Medical Records Transfer Fee

DiscoJango on 25/10/2019 - 10:00

New job means new gp dr, as the previous gp was right next to the previous workplace. New gp recommended a medical records transfer, which i signed for. Now i have received a $50 invoice from old gp for this service.

My gripe is, at no stage was i advised there would be a fee to this. The new gp's documentation did not mention it, nor did the previous gp advise me before initiating the transfer, that there would be a cost.

Based on the principle i refuse to pay this. I dont believe it right that a business can just perform a transaction and then send an invoice expecting payment. I have googled this and some medical centers state that they will confirm with the patient the cost before going ahead with the service. I believe that this is a very deceptive and misleading practice of the old medical center.

If i dont pay this medical invoice, what actions can they take. Can they automatically take funds out of my account, or send a debt collector/formal body?

Health & Beauty

Comments

    • DiscoJango on 26/10/2019 - 21:41

      The paperwork i signed did not say anything about a fee. Therefore i am not paying for a service which they made no indication would require payment.

      • CalmLemons on 27/10/2019 - 00:57
        +1

        I agree.

        Let's say it was an oversight, a clerical error that they forgot to tell you.

        If you were informed about it, would you still pay the fee?

        End result is the same isn't it?

      • oO0Dam0Oo on 27/10/2019 - 08:41
        +3

        Is anyone actually understanding the argument? Op is not disputing a fee exists rather that it was not made known at time of request. I’d be pissed as well.

        If you accept that this is reasonable where go you draw the line? Call for plumber to ask a general question in anticipation of booking a job. Do not go ahead as situation self resolved. Receive a $50 invoice for advice.

        Call a lawyer for general inquiry. At what point is it reasonable for them to start charging you? Is it reasonable to be charged prior to being made aware of the fees?

        • [Deactivated] on 28/10/2019 - 20:53

          OP had a prior business relationship with the former GP. So any time after that. If you call YOUR lawyer for a general inquiry you'll be charged because you would have signed something when joining their practice, not when leaving.

      • HeWhoKnows on 31/10/2019 - 22:13

        The paperwork is the authority to release the records.
        Not an invoice.

        When you visit the doctor does he tell you he is going to charge you for the consulation?

        Of course not! Its a given

        When you call a plumber out to fix your blocked sewer does he give you a price first or does he just get it fixed for you to save having elfuent running through your house. Hmmm

        Somehow this discussion is going down the toilet

    • canyoudoitcheaper on 28/10/2019 - 03:20

      The onus is definitely NOT on OP to ask if there is a fee.

      That would be like closing a savings account and being charged an exit fee that’s not in the PDS. “Oh, but you should have asked before you closed the account”… how absurd.

      Under contract law there has to be an offer and acceptance. The billing clinic neither offered the service directly to OP nor was it accepted.

      • [Deactivated] on 28/10/2019 - 20:54

        How do you know there wasn't an offer and acceptance when joining with the GP? There just wasn't one afterwards handed to him, but there is a publicly available fee schedule for GPs.

      • HeWhoKnows on 31/10/2019 - 22:16

        Actually OP did request the service and all doctors have a schedule of fees.
        So you are wrong on both accounts.

        • canyoudoitcheaper on 31/10/2019 - 23:13

          The point is that OP didn’t request the service from his/her original doctor. Having a “schedule of fees” means absolutely nothing - there is no contract with their former patient.

          A lot of these doctors are banking on the fact that nobody will bother taking a $50 bill to court - which still doesn’t make it honest.

  • bigbadboogieman on 26/10/2019 - 17:48

    If they follow-up or chase you, just ask for documentation where you may have agreed to pay a fee for such a record transfer. If they can't provide tough luck for them.

    • HeWhoKnows on 31/10/2019 - 22:17

      Not paying for a requested service is a crime. Its called theft
      Just because OP cant claim on medicare doesnt mean the doctor doesnt get paid.

      • bigbadboogieman on 31/10/2019 - 23:42

        OP was never informed of the charge and he/she never agreed to pay anything. Even if OP had agreed to pay it would still be under contract law / civil law and not criminal law. On the other hand if the clinic is trying to swindle money out of OP unfairly then it's a scam and therefore a crime.

  • MessyG on 26/10/2019 - 18:03
    +2

    I agree they should have provided informed financial consent - the receptionist at the new GP's practice should have checked with the old and informed you. But yes, they can do this.

    https://ama.com.au/tas/transfer-medical-records-guide

    • HeWhoKnows on 31/10/2019 - 22:20

      Thanks for clarifying.

      We have lots of scrouges here expecting people to work for nothing yet they themselves always expect to get paid.

