Provided by: PRMS

Telepsychiatry Webpage

Our telepsychiatry resources have a new webpage, including a 37-minute “Let’s Talk” video on telepsychiatry, which can be accessed at prms.com/telepsych. In the new video (non-CME), we offer an overview of the many complex issues involved in the provision of telepsychiatry.

November Fact vs. Fiction Resource

I will be retiring from practice soon and have decided to give my paper charts to the patients.  I’ve researched record storage options; when I mentioned to a colleague the outrageous cost, they shared their plan to eliminate that cost by giving the record to the patient.  I really like this solution because in addition to saving money, I will not have to deal with requests for records. Upon researching further, quite a few retiring psychiatrists are doing this, so I feel this is an appropriate plan.   
 
What do you think - fact or fiction?

ANSWER: Fiction! Regardless of how many of your colleagues are doing this, it is inappropriate for at least the following reasons:

• Failure to retain records may violate state law.

For example, as noted by the Florida Medical Board: 

According to Rule 64B8-10.002(3), FAC : A licensed physician shall keep adequate written medical records, as required by Section 458.331(1)(m), Florida Statutes, for a period of at least five years from the last patient contact; however, medical malpractice law requires records to be kept for at least seven years.

•  Failure to retain records may constitute unprofessional conduct.

For example, New York law includes the following within the definition of professional misconduct:

Failing to maintain a record for each patient which accurately reflects the evaluation and treatment of the patient…. Unless otherwise provided by law, all patient records must be retained for at least six years. Obstetrical records and records of minor patients must be retained for at least six years, and until one year after the minor patient reaches the age of eighteen years;

• Failure to retain records may violate your professional liability insurance policy.

While coverage issues are handled on a case-by-case basis depending on the specific circumstances, most policies exclude coverage for “…error or violation of law committed by an insured or any person for whose acts an Insured is legally responsible.”  So, for example, if a state law mandates that physicians retain medical records for up to six years, and a physician fails to do so, coverage for any claim that is related to this could be denied by virtue of this policy exclusion.

Also, policies may have a cooperation clause precluding an insured from taking any actions that could limit the insurance company’s ability to defend the case.  Not retaining the record could be such an action.
 
But even if coverage is intact, by giving up control of the original records to the person who is most likely to make a claim regarding the care documented in them, a physician could be very severely jeopardizing their defense.  The record could be altered, or there could be chain of custody issues resulting in the record being inadmissible. 

PRMS Blog

In his article from the Washington Psychiatric Society summer newsletter, Dr. William Lawson discusses the education and management of suicide among people of color. We hope you and your members enjoy this interesting post!