We routinely advise clients here at the Alaska Personal Injury Law Group about their legal rights concerning their medical records. We do this to encourage them to become knowledgeable consumers of medical services. Essentially, the more informed the client is as a patient, the better services they can receive from their health care provider. So, it was with some surprise that I was informed by my own doctor that “by the letter of the law” he was not permitted to provide me with the reports he had received from a specialist (mind you, I had requested that the specialist send him the records in the first place). I agreed to request the records from the specialist instead, and made a mental note to review the applicable law, thinking that perhaps there was some new provision about which I was unaware.
The short answer is my doctor has been misinformed. The “letter of the law” is that a patient is entitled to receive a a complete copy of their medical records held by their physician. This has always been the law in Alaska, and remains so today. Most states have laws addressing this right. Further, federal heath care law has recently articulated a federal right of access to one’s own medical records.
Alaska’s statute, passed in 1978, sets out a broad right of access in A.S. 18.23.005: “a patient is entitled to inspect and copy any records developed or maintained by a health care provider or other person pertaining to the health care rendered to the patient.” There are no articulated exceptions here, and the right of access would plainly reach to all records in the file, including lab reports, imaging studies, or the evaluations of other doctors since these are used by the physician in providing care.
Alaska’s Medical Board is responsible for promulgating regulations that govern the practice of medicine in Alaska. In one regulation, 12 AAC 40.967, the Board expressly defines for physicians the behaviors that constitute “unprofessional conduct,” including the failure:”to provide copies of complete patient records in the licensee’s custody and control within 30 days after receipt of a written request from the patient.” Most professions are also governed by an ethics code, and physicians are no exception. Alaska’s Medical Board, in 12 AAC 40.955, has adopted the medical ethics code set out by the American Medical Association. The AMA, in Opinions 7.02 and 10.1, also sets out an ethical precept for physicians mandating that a copy of patient records be provided to the patient. Stating that the “patient is entitled to obtain copies or summaries of their medical records,” the AMA sets this right out as one of the “fundamental elements” of the physician’s relationship with their patient.
In the federal regulations implementing the Health Insurance Portability and Accountability Act (“HIPAA”), the patient’s right of access is again broadly laid out, with some specific exceptions. In what is known as the Privacy Rule, 45 CFR 164.524, the regulation provides that: “an individual has a right of access to inspect and obtain a copy of” their records, and that right is only limited in certain situations that do not arise in routine health care, such as when the records contain information involving inmates, psychotherapy, litigation, or clinical research.
So, our advice to our clients remains the same. You are legally entitled to obtain a complete copy of your own medical records from your doctor, and you should get them if you want to be an effective participant in your own medical care.