Re: Medical authorizations and reports
I would like to respond to the ICBC article “Medical authorizations and reports” [BCMJ 2009;51:433].
I thank Dr Jensen for pointing out our obligations as physicians to promptly and accurately respond to requests from ICBC for medical reports; however, I don’t understand why she seems to be scolding us for properly following ethics and privacy law in these matters.
I have recently been receiving more frequent requests from ICBC for complete copies of my patients’ medical records. While it is true that the medical release signed by the ICBC claimant is very comprehensive, when I phone patients to inform them of this request, as Dr Jensen has suggested we do, they are uniformly surprised that ICBC would want their whole record and insistent that access be restricted only to pertinent details.
This is very much in compliance with what is recommended by the College of Physicians and Surgeons, the Canadian Medical Association, and the Canadian Medical Protective Association. The Personal Information Protection Act also states that we “may disclose personal information only for purposes that a reasonable person would consider are appropriate in the circumstances.”
Very little of a patient’s medical record, especially in a family practice, is pertinent to a motor vehicle injury and much of it is of a sensitive nature and/or can be misinterpreted by non-medically trained insurance adjusters.
Dr Jensen acknowledges this but leaves me a bit confused when she follows by saying, “It is not appropriate or acceptable to just omit or black out those parts of the chart.” I worry that this statement could lead some physicians to forget their ethical and legal obligations. I urge her to publicly clarify this in a subsequent article.
—Eugene Leduc, MD
Victoria