Our medical records

Just wanted to find out if any of you have ever requested to see your medical records or chart from your T?

If so...what was their response? Did they question why you wanted to see it? Did they try to convince you not to look at it. I know that there are some HIPAA laws around having access to our own medical records (I think), but I do believe that if you request to see your records and you sign a release, then you can get them.

I am really wanting to know what my old T wrote about me in my chart. I want to know what she saw and thought and how she viewed my disorders. I am afraid if I ask her for a copy that she will say no or want some explanation as to why. Really...I just want to know what she thought of me.

Anyone else ever broached this subject with their T's?

I haven't, nor do I have any desire to-but I am pretty sure your records wouldn't have what your T personal thoughts on you. I think they are more professional and follow a treatment plan or something. If they do take notes, I think its for their own viewing unless they get subpeoned oe something. Even the notes are meant to jog your T's thoughts on what happened in session, not their own personal thoughts. I could be wrong though!

Hmm no I haven't either, but I would imagine, your notes wouldn't give you much insight as to what your T thought/thinks of you.

Back in the day, T's use to keep both progress (diagnosis, treatment plans, etc) and process (subjective interpretations, transference, etc) notes. The progress notes were the notes the clients were privy to, and the process notes were the ones that only the T saw. Nowadays however, they are now not able to keep these documents separate as everyone is entitled to requested to see their notes. Thus, it is T's ethical obligation to only keep notes that they would have no problem showing their clients - thus, you are unlikely to get any subjective interpretations of how your T saw you.

Most likely if you request to see your notes, your T will want to look into why you are requesting them, and you will most likely have to look through them either with your T, or with some other personnel. I don't believe they like to let clients look through them by themselves as it could stir up some things that they would rather be present to help you with.

Hope this helps, and good luck
Jacq

It's unlikely you'll find much terribly insightful in your charts. They keep them pretty objective these days.

You have the right to your records. Your T cannot tell you no. However, most Ts will be hesitant to give them to you. They won't show much -- just diagnoses, documenting any suicidal ideation etc, note whether you're making progress.. they're pretty objective. But if you're not sure what your T believed your diagnoses were, they might shed a little light. Might not be worth the trouble, though, since your T will almost definitely ask why.

I've heard that T's usually keep their notes vague because insurance companies can ask to see them...

http://74.125.155.132/search?q=cache...&client=safari

This might help you distinguish between what notes you're going to be allowed to see and what notes will be kept private.

I hope the link worked!

I had to get copies of all my medical records because of a personal injury lawsuit. And they wanted a copy from my Pdoc. (the doctor I saw very just a few times because I didn't like her at all) I was really nervous about what was written in those notes. Turns out it's not too much of anything. Just my diagnosis, medication I was taking and then termination letter. The stuff you talk about is really just between you and your T and maybe a fly on the wall. Thank goodness. When I asked for my records I talked with the receptionist. I had to sign a release for the records.

mightaswelllive- the link worked. Great info!

I think the real question is not what is in your notes but why you are so interested in seeing your notes??
Medical records are soooooo boring, I'm sure there are people here who have jobs in hospitals etc where they see patients notes and know what I mean. I hate trawling thru notes trying to get an idea about what's happening with one of my patients. Most of them say nothing or just vague things that aren't that useful and it's easier to ask the patient what's been going on than believe the notes.

One thing that they write are things to protect themselves legally - eg patient stated they were safe etc. But they are mostly an observation of your mood, what they observed in your behaviour, issues you are concerned about and maybe a plan at the end. Maybe some things to jolt their memory for the next appointment. But they are pretty vague, who has time to write an essay??

If you are in a hospital where many people interact with you they will write more potentially upsetting things about your behavior so staff on following shifts know that you may be violent or inappropriate things you may have done on the previous shifts but this is important for continuity of care and staff safety. If you are seeing a private T with no one else having input there will be a lot less written and even if she hates you, she wouldn't write that because of legal implications.

My T has offered a few times if I want to see what she writes and I never even asked. I have no interest in seeing because I am there, I know what happens.

Maybe you should say you are curious as to what type of things she writes down and if she'd show you an example of a typical sessions notes. If she has nothing to hide this shouldn't be an issue.