Part of the trouble is that, on top of full-on errors, there's no real hierarchy of information on GP notes — it all seems to be presented equally, at least on the electronic front page.
I've had consultant psychiatrists spend months holding back on a diagnosis, gathering information, observing me over time, assessing my response to medication etc., before eventually committing to a considered diagnosis of bipolar disorder, which then duly appeared in my GP record as an active health condition.
I've had in-depth neurodevelopmental assessments by specialist psychiatrists, involving huge amounts of data-gathering and careful analysis, resulting in an ASD diagnosis on my active list.
But I've also had a rushed out-of-hours GP speak to me for two minutes before prescribing a couple of dozen diazepam, whose quick schizophrenia diagnosis immediately took top billing on my list of active conditions.
And there seems to be limited time available for cleaning up notes, too — my "active" conditions list is littered with older, inaccurate diagnoses, diagnoses that once fitted but no longer apply, current diagnoses with no start date, and things that were at one point suggested as working diagnoses. And that's just the psychiatric stuff.
For a busy GP who's got just a few minutes to scan my notes, talk to me, consider the possibilities and form a plan of action, there doesn't seem to be an easy way to look at the list of "active" conditions and tell the difference between
- a current, solid, carefully-considered, well-evidenced, long-standing diagnosis by experts in the field
- an old and inaccurate or outdated diagnosis from early in the course of my condition when things were less clear, and
- a momentary impression jotted down by a generalist in a hurry.