Gaining Access to Your Own
Medical Records

J. Greene


Q: I went to see a new doctor, and now my previous doctor won’t give me my medical records. What should I do about this? Should I get a lawyer?

A: Don’t start shopping for an attorney just yet. There’s a good chance your state has a law that guarantees you the right to see what’s in your medical chart. And if it’s not laid out in the books, you can pressure your old doctor into releasing the information in some other ways. If nothing else, you can appeal to his sense of ethics — even the American Medical Association has a policy stating that doctors are obliged to provide a copy or summary of the record to the patient.

      But despite such pronouncements, doctors and patients in the real world run into conflicts on this issue all the time. Several OnHealth readers have complained that their requests for records have been turned down. In most of these cases the trouble comes from small medical offices where the staff — and the physician — may not be aware of the law and their ethical obligations. It might also help to understand why your first doctor is balking. Maybe he's afraid of a malpractice suit, or is worried that you're "doctor shopping" — you don't like his diagnosis so you'll find another practitioner who'll tell you what you want to hear. It's also possible that you're dealing with an uninformed member of the office staff.
       So, with that in mind, here are some steps to try before bringing in the big guns, which shouldn't be necessary:

bulletMake sure your request goes to the right person in the office — the office manager or the physician himself.
bulletIf you try that and are still rebuffed, ask why the records are not available. This will help you find the most effective way to convince your doctor otherwise.
bulletEducate yourself about the law in your state. Many states have specific laws or regulations on the books that guarantee patients can get copies of the medical records from a doctor, hospital or other practitioner, with some notable exceptions such as certain mental health records. A smaller number of states don't address the issue at all. To find out how it works where you live, contact the state health department, the state or local medical association (which represents doctors), or the state hospital association. Any of these groups should be up on the law. Or, if you can locate it, try your state's affiliate of the American Health Information Management Association, whose members specialize in handling medical information; this group can also send you a booklet about how to get your medical records.
bulletIf you've tried reasoning with your doctor to no avail, try strong-arm tactics. Call the state board that licenses physicians and tell them your dilemma. Or just tell the doctor that you plan to file a complaint. That may scare him more than the idea of letting loose your documentation.
bulletIf you're willing to compromise a little and get the information transferred to another medical professional, just ask your doctor's office to ship copies of your chart to your new doctor. Physicians are much more willing to share information with other professionals, says Monica Pappas, president of the Health Information Solutions division of Quadramed, a big national health-information company. Because medical records are so personal, medical offices are under a lot of pressure not to release them to the wrong people, Pappas notes. So they may err on the side of caution. "It's very much a judgment call," she says, so try to negotiate calmly with office staff who may simply be trying to do the right thing. Be aware that they'll want a written release with a signature they can verify before they'll open up your records to another doctor.

      Chances are you won't run into this problem as often with hospitals or bigger medical groups, because they deal with information requests more often. What you may encounter, though, are exorbitant fees to copy your information. Here again, be aware of what the law says — often, copying fees are limited to what's reasonable. It also helps to know exactly what information you want out of the record so you don't spend 25 cents a page to copy stuff you don't need. In many cases, summaries of procedures or diagnoses are really what you want to see. Specific advice on which records to ask for and how to get them is available in  "You Can See Your Own Medical Records".
       That column also emphasizes the importance of checking your files on a regular basis to ensure that they are accurate. There could be a stray diagnosis that could dog you later when you apply for insurance. One simple way to find out what the insurance companies are looking at when they consider you for health insurance is to write to the Medical Information Bureau, a national database of consumer medical information used by insurers to avoid fraud and to evaluate new applications. You can get a complete explanation of MIB's process by looking at its Web site. Or call the group in Massachusetts at (617) 426-3660.


Our Rights Return
Our Rights Return