Keys to Patient Safety
Medical Records Disposition When Closing a Practice
As the first medical professional liability insurer to establish a patient safety department, The Doctors Company remains the leader in developing innovative tools that can help you reduce risk and keep your patients safe.
The physician or physician group practice is responsible for making appropriate arrangements for the disposition of medical records when a practice closes. The possibility of a lawsuit after a physician has left or closed his or her practice always exists. To help defend against any future claims, the retention of records is paramount.
- Although states may have different guidelines or laws for retaining medical records, The Doctors Company makes the following recommendations:
- California only—retain the records indefinitely or for at least 25 years after the patient’s last visit.
- Adult patients—10 years from the date the patient was last seen.
- Minor patients—28 years from the patient’s birth.
- Mammography patients—10 years from last mammography.
- Deceased patients—five years from the date of death.
- Physicians turning their practices over to replacement physicians should have an agreement that stipulates the recommended retention time and access capability.
- If physicians choose to destroy clinical records after a set period of time, confidentiality must not be compromised. There are record destruction services that guarantee records are properly destroyed without releasing any information.
- When a practice closes and medical records are transferred, patients should be notified that they may designate a physician or other provider to receive their records.
- If a patient does not designate a physician, records may be transferred to a custodian (physician or commercial storage firm).
Custodians who agree to retain the records can be physicians, nonphysicians, or commercial storage facilities. Custodial arrangements for retaining records are usually entered into for a fee and should be in writing. A written custodial agreement should guarantee future access to the records for both the physician and patients. A custodial agreement should include the following points:
- Keep and maintain the medical records received for the same retention times as above.
- No right to access the information contained in the medical records without a signed release from the patient or a properly executed subpoena or court order.
- Notify the original physician or physician’s personal representative of any change of address or phone number.
- Terms apply to all persons in the custodian’s employment and facility.
- Release copies of the medical records to a person designated by the patient only with the patient’s written request.
- Comply with state and federal laws governing medical record confidentiality, access, disclosure, and charges for copies of the records.
- Agreed-upon fees for maintaining the records.
- Language that addresses any personal practice decisions made by a custodian (retirement, selling, or moving) to ensure the safety of and continued access to the records by the original physician or physician’s personal representative.
By Susan Shepard, MSN, RN, Director, Patient Safety Education.
J8039N 7/11
The guidelines suggested here are not rules, do not constitute legal advice, and do not ensure a successful outcome. The ultimate decision regarding the appropriateness of any treatment must be made by each health care provider in light of all circumstances prevailing in the individual situation and in accordance with the laws of the jurisdiction in which the care is rendered.