  • [Deactivated] on 26/10/2019 - 18:06
    +3

    The fee seems reasonable to me although I've not known a practice to charge one. However I agree that you shouldn't be billed for something that they did not inform you at any time may have a few. Should you have assumed it might and asked? Maybe, but then I wouldn't have thought to ask and I'm a doctor.

    If there's a fee to the patient, does that imply that there is a Medicare billing code for it? Seems to me like it's fair for the doctor/practice to be compensated for their work, but ideally it should just be a small fee to Medicare.

    Anyway just pay it. My wife didn't ask the electrician his hourly rate the other day. Doesn't give me an excuse to not pay his bill.

    • HeWhoKnows on 31/10/2019 - 22:21

      Exactly. Same for the plumber that comes to clear a blocked toilet. You just want it fixed and pay the bill

      But the point is, had OP known about the fee would he have proceeded?….probably Yes.

      So whats the point of all this hullabaloo.

  • McMoots on 26/10/2019 - 19:35
    +2

    When I did this a few years ago I was sent a letter by my old practice informing me that there would be a $20.00 fee before they would send my records over.

    I paid it and they sent everything over.

    Apparently a lot of medical centres are quite old fashioned when it comes to record keeping everything on paper because they all use different computer systems or some shit which aren't compatible?

    • DiscoJango on 26/10/2019 - 21:42

      Finally someone who actually understands what i am saying. If they had called me before hand and confirmed there would be a fee, i would have absolutely zero issues.

      • HeWhoKnows on 31/10/2019 - 22:25

        Mate
        I worked in life insurance and I can tell you all doctors charge a fee for release of medical records.
        Its a given.
        Just like they charge a fee for a consultaion.
        Consider this a consultaion.
        End of story

  • eldudebrothers on 26/10/2019 - 19:55
    +11

    I'm a GP and usually most transfers of medical records contain a small fee but there are sometimes large ones (over $25) as it may take some time to do. Nevertheless, you should have been told by the other practice that there is a fee BEFORE they did the transfer (such as a phone call). What they do can range from nothing to debt collectors. You probably signed a document, ask to see what it contains.

    • DiscoJango on 26/10/2019 - 21:43
      +8

      THIS is exactly the point i am arguing. Thank you for being one of the few people in this thread with a brain.

      • HeWhoKnows on 31/10/2019 - 22:28
        -1

        I think you are the one in need of help.
        eldudebrothers like others confirmed that most transfers of medical records contain a small fee but there are sometimes large ones (over $25) as it may take some time to do.
        Expecting a doctor work for nothing?…OMG

  • Vote for Pedro on 26/10/2019 - 21:21

    Should new GP have advised there’d possibly be a fee? Yes.
    Should you have asked if there’d be a fee? Yes

    Take it as a lesson learnt. Have the discussion about costs before authorising work on your behalf.

    • DiscoJango on 26/10/2019 - 21:44
      +1

      Should i have asked if there was a fee? No. The consent form i signed made no such mention of a fee. Should i go around life asking every single transaction if there will be a fee? Perhaps next time i ask the waiter for a menu i should ask if there is a fee to look at it before hand…

      • [Deactivated] on 27/10/2019 - 02:41
        -1

        This is more like signing a work order, having you house painted, getting the bill and saying it should be free because you didn’t think to ask how much it would cost. Consent to do work IS legally consent to be charged, the costs they can charge are publicly available, what you did was like ordering a steak without looking at the menu, even though it was on the wall and free to look at.

        They’re doing work just looking at your files to give an estimate of how long it would take to make sure they can be transferred.

        If you would have paid it anyway if told then this is a big stink about nothing, if you wouldn’t then do you want to burn bridges with somewhere over $50?

        • Bren20 on 27/10/2019 - 07:38

          Not that I have an informed opinion, but I take the consent form as about privacy rather than any 'work order'.

      • Vote for Pedro on 27/10/2019 - 09:15
        +1

        With that attitude life is going to be incredibly difficult for you. Wishing you good luck.

    • HeWhoKnows on 31/10/2019 - 22:31

      Exactly!
      If you request a service its up to you to ask about the fee.
      I havent seen any tradesman rock up to a job and tell the customer there is a fee involved.
      Its a given.
      Same for accountants, lawyers and the like.
      You ask for a service to be provided. You are expected to pay the bill.
      Its up to you to ask for a quote in advance.

  • Donaldhump on 26/10/2019 - 22:19
    +1

    I’m charging you 50 to do this reply

    Pay up

    Seriously tell the doctor to get stuffed, if they were going to charge they should advise first, how do they know u aren’t day to day struggling

    • [Deactivated] on 27/10/2019 - 02:46

      Most GPS will waive fees if you’re genuinely struggling.

