GCMB Update: Your responsibilities for your patients’ medical records

GCMB UPDATE

Your responsibilities for your patients’ medical records

By John S. Antalis, M.D., past chair and member, Georgia Composite Medical Board

John S. Antalis, M.D.

One of the problems we face in health care is a patient’s ability to obtain their medical records once a clinician retires or their license is suspended or revoked. The usual procedure for these patients is to ask for their medical record to be sent to another/new clinician, and they normally pay a transmission fee. But if a clinician leaves their practice abruptly, the process for patients can be complicated and ambiguous. Medical records, including electronic ones, are owned by the treating clinician or pharmacist. Georgia law states that clinicians own their patients’ medical records, and they have decisionmaking authority to share those records with other clinicians – keeping in mind that this requires the patient to sign a consent and confidentiality waiver, except in cases that involve a subpoena or court order or suspected child abuse or venereal disease. It is also worth noting that a patient’s HIV medical information can only be shared with 1) the patient or 2) the patient’s parents or guardians if they are a minor or 3) someone that the physician “reasonably” believes is the patient’s spouse or partner. HIPAA generally requires a medical record to remain confidential. The three exceptions include 1) emergency treatment and 2) the introduction of health complications or injuries in a court case arising from an auto accident and 3) reporting to the federal government of births, deaths, and communicable diseases. Although a clinician owns their patients’ medical records, Georgia law requires them to provide a copy of the medical record to the patient upon the patient’s request. The first step for a patient or authorized representative (e.g., guardians) to acquire their medical record is to call the doctor’s office or hospital that has requested the record to determine if they want it in email, fax, letter, or some other form. Of course, the patient must always sign a written authorization. The clinician must retain their patients’ medical records for 10 years. If a clinician is going to retire, they should 1) notify their patients and 2) offer their patients a way to obtain their records in a reasonable amount of time. I would suggest four to six weeks. The same notification applies when a clinician sells their practice. If the new clinician is in the same office, the 10-year retention rule still applies. To transfer records to another/new clinician’s office, a patient needs to submit a written authorization requesting the records be sent. Patients who request that their medical records be transferred should expect to pay a record copying fee. The Georgia Department of Community Health sets this rate on July 1 of each year and posts it at https://dch.georgia.gov/medical-records-retrieval-rates. The Medical Association of Georgia (MAG) has posted some suggestions to help patients retrieve their medical records at www.mag.org/medicalrecords. Patients are encouraged to keep a record of their health history, medications, and insurance claims. Patients can email MAG General Counsel Bethany Sherrer at bsherrer@mag.org if they need help contacting a physician. As a last resort, a patient can submit a complaint to the Georgia Composite Medical Board (GCMB).

What should a patient do if their doctor’s practice closes or their clinician is suspended or has their license revoked?

The policy that the American Medical Association adopted in 2017 (3.3.1) only addresses physicians who are leaving practice, selling their practice, retiring, or have died. It is silent on a physician’s suspension or revocation.

If a clinician closes their office without advance warning, a patient can…

If a physician is suspended by GCMB, it is in their best interest to comply with GCMB’s rules and release all requested medical records. On MAG’s website, there are guidelines that can inform both physicians and patients. Georgia statutes don’t address the need for physicians who have had their license revoked to maintain their patients’ medical records in any specific way. As an alternative, contact the U.S. Department of Health and Human Services’ Office of Civil Rights at https://www.hhs.gov (especially when it involves Medicare or Medicaid services). And I always emphasize that Georgians should request their medical records as soon as they find out that their physician has had their license suspended or revoked. Neither AMA policy nor Georgia statutes are specific concerning the acquisition of medical records for a revoked physician. This is a major issue for the next physician who will care for the patient. Unfortunately, the only option is to acquire the records before the office is closed in Georgia. The Texas Medical Board has developed a solution that I believe warrants Georgia’s strong consideration. It has ruled that any physician who has their license relinquished, surrendered, or revoked must notify their patients within 30 days. And within the same timeframe, these physicians must designate a Boardapproved custodian to manage their patients’ medical records. I encourage physicians to contact me at jsantalis@gmail.com with any questions. Dr. Antalis is a member of the Whitfield-Murray County Medical Society, and he was MAG’s president in 2004-2005.