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Summaries vs whole access

Article

Am I permitted to offer a patient a summary of his medical records instead of offering a complete copy?

Q: Am I permitted to offer a patient a summary of his medical records instead of offering a complete copy?

A: Yes, but only if the patient agrees and only if he accepts the fee you may charge for the service. From a liability standpoint, however, it's risky to offer a summary. First, your view of events may not be shared by your patient. Second, it's easy in summarizing to omit something that your patient—or his lawyer—thinks is important. For these reasons, think hard before offering a summary as an alternative to a copy of the actual record.

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Jennifer N. Lee, MD, FAAFP
© National Institute for Occupational Safety and Health
© National Institute for Occupational Safety and Health