      You don’t get to avoid looking at menu prices and say the waiter should have told you it would cost. If you provide written approval for someone to do work, especially when fee schedules are public you don’t need to be told again to be charged, it’s normal with plumbers, tradespeople etc, you need to ask for the quote or you get charged, and $50 is hardly gouging. Not sure why people expect to pay less for a GP than some people pay for a haircut.

      • Donaldhump on 27/10/2019 - 09:01
        +1

        Nice try, but your menu item analogy is retarded, food in a restaurant is clearly going to cost money, xfer of go records, is unknown whether it would cost, or whether it’s done free. Gp should have told them before hand it costs money.

        But

        If you went to McDonald’s and asked for water, and u drank it, and then after you consumed it (and no time before) they give you a tap on the shoulder and say that it is $2, would you pay. After all it took labour and electricity, and plastic cup.

        • [Deactivated] on 28/10/2019 - 20:57

          You don't have a business relationship with McDonalds before you place the order, you'll have signed an agreement when visiting the GP for the first time. It'll let them charge you per the fee schedule.

          Just to be clear as well, the right for GPs to recover their costs here is enshrined in law already, while it might be polite to inform, it's not required, much like they don't have to swipe your credit card before paramedics restart your heart (which in some states still costs money for non members!).

    • ihbh on 27/10/2019 - 07:50
      +1

      Seriously tell the doctor to get stuffed

      Don't do this to your surgeon though, otherwise they might forget to remove scissors from your inside when they stitch you up. :)

    • HeWhoKnows on 31/10/2019 - 22:34

      All doctors have a schedule of fees in thier office.
      This is one of the services they provide.
      Its up to OP to ask how much.

      Now Mr "Get Stuffed". Would you work for free? I bet not!

  • gimme on 26/10/2019 - 23:02
    +1

    Question. Would you have still proceeded with the request if they had advised you about the fee? Only answer I'm interested in is Y or N ?

    • DiscoJango on 27/10/2019 - 10:01

      Yes

      • gimme on 27/10/2019 - 20:24

        There you go. Kinda moot then. Pick your battles unless you have a lot of spare time. Or just don't pay. The risk of ending up with a debt collector is pretty low.

        • idonotknowwhy on 28/10/2019 - 12:37

          The business couldn't have known this though, and the ends don't justify the means.

          • spaceflight on 28/10/2019 - 19:00

            @idonotknowwhy: Why would the new doctor know that the old doctor would charge a fee?

            It isn't up to the new doctor to research and tell people about fees of other doctors.

            • idonotknowwhy on 29/10/2019 - 17:32

              @spaceflight: The old doctor shouldn't presume that the patient would go ahead despite the fee.

              • spaceflight on 29/10/2019 - 19:15

                @idonotknowwhy: The old doctor may have mentioned this in their new patient forms that DiscoJango filled in years ago and never read or has forgotten.

                • idonotknowwhy on 29/10/2019 - 23:37

                  @spaceflight: It's possible. It's also possible that they didn't. I always read my new patient forms and have never seen this mentioned.

      • HeWhoKnows on 31/10/2019 - 22:36

        So the argument is mute.

  • Punda on 27/10/2019 - 00:08
    +1

    Is this why they started my heath record? Doesn’t that eliminate this type of situation

    • CalmLemons on 27/10/2019 - 00:58
      +3

      They started my health record so the russians can help us with our medical records.

    • [Deactivated] on 27/10/2019 - 02:47

      GPs get paid for that too.

  • Bren20 on 27/10/2019 - 07:35

    I had a similar issue a few months ago. I called up a few GPs to get quotes for a skin check. I went to one that charged a reasonable amount, had the checkup, and paid on the way out. The receptionist then told me there was a $30 new patient fee. I refused to pay it, as at no stage did they advise me of it.

    I would call them and explain to them that you were not advised of the fee and you won't be paying it. They'll write it off.

    • DiscoJango on 27/10/2019 - 10:02

      This exactly. They make a killing from springing these last minute surprise fees on ppl, most of who bitch out and pay.

  • AMelbournian on 27/10/2019 - 11:21

    Once I got this done for my partner at no cost. If you were not informed beforehand, I think it's better if you request them to waive the fee.

  • dcash on 27/10/2019 - 11:22

    Would be free at an old fashioned GP, but not surprising a modern medical centre would charge, considering for them it's not really about patient care but solely about the $$$.

    The reality is admin staff would spend up to 30 mins to export the patient data and quite often burn it to a DVD (or several) and post it, because imaged data (reports in particular) is quite large. Despite there being no doctor oversight in the process, it does take time and so there is a justifiable cost involved.

    Just pay what you owe and move on.

    • k15866 on 27/10/2019 - 13:19

      I agree with your first point

      I feel like it is the responsibility of new GP to gather an appropriate history as part of their duty of care, by getting an appropriate handover from old GP. If OP refused to pay $50 to get a transfer of medical records, would the new GP not ask questions and continue to treat OP as though they had no medical history?

