I think there might be a factual answer to this question.
I recently return to therapy at a community mental heath clinic that I went to previously. I saw my psychiatrist this past Wednesday and as she was looking at my file, I notice that it was a rather thin folder* and I mention this, she said that she was sure my old file was somewhere.
Later I wonder why they had yet retrieve my old file yet (I’ve been there since the beginning of April). It has the records of the 5 other doctors Ive seen at that clinic, plus copies from most of the doctors(but not all) I have seen since coming to San Francisco in 95 (psychiatric and medical).
So my question is Why? Why haven’t they pull my old file out?
From my limited recent experiences with mental health practitioners (who I think are indistinguishable from shaman witch-doctors, btw), I’ve noticed that they use a modern fix-it-quick model that focuses much more on the here-and-now, with rather little interest in your ancient history.
The focus is much more like: What brings you here today and what can we do for you today ?
“What’s not working well for you in your life today ?” (meaning, recently), rather than: “What’s not working for you over the course of your life for the last 5, 10, 20, whatever, number of years?”
The attitude popular these days tends to put emphasis on whatever is going on in your life currently, and changing (hopefully for the better) the pattern of current events in your current life. The old freudian psychoanalytic theories, which require detailed analysis of your whole history (and which are very time-consuming), are seen as not being all so important any more.
So I think that may explain why modern mental health therapists aren’t very interested in your records other than fairly recent stuff.
ETA: Hang onto your older files, though. If it ever comes to the point where you need to claim disability for it, you’ll want to be able to document it all. Just in case.
It’s possible it’s been digitized. A lot of places are trying to move to digital records.
It’s also possible that your old file has been reviewed and all pertinent information condensed for the new file - names of doctors, medications, what worked, what didn’t. My therapist writes a LOT down… things that are probably useful for that session, or maybe the next few, but knowing I was stressed out in 2006 because my sister lost her job and is asking me for money isn’t likely to be relevant in 2012.
Keep in mind that most doctors’ offices will ship files off to storage when a patient stops coming in, because there just isn’t space for everything. If they’re anything like the hospital I worked in, there are rules about how long they need to keep records around before they can move them to offsite storage, and more rules about how long they have to stay in storage. Depending on what rules apply, it’s possible that your file has been destroyed (but I don’t know the rules for mental health records).
The best way to know why they’re not using your old file is to ask them. You implied that they are aware you have a long history with that clinic and know you have a monster file, so at least they’re not treating you as a brand new patient from scratch. Ask them next time, whether the file still exists or is relevant.
Based on specific US state laws, many medical record storage systems purge the record after a certain length of time, removing the bulk of the info. It’s a tedious process, but when one runs out of storage capacity to hold all the physical charts, it’s often the option of choice.
Ideally, key info will be left, and many states do specify what must stay and what can go.
As a physician, I’ve occasionally been very frustrated by seeing the red label reading PURGED when I get to the critical section of the old chart, as I try to track down certain old lab results to see if they were ever normal to begin with.
But in 99.99% of the cases, medical info over 10 years old is not relevant to what’s going on today with the patient.
