The question: My family doctor is closing his office. He referred me to a pain management specialist, who I see more often than I do him for neuropathic pain, the root cause of which has not been found. To complicate matters, many of the neurologists I've seen have also retired. In my family doctor's file, there are reports and test results I want from neurologists, who over the years, have made efforts to diagnose the cause of my pain. Some of the tests I've undergone are unpleasant and I wouldn't want to start them all over again. Can I expect him to provide photocopies of the reports along with test results if I offer to pay?
The answer: Right now, your family doctor has a million things on his mind while getting ready to close his practice, so you are right to want to act fast. According to the College of Physicians and Surgeons of Ontario, your doctor is obligated to do one of two things: notify you he is closing his practice and transferring your records to another person legally authorized to hold them, such as a doctor or another health-care provider; or provide notice your records will be destroyed in two years and that up until then, you can have them sent to another physician. Doctors can also place records in a medical storage facility.
Typically, fees to obtain copies of medical records are nominal. In Ontario, patients pay $30 for the first 20 pages, plus 25 cents per page thereafter. Alberta charges $25 to make the request, plus 25 cents per page for photocopying. Manitoba and Saskatchewan require patients be charged "reasonable fees," leaving doctors to rely on recommendations from their respective medical associations.
Part of the issue in going through such a big file is search time: It isn't the mere act of photocopying a dozen sheets of neurologist reports, but actually having someone rifle through a thick medical file to locate the relevant ones.
I also wonder if you need more than just the neurologists' reports. Sometimes when a doctor looks at a medical file, trends are observed and links made, simply by perusing the breadth of information.
Ontario's Privacy Commissioner, Ann Cavoukian, had another suggestion: See if you can transfer your medical records to the pain specialist. It could be the easiest thing of all and ensure the full record is safely with a health provider.
She also suggested that in future, when making an appointment with a family doctor to learn test results, ask for a copy of them right then and there; they will often be given for free. That way you can build your own file.
"I kindly ask if they wouldn't mind giving me a copy of the test results," said Dr. Cavoukian, who holds a PhD in psychology. "They never mind, they do it right then and there. It's so important for patients to be their own advocates; they have to keep track of their data."
The Patient Navigator is a column that answers reader questions on how to navigate our health-care system. Send your questions to firstname.lastname@example.org.