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Medical Records; Getting Yours

Thanks to the Federal Freedom of Information Act, it is much easier for most of us to obtain copies of our CIA or FBI files than to get our medical records. Even though Americans will spend approximately $1 trillion this year on health care, the records of why we went to the doctors or hospitals, what they found wrong (or right) with us, what diagnoses they made, what drugs they prescribed or surgery they performed, and whether we improved as a result, are generally kept from us. This movement is based on a very old, very American Jeffersonian principle: that information is power. As old as this axiom is, however, it has only very recently taken root.

Patients in such diverse nations as Britain, Canada, China, Norway and parts of Africa as well as an increasing number of states within this country routinely have access to their medical records. In contrast, in 1978, when the original edition of this book was published, only seven states had statutes that granted patient access to records held by both doctors and hospitals. Now half of all states have statutes providing for such access and an additional six provide access to hospital records only. In addition, 27 states and the District of Columbia currently have laws allowing direct access for mental health records.

If you have ever thought about trying to get your medical record but did not know how to go about it or what your rights were, this book will help you. If in trying to get your record you have run up against doctors and others who tell you that you do not need your record or that it is not in your best interest to see your record, this book will help you. If you have seen your record but did not know how to interpret it, this book will help you. Put simply, this book tells you why you should have a copy of your medical record, how to get it, and how to understand what is in it.

The first section of the book discusses the importance of having a copy of your record. It tells you what to expect to find in a medical record, discusses the advantages of access, and demonstrates the fallacies in the medical profession’s objections to access.

The second section is a step-by-step guide to getting your record. It contains an overview of the law, tells you how to proceed in requesting your records and how to use these records once you have obtained them.

In the third section you will find a state-by-state survey of laws and regulations governing patient access.

The fourth section discusses the federal statutes and regulations such as the Freedom of Information Act and Privacy Act, which govern patient access to records held by Veterans Administration hospitals, Public Health Service facilities, federal prisons and military hospitals under the Department of Defense. It also explains an Occupational Safety and Health Administration regulation that gives workers information about exposure to toxic chemicals and the effect on their health. In addition, there is a description of federal regulations regarding health records for residents of long term care facilities that receive Medicare or Medicaid reimbursements, personnel of the federal government, individuals with records held by the Department of Defense, and those who have participated in a federally sponsored or regulated alcohol or substance abuse program.

The fifth section tells you how to obtain a copy of your record from the Medical Information Bureau (MIB), which is where insurance companies exchange personal medical information on applicants. There are approximately 650 insurance companies that participate in the MIB, each of which may have access to your personal information if you signed the waiver on the insurance application (which is usually a prerequisite to obtaining insurance). If the information in the MIB database is wrong, it may negatively impact your ability to get insurance. Therefore it is important to make sure the information is correct by obtaining a copy of the record.

If you live in a state that still does not require doctors to release medical records to patients, do not assume that you will not be able to obtain your records. A Public Citizen’s Health Research Group survey in the District of Columbia, a jurisdiction without such a requirement, found that almost 75 percent of the physicians who responded to the survey said they would voluntarily turn over a patient’s records to the patient if asked. This book will tell you how to go about asking. If you want to work to change the law in your state so that a patient’s right to his or her own medical record is recognized, the book contains a model statute to accomplish this.

Medical Records; Getting Yours

Published: July 1995

Cost: $10

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