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Why you have to pay for your own medical records

The question: My doctor is closing his practice. I went to the office and asked for my records, thinking that if I ever find a new physician, I could take them with me.I was told they would be transferred to a new doctor if I got one, but for a fee. These records are mine. What are a patient's rights to his or her records?

The answer: You are right, the information contained in those medical records belongs to you, but the doctor must keep the original. For a physician, a patient record carries with it, among other things, the responsibility to keep it confidential and not to allow unauthorized uses. As a patient, you have the right of full access.

The biggest issue for patients is not whether they get the original records or a copy of them, but the fees. Some patients face exorbitant costs - one health-care centre wanted to charge a patient $2,532 for a copy of their medical records. That patient complained to Ontario's Information and Privacy Commissioner, Ann Cavoukian, and the fee was waived.

Dr. Cavoukian, who holds a PhD in psychology, said: "We've had many complaints of this nature where we've reduced the fee significantly."

Patients, she said, are not always aware that they can complain to her office about fees they find high. In a recent order, she set a benchmark to help keep fees in line, which in most cases is $30 for the first 20 pages, plus 25 cents per page thereafter.

Alberta has regulations stipulating maximum amounts patients can be charged for copies of their own medical records - $25 to make the request, plus 25 cents per page charge for photocopying; there is a menu of other fees.

Though Manitoba, Saskatchewan and Ontario require patients be charged "reasonable fees," they do not have regulations governing the process. In other provinces, doctors rely on recommendations of their medical associations.

Cathy MacLean, professor and head of University of Calgary's department of family medicine, pointed out that the cost covers time to put a copy of the file together, which is often based on the size of the chart.

"We're not asking for patients to pay for the information that's in the file," said Dr. MacLean. "We're asking them to pay for the clerical time and the effort of putting the copy together."

Having a medical record is important if your doctor is retiring or quitting his practice, as it is customary for physicians to send their records to a storage facility.

"You've got to be your own advocate," Dr. Cavoukian said, "And in order to do that, you need your records."

She suggests this: If you are being sent for tests, get into the habit of asking for a copy of the results every time. That helps you build your medical record as you go and cuts down on search and retrieval time, which is likely to push up the cost - not to mention the hassle of obtaining copies down the road.

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