      The fact that money gets involved in something as basic as a handover to another clinician in your own profession sucks and says something about the current "GP" profession (doesn't surprise me)

      • dcash on 27/10/2019 - 13:27
        +1

        Yes, I agree. I find most modern "medical centre" practices tend to consider every appointment as a "one off", and aren't particularly interested in medical history. It's all about 5 minute appointments (billed for 15 minutes or more) and unnecessary and useless prescriptions for common cold viruses. It's all about quick turnover and volume, which can never be about the patient. Of course there are plenty of exceptions, but what is now commonplace would once have been unheard of. Medicare largely to blame. Time to introduce a modest co-payment.

  • pe arl on 27/10/2019 - 11:46
    +5

    Some of the replies suggest there is a fee for every service and it's the OP's fault for not asking beforehand. I don't think it's as simple as that; the rule cannot be all-encompassing. The argument would hold if a reasonable person could reasonably be 'expected to expect' a fee for a particular service.
    For example, if one rocked up to a store to ask for a copy of an old order summary, would most people expect and ask about a fee beforehand? If you applied for, say, a competition, size exchange, cashback, or a review on missing cashback, and only AFTER they provided you with the requested service they slapped you with a processing fee (that wasn't mentioned in the T&Cs that you diligently read), would you not question why they didn't tell you about the fee? What if they told you 'but it took x hours and x amount of effort to process!'?
    It's different when it comes to services for which one would reasonably expect to be charged even if it was not explicitly stated, e.g. if you walked in for a haircut, called in a plumber to fix your leaking tap, etc.
    So which is it when it comes to the OP's case? That's the dilemma here. But I don't think the all-encompassing argument above that all services incur a fee holds up.

    • dcash on 27/10/2019 - 13:20

      I agree, and in this case a "reasonable person" would probably enquire as to the possibility of a fee, given that transferring an entire medical history from one practice to another is obviously more involved than, for example, asking for a copy of a receipt. There is no argument that the OP's old practice /should have/ informed him of the fee, but he still needs to pay up and just chalk it up to experience.

      • pe arl on 27/10/2019 - 14:02

        That's a valid point too. However I don't think the amount of hours/effort necessarily equates to the reasonable expectation of a fee. When I challenge a cashback company's decision on my cashback, I can picture their unenviable task of going back to Amazon etc. to check the tracking algorithms and all my clicks and refund activities. As annoying and time consuming as I imagine it to be, as their T&Cs don't mention a fee I don't expect them to charge me for all their digging around (even if I'd been in the wrong about my entitled cashback amount). Just my 2c :)

  • c64 on 27/10/2019 - 13:56

    my gp charges $5 to print out a copy of test results each time i visit, which i duly scan and keep for my records. on the plus side they bulk bill so i don't think i've ever paid anything to see a gp

    • dcash on 27/10/2019 - 16:16
      +1

      Lol, time to change GP. I've never encountered one who charges $5 to push the print button.

  • cookie2 on 27/10/2019 - 17:22

    I don't get why so many ppl here are being d$&ks to op. Anyway I've never done a transfer and I also wasn't aware they would charge for it. Yes, yes, yes I've already read heaps of comments about "ofcourse there'd be a charge…. They're a business". Simple- If I'm getting a service completed, I expect to be advised of charges etc before I choose the service. To me, $50 is something. Neg away all the know it alls. Neg away.

    • dcash on 27/10/2019 - 18:22

      Negged, as requested. No need to thank me.

  • team teri on 27/10/2019 - 18:08
    +1

    I'm all the way with you here OP, if you did not consent to pay for a service before it was rendered you don't have pay for it. There's no such thing as implicit consent in the absence of a clearly visible price list that you get to see beforehand.

    When it comes to how to handle this: I would inform the original GP that you object to the fee because you were not informed in advance and that will not pay.

    The reason for informing them is to give them a chance to see that it is futile to chase you up and write it off, and perhaps learn from it and improve their process in future (i.e. call to confirm). If you don't contact them at all it is likely they will start some kind of default debt collection process after a while, which would be unnecessary hassle for both sides.

    • aliam on 27/10/2019 - 19:20
      +2

      Quote
      When it comes to how to handle this: I would inform the original GP that you object to the fee because you were not informed in advance and that will not pay.
      /endquote

      Yes that's absolutely fine. And the GP won't need to supply the notes either. Hopefully everyone happy with that. Agree that the practice should have informed you of the costs upfront.

      I am a surgeon, and have some patients transferring their cancer care to me, after their original surgeon retired. He wants to charge $200-300 for a transfer of the notes. Most of the patients have enough idea of where they had their xrays, blood tests, operations etc and with a bit of effort from my secretary, has managed to save the patients this fee.

