The following letter was sent to the College of Physicians and Surgeons of British Columbia and copied to the BCMJ.
I am writing to you about the policy manual revision of March 2003 which states that the physical medical records of a physician must be retained for the statutory requirement of 6 years beyond the last office encounter or in the case of an infant patient under the age of 19 years until those patients reach the age of 25 years. The College Quarterly recommends that the records be retained for 7 years and the CMPA recommends that this period be extended to 10 years beyond the date of last office encounter. At present I am in my 62nd year. It is hoped that I will be able to continue practice at least until the age of 65. The children that I delivered years ago are now well into child-rearing age themselves, and although I no longer perform deliveries, they bring their newborns to me for general medical care. If I were to stop practice in my 66th year, College policy would require me to retain my records for an infant born in that year for 25 years and the CMPA suggestion is to retain that record 4 years beyond this. Therefore I would be expected to retain my records for some patients until I reached the age of 94. It is unlikely that I will achieve this age. Statistics are against me. Presumably it is expected that my children will retain the records in the case of my death. My son died last year. There is no guarantee that there will be anyone left for me to transfer these records to for the period that you request. Is there a legal onus on a relative to safeguard such records?
In this day and age it seems to me that those making ever-increasing demands on physicians should bear the cost and responsibility of those demands. Is it not time that the College set up a depository to handle these types of records, particularly those that have to be retained for such a long period of time? Your thoughts on these matters are awaited with interest.
Thank you for your letter. The statutory requirement in British Columbia for the retention of medical records is 6 years or 6 years beyond the age of majority (i.e., age 19) for children. This is not the College’s arbitrary rule but is a matter of provincial law. Because prospective plaintiffs are given a year after filing a suit to follow up on that action, the College recommends another year for retention of records, making the total recommendation 7 years. Statutes of limitation vary from province to province and therefore CMPA, in the physician’s best interest, recommends 10 years for records retention. Even 10 years may not be enough for the physician or his or her estate to keep records since some matters such as sexual misconduct are outside of statutes of limitations and complaints or concerns may be expressed many years later. It is therefore not a College policy which you question, but a combination of provincial statutes and physicians’ legitimate self-interest in protecting themselves from potential civil court action.
With respect to your suggestion that the College assume a role or responsibility in this matter, please allow me to note the following. It is not the College making those demands, but it is the College summarizing the current state of provincial law. Secondly, the only source of income that the College has to support its activities is the annual licensing fees from physicians. Therefore, the establishment of a centralized depository for old medical records, as you suggest, would generate a significant cost which, with current financing, would ultimately be paid by the physicians themselves through their dues, unless physicians using such a service are charged individually for it.
The potential problems that you have outlined are significant and are a burden for retired physicians or ultimately for their estates. Many physicians have managed to arrange alternatives, such as upon retirement or leaving practice, placing their medical records in the care of a younger and willing colleague who can cull them and properly dispose of them when the elapsed time periods allow for this. There are also medical record retention and management companies that provide custody and access to medical records and charge a fee for such a service.
I hope you find these comments helpful.
—M. VanAndel, MD
Registrar, College of Physicians and Surgeons of British Columbia
Above is the information needed to cite this article in your paper or presentation. The International Committee
of Medical Journal Editors (ICMJE) recommends the following citation style, which is the now nearly universally
accepted citation style for scientific papers:
Halpern SD, Ubel PA, Caplan AL, Marion DW, Palmer AM, Schiding JK, et al. Solid-organ transplantation in HIV-infected patients. N Engl J Med. 2002;347:284-7.
About the ICMJE and citation styles
The ICMJE is small group of editors of general medical journals who first met informally in Vancouver, British Columbia, in 1978 to establish guidelines for the format of manuscripts submitted to their journals. The group became known as the Vancouver Group. Its requirements for manuscripts, including formats for bibliographic references developed by the U.S. National Library of Medicine (NLM), were first published in 1979. The Vancouver Group expanded and evolved into the International Committee of Medical Journal Editors (ICMJE), which meets annually. The ICMJE created the Recommendations for the Conduct, Reporting, Editing, and Publication of Scholarly Work in Medical Journals to help authors and editors create and distribute accurate, clear, easily accessible reports of biomedical studies.
An alternate version of ICMJE style is to additionally list the month an issue number, but since most journals use continuous pagination, the shorter form provides sufficient information to locate the reference. The NLM now lists all authors.
BCMJ standard citation style is a slight modification of the ICMJE/NLM style, as follows:
- Only the first three authors are listed, followed by "et al."
- There is no period after the journal name.
- Page numbers are not abbreviated.
For more information on the ICMJE Recommendations for the Conduct, Reporting, Editing, and Publication of Scholarly Work in Medical Journals, visit www.icmje.org