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Dr. Bob is Robert Hsiung, MD,
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Posted by gibbons482 on November 3, 2009, at 18:26:16
My psychiatrist (old one) who misdiagnosed me will not release copies of my records to me. Even after I told the secretary he had to. The only time I think they can say no is if they think it will be harmful. Their excuse was he used a lot of medical jargon and abbreviation so he will not release them, only to another provider. I don't want my new therapist to see my old records, remnants of an old sickly self. Any suggestions as to how I can get these records? Can he do this?
Posted by BayLeaf on November 3, 2009, at 19:17:25
In reply to My doctor won't release my records, posted by gibbons482 on November 3, 2009, at 18:26:16
No he can't - it's illegal. It's a violation of rights according to HIPAA.
http://www.hhs.gov/ocr/privacy/
He has a right to charge a you fee to copy the records, but that's it, unless as you said, he believes that you may be harmed. Let him know that you are aware of your rights as established by HIPAA. If that does not work, call your local NAMI office for assistance. This will annoy them highly.
Personally, I DO NOT RECOMMEND YOU READ YOUR RECORDS. It can simply be hurtful, and is almost always useles. I did it. It was awful. If you need the info for some reason (letigation?) I would let your current T have it. Heck, your new T will gain a LOT by knowing the old you. AND he/she will see how much progress you've made. It would be nice to share that with someone, wouldn't it? If you don't NEED it, let it go.
bay
Posted by psych chat on November 3, 2009, at 22:07:27
In reply to My doctor won't release my records, posted by gibbons482 on November 3, 2009, at 18:26:16
It can get pretty complicated, and I believe there are some doctors who misinterpret HIPAA. I remember when the law was first enacted, there were certain cases where even general practitioners would not patients have a copy of their own records. There was no reason for this except the office staff would say "we can't give you a copy of the records due to HIPAA regulations". Well the regulation wasn't designed to protect people from finding out stuff about themself, to guard a patient's privacy from the patient-duh.
But-there are rules pertaining specifically to psychotherapy notes under HIPAA. Here is the code pertaining to that section:
Sec. 164.524 Access of individuals to protected health information.
(a) Standard: Access to protected health information. (1) Right of access. Except as otherwise provided in paragraph (a)(2) or (a)(3) of this section, an individual has a right of access to inspect and obtain a copy of protected health information about the individual in a
designated record set, for as long as the protected health information is maintained in the designated record set, except for:(i) Psychotherapy notes;
etc.
http://edocket.access.gpo.gov/cfr_2002/octqtr/45cfr164.524.htm
You could contact HIPAA's Office of Civil Rights to inquire if there are other means to acquire them or to determine if your psychiatrist is in compliance:
http://www.hhs.gov/ocr/privacy/hipaa/complaints/index.html
There are loopholes. In certain cases, they have to provide the notes to a "designated personal representative".
I believe they also have to provide them to an attorney (unsure if there has to be an ongoing suit-but you could always call a medical malpractice attorney and just ask the question).
I'm not an attorney, but I know there are loopholes to many laws and regulations-I'm not saying you can do this, but you can check into this further - I believe a state's regulation governing psychotherapy notes supersedes HIPAA's. For example, if a doctor believes the notes will cause harm (to you or another) and does not disclose them while still complying with HIPAA, certain states' codes may have a provision that mandates there must be reasonable evidence that the notes will cause harm; for example, direct threats or things you said. You could check your state's code by Googling.
Your doctor may also have to provide written notice concerning the denial of your records.
I'm not sure why he couldn't release the medication portion of your records-that may be unlawful to refuse to do that. However, there are also regulations concerning what constitutes psychotherapy notes and medical records, pertaining to how the records are organized, combined, and maintained.
I think you might find more answers by contacting HIPAA's Office of Civil Rights. They certainly would be more helpful than I would be. If you don't make progress with DHHS, you could contact an attorney and ask them how to get a copy. Another option would be to ask your new therapist about this. Tell your new therapist you don't want him or her to see the records, but you would like to get a copy for yourself. I wouldn't hesitate to ask my therapist about this if I wanted a copy of my records from another therapist. Some therapists don't even want to see prior records to maintain their objectiveness.
In the end, if you do get a copy of the psychotherapy notes, the copy you receive may not actually be the same set of notes the doctor has kept. Only the doctor would know. So it might not even be worth pursuing. Keep that in mind.
The psychotherapy notes provision does protect patients, doctors, and other people in certain cases, but sometimes the law is perverted by those having control over medical records. Maybe he thinks you are going to sue him?
Posted by psych chat on November 3, 2009, at 22:12:49
In reply to Re: My doctor won't release my records » gibbons482, posted by BayLeaf on November 3, 2009, at 19:17:25
"Personally, I DO NOT RECOMMEND YOU READ YOUR RECORDS. It can simply be hurtful, and is almost always useles. I did it. It was awful."
That is a very good point, Bayleaf. I've never seen a copy of my prior therapy records..most hardly took notes, but some did. Now I'm curious.
Posted by Phillipa on November 4, 2009, at 11:51:23
In reply to Re: My doctor won't release my records » BayLeaf, posted by psych chat on November 3, 2009, at 22:12:49
I am also my records were never requested by other pdocs. I do have medical originals of MRI's and stuff as they belong to me. Also just learned as a medicaire patient I can refer myself to a doctor don't need a referral. I did this with an ortho and now I can't get anything straight. My life is a big mess. Love Phillipa
Posted by gibbons482 on November 4, 2009, at 11:55:36
In reply to Re: My doctor won't release my records, posted by psych chat on November 3, 2009, at 22:07:27
Thank you for your detailed post. I'm aware psychotherapy notes are considered the property and personal notes of the doctor, but I'm just wanting my medical notes. I'll defintely check out that link after class today.
Posted by gibbons482 on November 4, 2009, at 11:56:29
In reply to My doctor won't release my records, posted by gibbons482 on November 3, 2009, at 18:26:16
Does anyone think writing a letter would help? Or would that make the situation worse? I like this doctor and if I move back to the original state I may have to see him again, so I don't want to burn my bridges.
Posted by seldomseen on November 4, 2009, at 17:31:04
In reply to My doctor won't release my records, posted by gibbons482 on November 3, 2009, at 18:26:16
Did he decline, or was it his secretary? SHE may not know the laws. If this is the case, trying contacting the Dr. directly via a letter, or a phone call.
Posted by gibbons482 on November 4, 2009, at 18:01:08
In reply to Re: My doctor won't release my records » gibbons482, posted by seldomseen on November 4, 2009, at 17:31:04
It was the secretary. She said it was his office policy and I could talk to the doctor if I wanted. The problem is he never returned calls when I was a patient, he certainly isn't going to return mine now that I'm not his patient.
Posted by Nadezda on November 5, 2009, at 15:28:22
In reply to Re: My doctor won't release my records » psych chat, posted by gibbons482 on November 4, 2009, at 11:55:36
Hi, gibbons.
If your main issue is your new Ts access to the notes or original records, it might be more effective to discuss it with him/her and let them know how you feel and why.
I hope s/he would respect your feelings.
I'd like to point out though that your old doctor would only give you a copy o f any notes or records-- not the originals, which he would keep for his own records. So I don't think getting a copy would protect you in the way you want.
You would, at least, know what's in them-- but you might be better off not knowing-- and just agreeing with your new T that s/he won't look at them. They might upset you, and be more of a hurtful thing than a helpful one, in the end--which, if you could avoid, it might be better..
Nadezda
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