      $50 seems a reasonable fee though, but personally, as a doctor, if I have been looking after your health for a long time, and you've been a loyal patient who has chosen to keep coming back and seeing me, I would do it for free as a goodwill gesture.

      (This doesn't extend to the lawyers who demand a report is rewritten within 48 hours of receiving a request… but that's another issue)

      • team teri on 27/10/2019 - 20:40

        We seem to be pretty much in agreement here. Essentially the patient should be informed up front about the fee, then he can decide whether to go ahead or not. That decision will depend on the amount asked for and on how much useful information the patient expects will actually be transferred.

        In this case it appears the transfer has happened without discussing fees and that caused the problem. Even if the amount might be reasonable, it still was sprung on the patient after the fact. I don't think there is any legal basis that would compel the patient to pay, but of course the old GP would be within his rights to ask the new GP not to use the records and return or destroy them.

        Now what is surprising to me, and correct me if I understood that wrong: it appears not only notes the GP took, but also lab results and Xrays are treated as the property of the old GP. How so? The patient, or Medicare on his behalf, paid for all tests and the Xrays. The GP should only be the trustee who holds those kind of records on behalf of the patient and he should be obliged to hand them over to the patient or a new GP when asked. Is there any rationale why this should not be the case?

        • gimme on 28/10/2019 - 08:59

          Even if true, trustees don't have to be free.

          • team teri on 28/10/2019 - 11:27

            @gimme: Well, the way I see it is that paid-for records like Xrays and lab results are something a GP needs to do their job prperly, and storing them for an existing patient is one of the overhead items that are covered by whatever fees they charge for their consultations. Or have you ever heard of a GP charging a storage fee for those things in addition to a consultation fee?

            When the patient moves on, for whatever reason, handing over those items actually relieves the old GP from the burden of having to securely store them. To charge extra for handing them over appears a pure money grab. Sure they can try, as they have done in this case, but they have no legal rights to enforce payment.

            The situation could be different when it comes to items like case notes / interpretations that the GP themselves wrote. Even with those it could be argued that they were paid for as part of the consultation fee, but that's more of a grey area in my view. As long as a fee is disclosed up front and agreed on beforehand, let them charge. And let the patient make an informed decision whether they really need them or if they can do without those records.

            • gimme on 28/10/2019 - 11:28

              @team teri: The way you see it and the way the world operates may not always be the same.

              • team teri on 28/10/2019 - 11:34

                @gimme: Well, funny you should say that. Time and time again when I did challenge situations where the my view clashed with the way the world was, I came out on top.

                Simply because my view very often aligns with ethical standards and those often are reflected in the legal underpinnings of our society.

                But because most people can't be bothered to fight for their rights, they get short-changed over and over, and it takes someone like me (who is persistent) to get into a situation like this to then change things.

                • gimme on 28/10/2019 - 12:19

                  @team teri: I'm all for challenging the status quo and being different than the majority (sheep). My point is that your view in this case that a GP shouldn't charge for an administrative overhead because they're a trustee etc etc and it's a 'money grab' is misguided. Let's just assume that said GP gets 20+ requests a day to transfer data. This takes several admin hours to process and costs the GP $$$. Why shouldn't they charge a nominal fee? It is irrelevant whether they get 1 request or 100 requests a week - bottom line is that it's a FAIR fee.
                  You may not agree with the legality of it purely because (allegedly) OP was never informed of the charge (Also keep in mind this isn't necessary fact - They may have signed something when they first engaged the GP and who reads contracts right? But who knows). Notwithstanding OP may not be legally obligated to pay the fee but regardless the fee is not 'unethical'

                  • team teri on 28/10/2019 - 12:38

                    @gimme: There are some parallels here to another situation that was resolved in the consumer's favour. A few years ago some banks wanted to charge customers for the privilege of getting their deposits back. That was deemed illegal. Banks have to offer a fee-free method of getting money back.
                    I bring this up to show that not every service can always be a billable item that attracts fees. Some services are an overhead that is just part of running a business.
                    No GP charges a separate fee for storing patient records, and there are costs associated with that too.

                    • gimme on 28/10/2019 - 13:48

                      @team teri: Long bow - But feel free to share the legal requirement that states that a GP is not allowed to charge to transfer patient history to another provider. I know in some countries (e.g EU), data portability is a requirement under Data Privacy law and you may not be charged for it, however I don't believe this is the case in Australia. Apart from your moral objection (i.e the proverbial 'money grab' outcry) I don't see a basis for your argument. No different than, you know tradies 'robbing'us by charging a min 'call-out' fee and the govt 'gouging' us to provide information under the freedom of information act etc etc.

