Guest guest Posted February 10, 2004 Report Share Posted February 10, 2004 You do not have to release patient records to a patient by HIPPA law if you feel it is in their best interest not to. For example, say you have documented in your notes that the patient is mentally unstable, and you believe that releasing the notes to them will pose some sort of danger to them - you do not have to do so. You can deny the request. They then have the right to appeal to you the denial. At which time you are required to review it again with a colleague, and if there is agreement you can subsequently deny the request a final and second time. I am sort of reaching here but is the patient type A, have known cardiac problems, have delusions of paranoia and persecution which dwelling on persecuting you will only aggravate - whereby releasing these files may cause them undue stress. Perhaps contact your boards legal counsel - I wonder where the overlap of requirements to release informtion to the patient, and the 5th amendment which says we do not have to incriminate ourselves lie? If you know, and can document (by having the person who told you of this former patients intent to make you suffer) that this person only has mailicious intent towards you - would you have to release your records. Maybe contact your malpractice carrier as well - if they have said they intent to make you suffer, then a potential lawsuit IS in the making - and they would at least have to go through your carrier to get the records ....after hiring an attorney....all of which creates layers making getting the records all the more difficult. I am just thinking out loud here - how about a letter to the patient saying " I am most happy to release the records, however me thinks I smell a law suit a brewin', so I will have to request you hire legal counsel and obtain the records through my malpractice carrier " . This creates obstacles...going to an attorney and having to explain things to them (even if they take the case on contgency), time for the lawyer to request the files, time for you to copy them, time for them to go to your carrier, time to get them to the patient, etc. Time cools all things off. By the time the patient gets them, and everyone sees there is nothing in the files incriminating, then the patient will lose steam about persuing it more. Just thinking outloud....or through the keyboard Anglen Quote Link to comment Share on other sites More sharing options...
Guest guest Posted February 10, 2004 Report Share Posted February 10, 2004 Hi Ann, You bring up an interesting point ...one where I don't recall seeing/finding/hearing any recourse. The patient owns the content of the records but the doc has physical possession. The Record-Keeping chapter is just finishing and, in all the literature I read, I don't remember anything addressing this scenario. Especially if she presents a subpoena, she is entitled to a copy. Best talk with your attorney, Ann and work this from a fully legal viewpoint. Sorry I don't have a valid tactic for you. Sunny Sunny Kierstyn, RN DCFibromyalgia Care Center of Oregon59 Santa Clara St.,Eugene, Oregon, 97404541-689-0935 release of records Hi all: I know we have been discussing releasing x-rays, and I have a question about paper records. A patient has just sent me a letter requesting her entire file. This patient made a complaint to the board a few months ago and told a friend that "she would make me suffer". The board did not find any violations with my treatment. I am reluctant to release her file knowing that she is probably going to try to continue hurting me. Dave et al., is there something I can do to protect myself in not releasing the records? Ann Goldeen, AstoriaOregonDCs rules:1. Keep correspondence professional; the purpose of the listserve is to foster communication and collegiality. No personal attacks on listserve members will be tolerated.2. Always sign your e-mails with your first and last name.3. The listserve is not secure; your e-mail could end up anywhere. However, it is against the rules of the listserve to copy, print, forward, or otherwise distribute correspondence written by another member without his or her consent, unless all personal identifiers have been removed. Quote Link to comment Share on other sites More sharing options...
Guest guest Posted February 10, 2004 Report Share Posted February 10, 2004 There is nothing like getting the patient royally upset by refusing to release their records to them when they have a properly signed release and pay for the copies. Why make matters worse ? Take a look at OAR 811-015-006(1) Disclosure of Records , and that will guide you. sharron fuchs dc Re: release of records You do not have to release patient records to a patient by HIPPA law if you feel it is in their best interest not to. For example, say you have documented in your notes that the patient is mentally unstable, and you believe that releasing the notes to them will pose some sort of danger to them - you do not have to do so. You can deny the request. They then have the right to appeal to you the denial. At which time you are required to review it again with a colleague, and if there is agreement you can subsequently deny the request a final and second time. I am sort of reaching here but is the patient type A, have known cardiac problems, have delusions of paranoia and persecution which dwelling on persecuting you will only aggravate - whereby releasing these files may cause them undue stress. Perhaps contact your boards legal counsel - I wonder where the overlap of requirements to release informtion to the patient, and the 5th amendment which says we do not have to incriminate ourselves lie? If you know, and can document (by having the person who told you of this former patients intent to make you suffer) that this person only has mailicious intent towards you - would you have to release your records. Maybe contact your malpractice carrier as well - if they have said they intent to make you suffer, then a potential lawsuit IS in the making - and they would at least have to go through your carrier to get the records ....after hiring an attorney....all of which creates layers making getting the records all the more difficult. I am just thinking out loud here - how about a letter to the patient saying " I am most happy to release the records, however me thinks I smell a law suit a brewin', so I will have to request you hire legal counsel and obtain the records through my malpractice carrier " . This creates obstacles...going to an attorney and having to explain things to them (even if they take the case on contgency), time for the lawyer to request the files, time for you to copy them, time for them to go to your carrier, time to get them to the patient, etc. Time cools all things off. By the time the patient gets them, and everyone sees there is nothing in the files incriminating, then the patient will lose steam about persuing it more. Just thinking outloud....or through the keyboard Anglen OregonDCs rules: 1. Keep correspondence professional; the purpose of the listserve is to foster communication and collegiality. No personal attacks on listserve members will be tolerated. 2. Always sign your e-mails with your first and last name. 3. The listserve is not secure; your e-mail could end up anywhere. However, it is against the rules of the listserve to copy, print, forward, or otherwise distribute correspondence written by another member without his or her consent, unless all personal identifiers have been removed. Quote Link to comment Share on other sites More sharing options...
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