Stop trusting US medical staff to take charge of your record transfers between. The odds of this happening with zero errors are not in your favor. HIPPA means that all US citizens are entitled (whether insured or not) to all personal medical information. Because the current medical focus is on obtaining and coding records for insurance billing, but not on sending information between practices or you, the patient, you need to be proactive in this area.
Is it absurd that female cardiac patients have to research, follow up and micromanage (sub contract) their own complicated health care between doctors? Yes. It is the current state of medical culture at this time. Do yourself a big favor and get started building your paper trails if you haven't yet begun.
A few suggestions
1. Get into the habit of automatically requesting copies of each doctor visit (no matter what the specialty). If possible, ask at check-in. If not, request copies be mailed to your address. Faxes are ok, but far more likely to be sent haphazardly or appear illegible in critical areas. If your request is refused, ask for the refusal reason in written form. This is serious business. Follow up refusals with on-line reports of these incidents to the Attorney General in your state.
2. HIPPA means this is FEDERAL LAW and doctors cannot refuse a patient copy requests. Any medical facility that shows resistance to this request from this point on is a facility that you may want to consider distancing yourself from as quickly as possible. If they are resistant about record sharing that indicates overt patient-hostile atmosphere. Not where you want to get health care if you have other choices. Report these incidents to the Attorney General in your state. Even if you choose to go elsewhere, the women coming behind you may face revised office attitudes if they are audited by the state AG's office.
3. Make the time to organize your medical records in some fashion that makes sense to you...so you can easily retrieve even when alone, confused, under duress from medical symptoms and medication side effects. Do your best to take time every 6 months to revisit your medical files to ensure they are up to date and stacked/filed/stuffed/slung somewhere YOU are able to get to.
4. Take copies of any heart related surgical intervention descriptions (usually 1-4 pages), including event lab tests (blood, etc). Just enough info to hand over to each new doctor you see (no matter what their specialty, including dental). All cardiac events impact entire body. All your doctors should have access to this info BEFORE they proceed with treatment.
5. Hand your cardiac event description papers over as soon as your doctors walk into your exam space. That will pre-empt precious (expensive) wasted time and preclude dismissal of you as a serious cardiac risk patient. From that moment forward, this doctor will have upfront access to info that will effect the medications and treatments he/she prescribes.
Handing over this information will make your doctors decisions as safe and helpful as possible. They are free to use your copies to request doctor to doctor patient files transfers of the same thing you handed over, but it gives them a useful heads up....and a place to start.
6. Eventually, transparency of medical file info and transfer will be the norm....but in the meantime, remember that all your doctor has when entering your exam space is your person and possibly a sketchy written discription of your CURRENT complaint. YOU need to take responsibility to inject your extensive and most critical patient history records into the picture. Unless you do so, it is unlikely any of your physicians are taking the initiative to correspond or confer regarding your history and ongoing care. You need to be your own advocate. Start talking WHILE you hand over the heart issue documents. It's YOUR dime!
7. Do your best to override cultural training that makes you feel you must apologize for 'being an inconvenience' when speaking to a doctor. Do not apologize, do not minimize your actual symptoms, (docs are trained to listen for key words and start building a treatment/diagnostic tree....although this will possibly entail dismissal of the most distressing symptoms you are experiencing). You only have 5-11 minutes face time during an average visit, so take deep breaths, do your best to calm down and speak clearly in words that make sense to you.
8. The calmer you are able to remain (I know this can be extremely difficult), the better your chances of assessing the doctor's abilities and absorb clues as to how your symptoms are being interpreted and addressed. An easy going physician style can be reassuring and also deadly if your symptomology is being dismissed even while you are speaking. Do your best to keep eyes open and mind calm and alert for cues. If you find you are feeling in a defensive postition while describing your chest sensations, nausea, clamminess, etc....you may have already picked up this particular doctor is already dismissing what you are telling him/her and going instead to what they were taught in medical school (generally that females under 55-60 proclaiming cardiac symptoms are not at high risk of heart attack).
9. Keep searching for a heart doctor that feels like a good fit for you but do not expect female cardiologists to have different mindsets than male colleagues. Not at this time.
10. There is a possibility that in the not too distant future, something like universal health insurance will become a reality. This offers the implication that 'pre-existing' denials will disappear. It will always remain important to vigilantly request and obtain copies of your medical records. This is not the time to be leaving your cardiac/health care coordination to chance....especially in the event there are massive health care industry changes. Make the effort to obtain all your records now.
