I think there are a few issues going on in this thread, all of them interesting
1. How agencies keep track of patient info -electronic, combo, or both
2. Willingess of Dr.'s Therapists etc. to fill out forms, write letters, on behalf of clients.

The two main hospitals I go to, one for addictions treatment, but it's a full service hospital, and my psychiatric hospital, have both gone to electronic record keeping. I love it, particularly at the psych hospital, as I frequently have to deal with multiple departments care providers, everything is stored in one file, so all my treatment providers can see what I'm on, who i've seen for what, and a brief summary of what was discussed. For example when I was IP this summer, I was scheduled to meet with a dietician, who looked at my file, saw I'd been treated for a blood clotting disorder 10 years ago at a completely different hospital and was therefore able to recommend that I not take Omega 6 or 9 since they could potentially interfere with blood clotting. Imagine doing that with paper files.

The other issue - paperwork. Up here Dr.'s are publically funded, psychologists and other T's are not. But OHIP (provincial health care plan) will not reimburse for writing letters or filling out forms, they only pay Dr's for direct patient time. So my family Dr. has a fee schedule for all services not covered by OHIP - one time I needed an assessment done regarding my driver's licence, she charged me $40. The more complicated the paperwork, the more she charges. My addictions Dr. doesn't charge for letters, but only writes them when you're in a meeting with her, so she can bill for patient care. If letters are needed around completing treatment or abstinance and they don't require a Dr's signature and a nurse can do them, then there's no charge. I don't know what my psychiatrist's policy is on charging for things like forms / letters as I haven't needed any from him. My last psychiatrist didn't charge and she sent a few letters on my behalf to the ministry of transportation. But as far as I know most Dr's - especially family dr's charge extra for letters / forms.

--splitimage