In the US you're legally entitled to your medical records too but every time I've done it the response is always defensive, ie "why do you need them", "send me the doctors information and I'll fax it to them myself".
every time I've done it the response is always defensive, ie "why do you need them"
I was asked this once after requesting mine. I flatly said "I don't", and waited. The person on the other end of the line was clearly thrown off by this, probably expecting something they could dish out a canned response to, hoping I'd give up. It was obvious from their voice they were scrambling for what to say to that.
A bit of rigmarole later, I had my medical records.
My understanding is that, in the US, your medical records are the property of the healthcare provider, absent some contractual language otherwise. The new thing was the federal law that required them to give you a copy of everything at cost. Before that, the only sure way to get a copy of your medical records was to sue the provider and perform document discovery.
Some doctors have been concerned that patients lack the education needed to interpret their own charts. So when patients don't understand something they call back and ask a lot of questions, which doctors see as a waste of time. (I don't agree with this perspective, just giving some context.)
> In the US you're legally entitled to your medical records too but every time I've done it the response is always defensive, ie "why do you need them"
Whenever I've been asked, I just say "I want them for my files," and I've had no problems.
Sometimes questions like that could actually be an attempt to be helpful. For instance to send along only the needed records rather than a fat file full of extraneous info or save the patient the trouble of being a middleman between two doctors.
Sometimes questions like that could actually be an attempt to be helpful.
This is my thinking, annoying as it can be-I understand and can appreciate this position. It's possibly a matter of how that help is intended to be delivered.
"Why do you need the files?"
versus
"Is there something about your last visit you have questions about/do you have a follow up question for your doctor?"
etc.
I mention this because when I was on hard times financially and fell behind on a few bills I found it quite invasive and annoying when I called, on my own initiative to make a payment only to be asked "Why were you late on this payment?" in a rather abrupt manner. My response has always been "Is this question required for you to process the payment?" to which "No but we have payment options and plans to help individuals who may have fallen on hard times".
Okay, that's fair. I'd be more receptive if that olive branch was offered more delicately than "Why were you late?" which is frankly none of the debtor's damn business.
I agree that it could be handled more delicately, and that doing so would probably be more fruitful (and just more pleasant). I'm not sure it's none of the creditor's business why a payment was late though. It's certainly in their interest that payments be made on time, and to have the ability to estimate the likelihood that future payments will be late. Given an obligation to pay an amount by a given date, it doesn't seem completely unreasonable for an explanation to be requested if the amount isn't paid.
this is probably just because there is a pop-up dialog box the secretary sees when she puts in the request, and they are obligated to ask. there is no answer that will result in your request being declined, including "I'd rather not say".
This is interesting, and I didn't know it! Does it include everything (doctor's notes, etc.), or just whatever your doctor/organization wants to include in your "official" medical record?
I'd like to do this myself, but I want to understand what I'm actually entitled to so I can be prepared if they push back.
I recall reading perhaps 30 years ago that in China people (from birth) possessed their original medical records and brought them to the doctor's office or hospital. I have no idea if this was/is true. I remember thinking how wonderful this would be, as opposed to the U.S. system (I'm a retired neurosurgical anesthesiologist with 38 years of experience — UCLA/USC/UVA). As a rule, I administered anesthesia to people whose records were often lacking very important information from outside physicians/other hospitals that was simply unobtainable in the time frame available to get it: i.e., patients were admitted the evening before craniotomy/brain tumor resection etc. scheduled for the next day, and their previous records — other than those from the hospital I/they were in — might as well have not existed.
Faxing to you carries a bunch of bureaucratic hurdles to avoid HIPPA violations. Facing to another physician doesn’t, and the other physician will be quite good at narrowing down exactly what records he wants.
It’s just way less work to send them directly. And since that’s what most patients are asking for...
At Kaiser, you just have to walk into any member services office and request. It doesn't happen right then, but I believe in a few days you get a thumb drive with all of your records on them.
However, the law allows the doctors to redact certain portions in your copy that they feel could be harmful to you.
1-2 years after moving to Finland I had a brain-scan done, and the doctor involved told me I could get a copy of the data if I was interested.
In the past I worked at a medical company, so I was familiar with the joys of DICOM, etc. I paid €20 for a copy of my own brain-scan data on CD-ROM, posted to my house.
Pretty mind-blowing to have access to a scan of my own brain (well blood-vessels at least) on my home PC.
Scroll down to "Information Excluded from the Right of Access", particularly the bit about psychotherapy notes.
Also see "Reviewable grounds for denial (45 CFR 164.524(a)(3))", which includes things like "The access requested is reasonably likely to endanger the life or physical safety of the individual or another person" or "The access requested is reasonably likely to cause substantial harm to a person (other than a health care provider) referenced in the PHI".
> Another limited ground for denial exists if a licensed health care professional determines in the exercise of professional judgment that the access requested is reasonably likely to endanger the life or physical safety of the individual or another person. For example, a covered entity may deny a suicidal patient access to information that a provider determines in his professional judgment is reasonably likely to lead the patient to take her own life.
There was an interesting discussion earlier on here about the potential emotional harms of suggesting to a patient that they are likely to develop Alzheimer's within a few years (an AI based early detection system).
On the one hand, you might catch it and treat it earlier. On the other hand, it will color every interaction you have with others and cause stress every time you try to remember something. The potential harm may very well exceed the harm of not telling the patient (up to and including suicide).
If a doctor suspects something but lacks evidence, they may simply make a note to look for more signs at subsequent follow-ups. A patient seeing that may read more into it than is there, and subsequently suffer undue stress or paranoia.
This may actually be financial. The rules vary by state, but most states allow practices to charge copying fees (even though they're generally no longer copying paper charts).
I think those are regularly charged if records are being obtained for legal reasons (e.g. drug/equipment manufacturer lawsuits) but are generally not charged if records are being sent to a new provider. Copies for personal use/records are probably on a per-provider basis.
That’s just clerk-speak for “I don’t feel like doing this”. You handle it like any other lazy customer facing person. Dig in and escalate if necessary.
I was asked this once after requesting mine. I flatly said "I don't", and waited. The person on the other end of the line was clearly thrown off by this, probably expecting something they could dish out a canned response to, hoping I'd give up. It was obvious from their voice they were scrambling for what to say to that.
A bit of rigmarole later, I had my medical records.