                      • team teri on 28/10/2019 - 14:20

                        @gimme: In the absence of specific legislation I usually check where the Australian Consumer Law stands. In this case it comes back to Chapter 2.

                        I would argue that charging a fee after rendering a service without prior agreement to it is misleading and deceptive conduct.

                        The fact that many GPs do not charge a fee at all and the example of a GPs who doesn't charge a fee for selected patients they want to get rid of (as mentioned by someone here) could be sufficent evidence that levelling a fee is unconscionable. Especially when it comes to records that the patient already paid for to create.

                        It's quite different to a tradie who charges a call-out fee in order to cover overheads.

                        In fact, the fairest way of handling this whole scenario, and akin to a call-out fee, would be if GPs had a 'account establishment fee' that covers the overheads of creating a new patient file, requesting records from the old GP and sifting through those records to get an idea on what's up with the patient. All that is a lot of work and should be reimbursed. And perhaps at that point already, add a little extra to cover for the fact that the patient will eventually move on with his data…

                        • gimme on 28/10/2019 - 14:46

                          @team teri: I already agreed 2 posts ago about informing the patient first. That's the only legal ground. That wasn't ypur original argument though, as you'd object to it regardless of whether notice was provided or not.
                          Rest of it is just fluff, entitlement and personal opinion. Either way good luck to you.

                          • team teri on 28/10/2019 - 15:01

                            @gimme: Yes, I believe we are mostly in agreement. Perhaps the main difference is what we understand those records in question to be.

                            So just to clarify that a specific question: would you agree that a patient has a right to receive, free of extra charges, those parts of their medical records that were created as specific paid services, things like lab results, Xrays, CT-Scans, etc?

                            I would treat those differently from notes that were taken by a doctor that were intended to be used in-practice for the purposes of treating that patient. I understand that those notes might need some cleaning up before they can be transferred to someone else and I don't object to a fee in that case, provided a patient is given prior notice and a choice.

                            I guess in my mind the records I would want transferred are mostly of the first type, less of the second. From your perspective that might be exactly the opposite…

                            • gimme on 28/10/2019 - 23:00

                              @team teri: The records OP was asking for included GP's notes etc as far as I can see but if your question is whether it's reasonable to charge for a paid xray or scan then remember the payment was made to the pathology and not the GP so even in that case there's some justification. People seem to forget that GPs are a business, not a charitable institution

  • meowsers on 27/10/2019 - 21:50
    -1

    I'm sure you're a fantastic patient to have. You will be missed at the old GP.

  • dp1 on 28/10/2019 - 09:37

    There are some patients, when I receive a letter that they are transferring to a new GP, I feel a sense of loss. Others, I do a high-5. The high-5 patients get a free transfer of their records.
    This reminds me of the time a neighbouring practice was SO glad to get rid of a patient they hand-delivered me a copy of the records (a good 2kg of paper) within a few hours!

    • team teri on 28/10/2019 - 11:31
      +1

      Let me interpret that: so some patients who are easy to work with and therefore an easy source of revenue, you'd miss, therefore you charge for the privilege of letting them leave with their records?
      Others who are more complicated a thus a pain the a** to work with, you're glad to see go, so you don't charge?
      That indeed highlights the arbitrary and unjustified nature of those fees. Thanks for making that so clear.

      • dp1 on 28/10/2019 - 12:36

        Entitled patients who think they can dictate their terms to my staff are a PITA. I don't want any barriers to another doctor taking them off my hands!
        The default position is to charge everyone but once every couple of years I make an exception. It is nothing to do with being complicated, complex multimorbidity is the lifeblood of a good GP.

        • idonotknowwhy on 28/10/2019 - 12:39

          Cool. So I'll start being a PITA when I need to transfer and my GP will high-five me and won't charge me. Thanks for the tip!

        • team teri on 28/10/2019 - 12:40

          Totally, and as a patient I can say: entitled GPs who want to put up barriers that stop patients from moving on for any reason, should not be allowed to do so.

          • dp1 on 28/10/2019 - 12:47
            +1

            @team teri: Agreed. And we have established that the fee does not exist as a barrier to the patient leaving the practice, only to partly cover our costs and time

  • Jikx on 28/10/2019 - 10:46
    +2

    The GP should be vetting EVERY SINGLE PAGE to ensure there are no confidential notes that are on the file (e.g stuff a partner has said in confidence about a patient, placed on file, but not for disclosure).

    There is NO medicare rebate for this. This takes time. They're not seeing other patients during this vetting process. That's why it costs $50.

    Most will, however, give a medical summary for free (your medications, brief summary of conditions, allergies, vaccines etc).

