Health Records

Joe Bowler said he'd be willing to change his attitudes about the nature of our health-care system if an alternative system could promise to anticipate his future illnesses with an 60 percent certainty.

Of course, no one could make him such a guarantee, but the odds would definitely increase if one simple practice were followed among care-givers, and that is sharing medical histories among family members. Currently, this practice is almost unheard of, even when it could do the most good.

Because I believe that sharing medical histories among family members is important to health care, I wrote down my own medical history and gave copies to my parents, three brothers, and three grown children. My brothers and I benefited most, because our medical histories were very similar. They told me some of the problems they had had and how they solved them. Among the three brothers, two of us had had bursitis in the same shoulder at the same age. Two had the same foot bone problems, both the result of exercise; two had lower back strain, and two had had the same kind of skin rash under the same circumstances. We compared notes about which treatments worked best, something that we all found extremely helpful.

If the idea of giving your medical history to members of your family doesn't strike you as too embarrassing, you may not have really thought about it or you may be one of the few exceptions to the rule. So far I haven't met a person who could do it without any qualms (assuming they have a family of close relations in the first place).

Family members are the humans with the most genetic similarity to each other, and consequently the people whose bodies offer the most information, in minute detail, that is relevant to the health of one another. If I had the medical histories of my brothers, parents, and four grandparents I could expect to predict 85 percent of my medical future, not just 60 percent. And if all of us had similar kinds of records over long periods of time, like my pilot's physical, which uses the same tests and has been given to me every two years going back for 25 years, the data might yield 95 percent reliability. Not to mention that the history would include the success rate of a variety of treatments.Yet though the United States spends billions of dollars in medical research each year, none is spent on this obvious source of wellness.

My other family members never sent me their medical histories; they are obviously more traditional than I am. Even Joe Bowler refused to increase the chances of improving his heath by giving his personal medical history to members of his family.

Why is this taboo so strong? A taboo is any behavior that is proscribed by our culture, including the discussion of behavior. Taboos are often considered irrational because there is no testable explanation available. The term originated in Polynesian societies and refers to religious and marital restrictions. Some taboos, such as incest, and marriage among close cousins, are likely based in psychological or scientific reality. But most taboos don't make quite as much sense as these. My experience is that when people are unable to explain why they feel it is forbidden for them to do certain things, the specific taboo deals with a connection between two larger taboo areas.

For example, the discussion of incest has been a taboo that has changed slightly in the past 30 years. Now it is discussed and reported to a greater extent than ever before. I think that this is because the refusal to acknowledge incest (which is a very deep and ancient taboo) was based on two spurious beliefs. The first belief was that children are not sexual, a belief that was first questioned by Freud. The second belief was that parents can always be trusted to uphold the sacred trust of parenthood and treat their children with love. This belief started to fall apart in the sixties, with the rise in divorce rates and the increase in the reporting of child abuse.

Similarly, it appears that the health records secrecy taboo is based on two false beliefs: (1) that healing is magic and all of its implements are magical ritual objects; and (2) that all children are born as completely free agents, future individuals who can live independent of their family. Open family health records seem to contradict both of these widely held assumptions.

The medical taboo against telling a patient the detailed truth about his or her condition is very old and is widespread among a variety of cultures. Its real function is to create a high-ranking priesthood of people who gather, protect, and transmit life-saving information.

Our desire to view children as blank slates, who will grow-up and live on their own, is widespread in our culture because it is fundamental to the concept of the rugged individual on which this country was based. It is the basis not only of democracy, but of capitalism.

The belief that healing is magical and depends on the magical powers of medical practitioners has been under siege for the past twenty years, and today doctors are no longer considered gods. But even though science now views inherited genetic attributes as a matter of fact, this understanding hasn't really been incorporated into our belief system about individualism. On a deep emotional level, many people really do not believe that inherited traits are significant. The more advances science makes in identifying inherited traits, the closer we might come to eliminating this false belief, and the more likely it is that someday we will be able to take advantage of shared family medical histories.

Michael Phillips, 1984 (revised 2000)


A reliable study was done in 2000 to measure the genetic contribution of disease. To read a summary click here.

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