescribed and the reasons for those prescriptions. I feel that if you don't like the relationship with your doctor, don't go back to that doctor again. Let that doctor keep the information records that you provided for that visit, but you as the patient are the original owner of that info, not the doctor, not the hospital, not the insurance company. As a standard of practice, I feel it is vital for a patient to make sure he/she review their own medical records from all their physicians every 2 years or so.
Our government recommends that we review our credit history every year, so why not your medical records? I also believe that a patient should be responsible for all of their own records. This information is about you and you have a right to understand if say an eye doctor is noting down psychological opinions about you and your mental state where he/she is not an expert. They have a right to an opinion, but it observations should be as non-biased in nature as possible, the information they write down should be factual, not conjecture, and if your copy of the medical records is not exactly the same as the physician's copy, then this should be an issue for everyone.
When a patient volunteers information such as "I've just lost my job and I'm struggling to get out of bed, because I feel so deflated", that can and should be reported. If the doctor responds with the following, "It sounds like you're experiencing depression." I feel the patient/doctor should both have to initial this discussion. Unfortunately, this will open up a can of worms on a legal front should the mental capacity of the patient come into question.
What happens when a doctor has his own medical issues such as a drug and alcohol addiction and is treating a patient, and the above statement is made, who is still scrutinized worse the patient or the doctor?
Sadly, I have met many doctors in my life, some are excellent and will take time to talk to a patient and are happy to share all medical records, while some (that I've met) believe that since you're not a doctor, you're too stupid to understand your issues and that's why you came to me complex. These are people who believe that they are more intelligent than their patients and that patients have no right to look at medical records that they cannot possibly comprehend. (to that I say Horse-shit)
I'm a voluptuous blonde haired woman who has had many doctors think that I couldn't possibly understand anything, and then when I actually ask intelligent questions, they are condescending in their response..."that's a difficult question my dear.../patknee" and that's the only response I've received. Those doctors never see me again, and if anyone inquires as to their abilities, I state that they refused to answer my questions and I won't see them again.
I've been lucky also to have doctors ask questions of me about my medical conditions and are forthwith in their lack of knowledge in a particular area, and these are the ones who will also state that they need to perform a little research to familiarize themselves with my conditions before they are willing to discuss them or call those conditions into the current diagnosis.
No one doctor knows everything, they need history, they need the knowledgeable patient to work with them. Let us not forget, long before medical degrees existed, people were pretty capable of diagnosing their own ailments.
Let me give you a real-life example of what doctors are bracing themselves for. My wife saw a patient, and that patient later requested a copy of her medical records. No problem; my wife's office gave them to her. I personally witnessed this exchange afterward while I was picking up my wife from work:
Patient, storming into office: I WANT TO SEE DR. MRS. JUST SOME GUY!
My wife: Hi! What's wrong?
Patient: You slandered me and you're going to Fix. It. Right. Now!
Wife: What... what did I say?
Patient: You called me a drug abuser!
Wife: No, I did not!
Patient: It's right here! shows everyone who will look a highlighted section from her chart
Wife: Right...
Patient: I told you I didn't do that, and you said I'm in denial about it! If you don't fix that, I'll sue.
Wife: But that's not what we mean by "deny".
Patient: FIX IT OR I'LL SUE!
I swear that's not an exaggeration or misrepresentation. The patient was threatening to sue for defamation of character because my wife wrote "patient denies excessive drinking, tobacco, and drug use." That's medical jargon for "I asked the patient if she did this stuff and she said no" and is the industry standard way of documenting a "no" answer to a question.
Of course patients deserve complete access to their records, but I fully understand doctors who'd just as soon disarm a hand grenade as to hand over records to people who aren't trained in their interpretation.
I'm a doctor in the US, and I'm stepping into the line of fire here as there is some serious doctor hate going on in this thread, but here goes...
First of all (in the US at least) most of these arguments are moot because patients by law have the right to their medical record. So, regardless of what your doctor thinks, by federal law you have the right to request and get access to your medical record.
In regards to the attitudes about IF patients should have this access I would be willing to bet that older physicians would be more against it than younger physicians. Doctors above a certain age tend to be more paternalistic towards patients than younger doctors.
My personal opinion is that any individual should be able to obtain access to their own medical notes.
However, most people are not familiar with the diagnostic process and jargon used in medical records. This could definitely lead to misinterpretation or confusion by a patient or the feeling that information was withheld when that is not the case at all. For instance I may write in a chart "left lung cavitary mass - malignancy vs TB vs fungal infection" indicating that I'm not yet sure what it is and more workup is needed. Do I tell the patient every possible differential diagnosis? No, because that tends to freak patients out, I say "I don't know what it is yet, we need to do some more tests."
If the patient read my note without understanding how to interpret it they may feel that information was withheld or the doctor has no clue what's going on.
I think that is more what is behind the results of this survey than doctors "covering their ass", because if a patient wants to sue they will sue, and every single piece of information about that patient will be subpoenaed and scrutinized by lawyers. You cover your ass by putting complete and accurate information into the medical record, and not trying to cover up mistakes if they happen.
Personally I would not care if any of my patients read their chart. I will even show it to them "See, last time I wrote that this was going on, is that still a problem?"
A consultant is a person who borrows your watch, tells you what time it is, pockets the watch, and sends you a bill for it.