    HOWEVER - yYu're completely correct they should have advised you on the fee PRIOR to doing the service. In fact, my clinic wouldn't even do it until you've paid !!!

    • team teri on 28/10/2019 - 11:37

      Can you give an example of what such information would look like? Something that you as the original GP have a need to keep a record of, but that another GP can not also know? I can't come up with examples myself.

      • [Deactivated] on 28/10/2019 - 21:02

        If Person A has said that their partner, Person B, has attempted self harm, the GP will probably want that on Person B's record. But given only Person B has given consent to have their records transferred, if that shows up on the records transferred to the new GP, the new GP could violate the confidence Person A had in sharing that information. If the new GP brings it up with Person B, it might get messy.

    • team teri on 28/10/2019 - 11:41

      Thanks for your post though, it appears broadly in line with my understanding of how things should be.

      Prior agreement, or no obligation to pay.

      And payment only for additional work on records that you personally created, not for items like lab results or Xrays that you merely ordered.

    • MorriJ on 28/10/2019 - 12:36

      In fact, my clinic wouldn't even do it until you've paid !!!

      Your clinic shouldn't refuse if you refuse to pay, it opens them to medico-legal issues.

      http://www.avant.org.au/uploadedFiles/Content/Resources/Memb…

      ^^ This (run by doctors) has a good summary of why

  • team teri on 28/10/2019 - 12:52
    +3

    This discussion is so interesting as it confirms my experience with GPs.

    Some, it appears, joined the profession because they want to be treated as gods in white and it also can be a good way to make money. Others became doctors because they genuinely care about their patients and want the best outcome for them.

    It doesn't always come down to money, but the attitude is what matters. I'd be happy to visit Jikx, and I'd be happy to pay his transfer fee after a friendly explanation what it is for. I'd stay well clear of the likes of dp1.

    Took me a long time to find a good GP. I hope she stays around for another 20 years. Happy to drive 1 hour to see her, passing by numerous other practices along the way.

    • Nillionaire on 29/10/2019 - 13:56

      Would you go to @dmcneice? (Posted below you with a solid perspective)

      • team teri on 29/10/2019 - 15:50
        +2

        Yes, no problem with that post from dmcneice.

        Not everyone needs to agree with me in every detail to be valued and respected, in fact I learn a lot more from people who disagree and take some time to explain their point of view.

        Main learnings from the discussion in this post: handing over medical records can be a lot more work than attaching a few files to an email (that's what I naively thought it would be). As such a reasonable payment is justified if a patient requests such a complex task.

        A majority of GPs who commented on this thread appear to agree with my main point though: without prior agreement to a fee, there is no basis for charging it. Nor is there a basis (moral or legal) for claiming that someone should have known or perhaps might have signed some small print years ago that contained that information.

        Most of the GPs justified fees only in the context of notes written by the GP that require time to clean up or check. In my view that vindicates the argument that if someone only requests other items, like lab reports and Xrays, that ought to be free to the patient. That is just part of the unavoidable overhead, just like filing those items in the first place and storing them for years - no GP can charge for that either.

  • ar7ist on 28/10/2019 - 14:28

    Noob question here. Isn't the record always on MyGov? Like a few weeks ago I did some blood tests through my GP but I couldn't find any record of it on MyGov. Even though the GP did hand me a hard copy of the report.

    • realfancyman on 28/10/2019 - 14:37
      +2

      The only thing on my health record for me is a record just showing I went to the doctor, but not any notes about the visit, as well as my prescription and vaccine record. That leaves a lot missing

    • Carmen Sandiego on 28/10/2019 - 16:28

      I've asked that recently to my new GP and he told me that it's a completely different system (assuming you're also talking about My Health Record) and they're not able to access it. The general tone was one of disdain (can't say I can disagree though)

      Also, I've gone on to MyGov and My Health Record to see what they had written there - no result. Just a 1 sentence description of the consult/what was done which is incredibly unhelpful to anyone who wants more detail (including me!)

      • ar7ist on 28/10/2019 - 16:40
        +1

        It is unhelpful right? Like I don't want to carry my medical copies with me. The whole point of the online system is to make these records available all the time accessible from anywhere.

      • DavidFong on 28/10/2019 - 21:02

        I am a GP, though I am probably more technically savvy than most (I write software to analyze patient data, such as dMeasure, and use electronic data to improve patient care).

        It is true that MyHealth is a 'completely different system', it is not a health record. It more closely resembles a patient 'bulletin board' where parts of health information is shared, some automatically and some by deliberate choice, between health providers who care for the patient.

        I can access it, have been accessing it for years, have actively enrolling patients for years and have avoided medical mistakes and needless duplication with the help of MyHealth.

        One thing to remember is that MyHealth is probably not designed for people with a limited number of conditions and have a fair to good understanding of those conditions and how they are being managed.