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Cardiac Patients: Obtain record copies now
- By martzj
- Posted February 24, 2009 at 4:44 pm · 12 replies
- Shared with the public
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12 replies
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- By SickOfBeingSick
- Posted February 25, 2009 at 4:10 am
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I tried to get simply a copy of my medical file from two different hospitals for about a 5 day stay at each of them. They both wanted almost $500 just for the copy, no interpretation, etc. Asked during my last hospital stay every time a test was run for a copy of the results. I came away with only a copy of one test. So I have patchy records from one stay and no records (except for the one test) from the other two hospital stays ):
Wish I had the time, energy and health to report them to the appropriate agency. $500 is not a "reasonable" fee for copying. Wish I could get $500 per file for pulling files and making copies of them. I would be rich right now instead of going hungry.
Cathy
- By DrD11
- Posted February 25, 2009 at 12:35 pm
- Report post
Martzi
Having read your essay about getting medical records, I want to simplify the whole process.
Since the whole subject involves communication,
one must find the most effective and cost efficient process to both sides:The patient and the Health provider.
The patient:When one goes to the doctor:
Write,type in precise way the chief complaint/reason for the visit.Describe it precisely.Include any associates complaints.
Write precisely all the medication you take.Medication is anything you you put in your mouth,inhale,cream or
suppositries.
Food,health supplements,or something that a friend got it from Mexico.
Give this paper to the nurse,so she will enter the data
into her computer.That saves time for everybody.
At the end of the visit,ask the doctor to push the button on the computer:Print(Print the narrative of the visit.That's it)
Most of doctors office are not sophisticated.That
leaves you with the paper you brought.Still you are entitle to "Patient Education Paper"right there and
right then.
Remember a written word has much more clout.
It prevents the endless argument:"I said,he said"
I,as a retiring physician,always dreaded the moment
when I was leaving the examining room,holding the door handle,and the patient who came for runny nose,said:"Doctor,by the way,what about the chest pain that I felt yesterday?"
My immediate reaction was:"wow!stop it right there.Let us start the doctor visit AGAIN"
"Why didn't you tell me?I forgot.
- By martzj
- Posted February 25, 2009 at 1:12 pm
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DrD11,
"At the end of the visit,ask the doctor to push the button on the computer:Print(Print the narrative of the visit.That's it)"
Thank you for the excellent suggestions on how to initiate/expedite accessing copies of patient records.
Didn't know about 'print narrative'. My sports med dr and PCP are both very computer savvy and always offer print copies and CDs of MRIs, etc. Then there are other specialists fighting the digital age tooth and nail. They haven't yet figured out it will save much duplication of effort.
Your doctor's perspective on patient exam time is enlightening. That had to be frustrating. And it is so common I wonder if it may be that it takes most humans at least 5-10 minutes to let their guard down with any doctor (stranger)...and then the extra worries come pouring out just as you are headed for the door. I'm sure I have driven more than a few doctors nuts doing just that as I never arrived with single complaints, always clusters.
I followed some of your profile links....Is your research involved in working with (Italian)domestic violence interventions? That is such a worthwhile endeavor.
Jaynie
- By martzj
- Posted February 25, 2009 at 1:16 pm
- Report post
Cathy,
"I tried to get simply a copy of my medical file from two different hospitals for about a 5 day stay at each of them. They both wanted almost $500 just for the copy, no interpretation, etc"
Don't give up completely. Patient access to their own hospital patient records on-line is already growing...You will just need to get an account number to log in and see all your personal files....free. It is coming!
Jaynie
- By vrolijk
- Posted February 26, 2009 at 4:52 pm
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Hi, martzj
It must be so different in all states; I know that according to Hippa you should be able to get all your medical records.
I have tried and do this over the years, actually until around three years ago they would just give them to me without asking.
Now, I have to pay for my records from the Hospital. I also got a Gemms disk but I found that even the hospital where my doctor practices will not put it in their computer..
Most of the information is accurate but some of it is strange... Like the doctor mentions something from a visit I had with another cardiologist in a time space of three years different....
It seemed such a fantastic way of keeping records and keeping it in your purse!! Since I thought this would be a great way to keep records handy and then I found it was a waste of money and the info is not even right.
Yesterday I had even a hard time to get records transferred from my Pulmonologist to an other doctor….The cardiologist was no problem at all….
But I would love to have them my self… especially the once from the Hospital, they want 40 cents a copy.
Wow, you’re such a wealth of information, Vrolijk
- By martzj
- Posted February 26, 2009 at 7:47 pm
- Report post
Hi Vrolijk,
HIPPA is non-negotiable. Doctors are now federally mandated to hand over copies of every scrap of patient info (including jotted doctor notes). They can however, charge arbitrary amounts. You can expect to pay out of pockets dollars at some practices. Others offer copies free of charge.
