Dr. Alice Fuisz Testifies on Medical Record Bill April 21, 2021

On Wednesday, MSDC member and ACP DC former governor Alice Fuisz, MD, MACP, testified before the Committee on Health on B24-133. This bill would, among other things, set high fines for failing to provide requested medical records within 30 days, extend the requirement to keep records to 10 years, and limit the charges on providing medical records.

Dr. Fuisz testified on behalf of ACP DC but MSDC assisted ACP DC and associated itself with her comments. The Society is concerned that the bill as written could overburden smaller physician practices and open the door to more frivolous lawsuits. 

Below is Dr. Fuisz's written testimony. To learn how to testify before the Council, check out our guide here.

Dear Chair Gray: 

My name is Alice Fuisz, MD, MACP, and I am a Managing Partner of the Washington Internists Group. For over 90 years, the Washington Internists Group has served the Washington metropolitan area's primary care needs. Our physicians are all board-certified and practice general internal medicine with a focus on preventive care. I am a former governor of the Washington DC Chapter of the American College of Physicians (DC ACP) and former Executive Committee member of the Medical Society of DC (MSDC). 

Today I am pleased to speak on B24-0133, the Personal Medical Record Fee Amendment Act of 2021. As physicians we support the right of a patient or their caregiver/surrogate to have access to their medical records if needed. However, even in this electronic age, immediate access to years of medical records on demand is in some cases an overwhelming task. This is especially true for smaller private practices like mine, who lack the large infrastructure and support system of my colleagues who work in healthcare systems and hospitals. If a patient requests their complete medical record, it will often be hundreds of pages of documents. The time it takes to print out these records, review them for completeness, and mail them is tremendous. My practice, like many, is currently on an electronic medical record system so the records are in an electronic format, but the work involved remains significant.

I would like to focus on two specific aspects of the bill, to make the bill more practical for the District’s medical practices:

• The bill separates electronic requests and physical copy requests. The fee for an electronic request is $6.50. When I surveyed my staff, I was told that it takes on average 30 minutes to process an electronic request. That time does not include the time spent by the physician to review the records for completeness. $6.50 does not adequately compensate for an employee’s time to process the request. As for the paper copies, my practice charges a set fee so as to be able to tell a patient what the charge is prior to starting the work. I think the per page fee is fair assuming the records are on site and simply need to be copied, but what if the records are held off site and need to be retrieved before being copied? There are costs associated with the storage of paper records and collecting them from an off-site location. In this situation, perhaps a processing fee is fair.
• The new requirement for all physician practices to hold medical records for 10 years is well beyond the current requirement for non-hospital practices, and exceeds the 7 years recommended by most medical malpractice insurance carriers. For a small practice like mine, holding all of my patients’ records for 10 years (and longer if the person seen is under 18 years of age) is a major infrastructure cost to my practice. In addition, we are routinely asked by colleagues closing their practices to retain their patient records, to ensure these patients have the legally required time to access their records. Adding new patient records and either needing to digitize them or holding them ready to provide is an infrastructure burden to our practice.

I suggest the fee for electronic records be raised to cover the true costs to a practice like mine. 

I suggest you eliminate the language regarding holding records for 10 years from this bill. It is a “side topic” that I do not think is relevant to the concerns related to access to medical records.  

The DC Chapter of the American College of Physicians and MSDC want to ensure the District is a place where physicians and patients can not only practice good medicine, but are leaders in the medical field. This bill as written adds new onerous requirements that opens practices up to unnecessary lawsuits or incentivizes them to leave the District for surrounding jurisdictions. Please contact me, DC ACP, or MSDC if we can assist with making needed changes to this bill.
Respectfully submitted, 

Alice Fuisz, MD, MACP, Past Governor

Shmuel Shoham, MD, FACP, Governor