        The biggest beneficiaries of sharing information is to benefit those who have too much health information for them to remember, and have difficulty communicating what they do know to health care providers.

        This could be any one of the elderly, those with low health education/literacy, those under high levels of psycho-social stress, or those for whom English is a second language. In my practice, about half of the patients I see have at least three of these social determinants for poor quality healthcare.

        Admittedly, how to use electronically stored patient information to improve patient care is a strong interest of mine. And trying to figure how to help a patient improve their self-care, one step at a time.

    • DavidFong on 28/10/2019 - 20:48
      +1

      The MyHealth system is not a true health record, more of a place for information exchange.

      Current 'automatic' information, if you allow it (which is the default), are items like prescription information and Medicare billings. Recent immunizations will also be recorded in the "Australian Immunization Record (AIR)" component of MyHealth, but this is dependent on the immunization provider being AIR compliant (not all are, at least some 'workplace flu' immunizers are not compliant).

      The latter (billings) might seem to be obscure information, but has allowed me, as a GP, to determine where a patient has had blood tests, imaging, investigations done or even which other doctors (GPs or specialists) the patient has seen but has not, or is unable to, disclose to me. If you looked hard enough, and you haven't disabled this feature of MyHealth, the 'detail' of the blood tests (the fact that it was done, and which doctor was responsible for the execution of the blood test, but not the result) will be in the Medicare billings information of your MyHealth record.

      What is NOT recorded is the detail of every consultation you have with a doctor, just the fact that you visited the doctor (if a Medicare item was claimed). It is optional for the health provider to provide any details of the consultation.

      Recently some hospital (such as Royal Melbourne) upload discharge summaries to MyHealth.

      Some pathology companies and radiology companies upload results to MyHealth (none in Victoria that I know of, but I have seen the results of investigations done in NSW for patients I see in Victoria).

      In some ways, MyHealth is more like a patient 'bulletin board' for health providers.

      It is not the detailed notes of the patient record unless the health care provider decides to nail a copy of some of the notes to MyHealth to the bulletin board. This is in some way a deliberate part of the design, the health provider is being asked to make an explicit decision if specific consultation notes should be 'shared' with other health care providers. This was part of an effort to protect patient privacy.

  • jason101 on 28/10/2019 - 17:33
    +1

    Completely off topic but if the gp says “is there anything else I can help you with”, answering with anything other than a “no” results in a “multi issue consultation” fee being levied in addition to the base consultation fee. This charge irked me last time I visited a gp. I was upsold without even realising until I received the invoice.

  • dmcneice on 28/10/2019 - 17:49
    +3

    I'm a GP, here's my take:

    1) Lack of financial consent - agree with you completely OP. I've seen some practices charge this, but usually they refuse to do anything until they receive payment, which is fair enough. They should not do it without your consent, no consent, no payment.

    2) Depending on the extent of your history, $50 seems a bit steep, that being said, some complex patients I've constructed a record for it would definitely be warranted as it can take 15-20 minutes to go through relevant stuff

    3) Unpaid work - for some reason I dont understand why people think doctors should do stuff for people for free (tbf, not you OP). Things like phone calls, referrals when your not there and transferring records we dont get paid for at all. You'd never be able to get any other professional to do anything like this for you.

    • PurpleClover on 05/11/2019 - 23:22

      Speaking of unpaid work, I can tell you pharmacist does a lot of them as well, for example -

      • Give free advice to patient who just bought something from chemistw******** and doesn't know how to use them

      • Give free advice to patient so that he/she can go to chemistw******** and get the product at cheaper price

      • Dispose of unwanted medications - including DDs which also involve some admin work

      • Faxing or posting documents (e.g. PRF for safety net, dispensing history, webster packing record etc.) to other health professions
        (Should pharmacist start charging when hospital ring up for dispensing history or webster packing record?!)

      Yes, I agree with OP that if there is a cost involved, he/she should be informed first before the transfer proceed.

  • abc123z on 28/10/2019 - 19:27

    I was told I would have to pay about $40 to get a one or two page radiologist report from the hospital and $20 to get a one or two page report from a lab.

    However my last gp charged only $15 to send my full record to a third party.

  • minotaurian on 28/10/2019 - 23:34

    …….A gp charging $50 for their time is criminal….this is worse than lawyers charging $40 to read my emails or $5 to pick up my phone calls…Or mechanic charging $30 to dispose my car waste that I did not agree too. (Sarcasm).

    Everyone does it,but we expect it from other professionals so we just take it on the chin, but when it comes to healtcare everything is expected to free. Double standards.

    At the end of the day, the old gp did a service, most would wait until u paid. Nevertheless, your old gp would just write off the debt if you did not pay, there is no point hiring debt collectors.

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