Medical Records and Your Doc’s Death/Impairment

Many of us have a PCP (primary care physician) and some will have nurse practitioners filling that role now or in the near future as rules and availability change. For most of us, we assume that our medical records are safe and that whenever we might need them, they’re there. We also assume that our caregiver (whether MD or RN) will be there when we need them. Fast forward into the reality zone.

Solo practitioners may be a rare commodity in metropolitan areas, but in the rural sections of our country, the solo practice may be the norm rather than the

anomaly. These small offices, where staffing is kept to a minimum, also try to keep their records readily available in those multi-colored folders lining the walls or filling file cabinets. Electronic medical records may not be something with which they are comfortable or which are available. True, the internet may be running in their area, but not all offices will have an IT connection.

The staff may be familiar with you and you may even send them holiday cards or gifts to show your appreciation for their continued concern for your health. It’s a relationship that can build up over generations as one doc may go into practice with their parent and staff may bring on their kids. Obviously, you want to keep going to them because you know that they know your medical needs, but is there a storm cloud just over the horizon?

Tomorrow, thanks to Annie, the sun may come out but the physician or nurse practitioner may not be there and that’s a reality most of us never consider. If they aren’t there, what happens to our mound of records and all that knowledge the office accumulated on our health? Something to think about, surely.

Today, a peer had to call her physician to schedule a routine blood test that is needed every few months. The woman who answered the phone, someone she’s known since this woman was in high school, didn’t sound quite like herself. Then the reality of our frail existence hit. The physician had a heart attack in the gym three weeks ago and he had emergency triple-bypass surgery. He is now in rehab for the next three months and is expected to return to practice, but there’s no definite assurance when and if he will continue.

Unfortunately, the physician, who is fastidious about his diet and exercise routine, had his dad die at age 50 of a massive coronary and he wanted to avoid that happening to him. He preached to all his patients that they must watch their weight, eat a healthy diet, exercise regularly and “stand up straight.” Of course, he also offered referrals for counseling if anyone experienced inordinate stress in their lives. But, in his own life, he had a rough year himself.

A month ago, one of his kids had an elusive malady which took months to diagnose and finally, once diagnosed, required major surgery. Another had a miscarriage and is now having a difficulty second attempt with her pregnancy. His wife had a lingering and quite unusual viral infection that went on for over a month. All in all, his family was quite stressed while he maintained his solo practice plus a teaching schedule.

What do his patients do now that his office is officially on hold for three months? Enter the network of physicians he has relationships with in the area and the

major hospital where he has privileges. It is now up to one staff member who remains in the office to provide the names of back-up physicians to all patients while she manages her own stress and a badly sprained ankle.

But suppose the medical person had died suddenly? What about all those paper records in the office, in the cabinets and in the basement storage area? What is the legal responsibility here and how would you get your’s if you wanted them?

If you had to get your medical records, keep one thing in mind; not all records must be kept in perpetuity. Some records must be retained for six years, some longer and it can vary by state, so familiarize yourself with your state’s rules on this and who can have access to these records. You may have to pay to get the records (some states say $1/page is reasonable), but there may still be some lag time because many physicians have hundreds of patients and thousands of pages of records — not computerized.

The government does have rules about medical records and how to obtain them, so that would be a good thing to keep in a safe place. They also give specific information about medical records’ privacy and how they are to be protected. In fact, when you go into a medical office, there should be a HIPAA (Health Insurance Portability and Accountability Act) form for you to review and sign that you are aware of its contents. Some offices post it on the wall, others will give you a copy for your records.

Do you keep copies of your ECGs, blood tests and any other tests you’ve had? Should you? Really a matter of how much control you’d like over this material and whether or not you want it easily accessible in the future. Might be a good idea.

We all live in a state of refusal about our mortality. Not a bad thing because it would be unwise and unhealthy to go around constantly thinking about your demise. But there are some things which must be tackled while we’re healthy and cognitively intact sufficiently to take steps for the future. Yes, some people live to be over 100 but that’s not the rule and no one knows when an accident or sudden illness may affect us.

Dwelling on these possibilities isn’t what I’m suggesting, but taking a few steps of preparation isn’t such a bad idea. Think about what you need to do.