Hope you are breathing easier today and your flowers got planted. That sounded like such a relaxing thing to do.
Jaynie
- By djwaz184
- Posted February 27, 2009 at 9:27 am
- Report post
In today's society, and with the advancements in medicine and technology, it still amazes me that people have such a difficult time obtaining their own records. Being asked to pay ridiculous amounts to obtain something that they should have been given in the first place, just boggles my mind.
Wow! So, I guess I'm a lucky critter in this regard. Up until 2008, I never asked for copies of anything, then peritoneal cancer hit me June 2008, and now high blood pressure and heart disease - which runs on both sides of the family. I got copies of every single blood test, surgery pathology report, etc. EVERYTHING! In fact, all the doctors that I've dealt with through this have asked me if I wanted copies, which I find absolutely amazing.
I'm also very happy with the fact that since I've stuck with docs that are affiliated with the hospital (we have 2 in town) that the information is available to them via computer. For instance the bloodwork I had done at the hospital lab was immediately available to another doctor, and didn't have to order me in for another blood draw. Which saved time and money for everyone, including the insurance company.
I've gone through my "file" (both physical and virtual) at appointments and have looked through it plenty of times. I've even asked for copies of past blood work (5+ years old) and have had no problem.
Now, my problem is how to organize the mounting piles of reports that I have!
- By DrD11
- Posted February 27, 2009 at 2:12 pm
- Report post
Hello Martzi.
When I retired,(Still practicing as a volunteer in the
clinic for the uninsured),I had more time to think.
It was only natural for me to focus on Prevention of Death.
My research(Done in my private residence)Involves two channels:A)Prevention of Sudden Cardiac Death.
B)Prevention of Criminal Death.
In both cases,I have my ideas(Published one)
I also invented couple of tools,which,I believe will
decrease mortality,significantly.
I have all what I need for my research:Head,eyes,ears
and computer of course.I also have the time to think.
I hope people will listen.
- By martzj
- Posted February 27, 2009 at 5:00 pm
- Report post
DrD11,
"My research(Done in my private residence)Involves two channels:A)Prevention of Sudden Cardiac Death.
B)Prevention of Criminal Death.
In both cases,I have my ideas(Published one)
I also invented couple of tools,which,I believe will
decrease mortality,significantly.
I have all what I need for my research:Head,eyes,ears
and computer of course.I also have the time to think.
I hope people will listen."
I can't imagine a more deeply gratifying way to put your lifetime of medical experience to work.....for the benefit of posterity. SCA (and heart attack) is a very violent experience. To also tackle criminal death ( I assume you speak of assault victims) rescusc
itation is both intriguing and remarkable.
Wishing you much tenacity and energy as you proceed,
Jaynie
- By martzj
- Posted February 27, 2009 at 5:18 pm
- Report post
hi djwaz,
"Wow! So, I guess I'm a lucky critter in this regard. Up until 2008, I never asked for copies of anything, then peritoneal cancer hit me June 2008, and now high blood pressure and heart disease - which runs on both sides of the family. I got copies of every single blood test, surgery pathology report, etc. EVERYTHING! In fact, all the doctors that I've dealt with through this have asked me if I wanted copies, which I find absolutely amazing. "
The Obama health care teams are focusing on the streamlining and sniffing out billions in fraudulent claims/practices....In addition, Obama appears to be relentless about pushing the use of computerized medical systems, so within 3-5 years all practices should be up to speed. There will incentives to computerize records and penalties for practices determined to cling to the Stone Age (higher malpractice insurance rates). Requiring computerized, auditable, transparent, LEGIBLE type will also cut way down on death (55,000 in 2007) and injury to patients from medical errors. Streamlining will be temporarily painful....and then patient experience (& survival) quality will rise exponentially....For medical staff too.
We are truly all in this together! ANd we're all getting there.
Jaynie
- By djwaz184
- Posted February 28, 2009 at 6:28 pm
- Report post
Funny you mention the computerized stuff, me a dear friend were just talking about having a memory stick with all our records and taking it from appointment to appointment to have so we can come home and print anything we want or upload it to get 2nd opinions etc.
It's amazing how fast things are changing these days.
Went in for bloodwork this morning and expected to be in and out fast like before, nope, took almot 45 minutes. They had to register me in, then they went in to review my ccount and then we had to talk about setting up a payment program ..... gosh things have sure changed!
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