No, I’m not sure of that. Which is why I said “as I recall”. I should have said “As I scrape out of the crevices of the slowly decaying blob of cholesterol and electrolytes I laughably refer to as a ‘brain’.”
And it does shock and frustrate me that anyone would not be told of their own diagnosis.
(And that’s as much as I’ll say about it in GQ.)
Anyway, HIPAA does indeed give patients broad rights to access their own records. It closes off the records to pretty much everyone but the patient, the people actually treating the patient, and the people the patient has chosen to share information with. I don’t even think the person paying the bills (if different from the patient and not someone on the patient’s A-list) has full access to the records, only the billing information.
I guess the moral is always to remember that you’re ultimately responsible for your own health, so fight for information as though your life depended on it.
My doctors wanted a bit over $90 in “reasonable copying fees” for my medical records. $3 per page. From all the different doctors and hospitals I had ever been to, it would have been over $200.
Having seen a lot of charts…you’re not missing much, and you’d have great difficulty reading most of it because of the combination of jargon and bad handwriting.
Most doctors know to keep the charts decent, but you do get the odd “please see this unfortunately fertile lady” or something equally insulting.
Last time irishfella went for his mole patrol at the dermatologists, I went with, and they let me see the pathology report on his biopsy. It put my mind at rest and allowed me to explain it to him a lot better than the dermatologist had.
If you do access your records, you have right to be able to understand them…ensure that you do.
The irony here is that the charts are routinely left in plastic trays outside the exam room, where you wait 15 minutes or so for someone to come in; and in the meantime, anyone could be looking at the charts. I was only looking at my own, but just imagine if I were nosy about someone else’s.
So how are they private when they’re right out there in the open hallway?
The way most doctors’ offices are set up, typically the only people who should be in the hall are the patients being escorted to the rooms, and the physicians/nurses/other medical personnel. This minimizes the chance that any random person would have an opportunity to look at your chart without being observed.
I think the nurse was blowing smoke to keep you from poking at her nice, arranged paperwork.
There’s no reason you can’t poke through your charts (under US law anyway). There is some concern that patients sitting in a waiting room will poke through someone else’s chart, then the staff has to sit through a mandatory HIPAA gassing. As someone who’s been through that, it’s boring and unpleasant.
You may be right, but I (a non-lawyer) am not entirely convinced that a medical chart is purely a simple listing of facts.
And to use irishgirl’s example, I think that a chart containing the phrase “please see this unfortunately fertile lady” might well be considered to be an “original work of authorship”.
I will make the prediction that this area of copyright law will receive more attention in the years to come. All it’s going to take is one disgruntled patient posting on a website something to the effect that “In my opinion, Doctor X is a doofus. Take a look at this copy of my chart. If he can’t even spell Cerebyx™ correctly, how can he prescribe it?”
Your medical records belong to you; they are for you and about you. However, your doctor and other health care providers have a right to retain at least a copy, if not the originals, for it is also a record of their treatment of you.
However, do you have the right to view communications between your doctor and the lab? Between the doctor and your HMO. Between your doctor and another doctor?
I worked in a hospital archive once. Another reason why they don’t want you to handle your own chart is that some patients try to steal documents from it or make changes. Our patients had the right to view all their charts in person or request an overpriced copy. When patients read their charts, I, the cheapest worker available, had to watch them all the time.
I think that’s a big part of it. The viability of the insurance industry depends on its access to accurate and complete medical records. Leave a medical chart with someone in the market for life insurance and you’re asking for theft of some documents, which could conceivably spread any liability in later insurance fraud cases to the medical center. As such, I’m guessing the center has legal responsibility as some type of guardian over this paperwork. Of course, in this era of managed care, it’s like an HMP could reconstruct much of the medical chart, from their own photocopied records.
What some insurance reps will tell you, off the records, is that if you’re looking for privacy, go to another physician, pay cash and consider using another name. Not sure if that’s illegal, so I didn’t advocate that, of course. That said, I’m not sure why it wouldn’t be, as long as no party is damaged.
Remember this from Seinfeld?
Attendant: The doctor will be with you in a moment.
Elaine: [looking at her medical chart] Difficult?
Doctor: Elaine, you shouldn’t be reading that. So tell me about this rash of yours.
Elaine: Well it’s, it’s. . . . You know I noticed that somebody wrote in my chart that I was difficult in January of ‘92 and I have to tell you that I remember that appointment exactly. You see this nurse asked me to put a gown on but there was a mole on my shoulder and I specifically wore a tank top so I wouldn’t have to put a gown on. You know they’re made of paper.
Doctor: Well that was a long time ago. How about if I just erase it. Now about that rash. . .
Elaine: But it was in pen. You fake erased.
Doctor: All right Ms Benes. This doesn’t look too serious. You’ll be fine.
Elaine: What are you writing? Doctor. . . .
I had an experience just like Elaine’s in Seinfeld. The doctor really was a bitch who didn’t even come out from behind her desk after I’d waited for 3 hours. She said I was imagining a skin infection and should try soap- I later asked a dermatologist friend to take a look and he confirmed whatI’d suspected, and recommended a specific topical cream. The next time I was in, I took a look when a different doctor left the room (I guess this would be my “file” rather than my “chart”) and she’d written something along the lines of “patient seemed hysterical” and basically implied that I- who visit the doctor maybe once a year- was a hypochondriac. So I simply added a note explaining the situation from my point of view. Nothing ever came of it, though she hasn’t made an appearance since.
