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Ok. The law doesn't require doctors to enter into these sorts of contracts. So, there is no legal obligation for a doctor to have this contract. That being said, there is no law stating that they can't have this contract, which is why you will see some doctors with a contract and some without a contract. The doctor may have dealt with a number of individuals that are doctor shoppers. To protect himself, should he decide to cease treatment, the doctor has decided to establish this agreement and nothing in law will stop him from doing so.
Now, the doctor prescribed the medication to you, but for you to continue to receive the medication you would be required to enter into the contract. That makes sense, because before that date, the doctor did not know if you were going to be a long term patient. The medication may have proven ineffective or something else may have needed to be done. However, once the doctor decided that he could move forward with you, he decided that he wanted to move forward on the terms of the contract.
The doctor, who is not a lawyer, has no legal obligation to explain the contract to you. That is for you to do for yourself, asking for time to review the contract and even to have it reviewed by an attorney for you, before you sign it.
So, to your questions.
1. Yes, it is. The doctor can legally choose to not work with you, if he wants to.
2. The drug test can be in your medical history, because it is factually part of your medical history. You submitted to the test and if the test is accurate, it is an accurate reflection of your medical history.
3. If you got a new doctor, that doctor is going to ask about prior medical history and doctors you've worked with before. Now, your current doctor would have no obligation to hunt you down, to see where you are being treated. He wouldn't have any legal purpose for that either. However, if your new doctor finds out about your old one, they can discuss your medical history because it is important in treatment, so HIPAA would not stop the sharing of information. The old doctor isn't obligated to find any new doctors you go do, but your new doctor is ethically obligated to try and figure out your medical history, simply because it matters in terms of your proper medical treatment.
Thank you for your thorough answer- it was very informative and helpful. I do have one last question- If I switch physicians and have my medical records transferred from my previous doctor to my "new" doctor, wouldn't it be likely that such results be included in the history because he would need to know information on my current prescription- I guess I don't understand how what one physician may consider relevant to treatment (my doctor will not prescribe to patients using marijuana) while another may have no interest in such matters- if it is left to their discretion- how is this information objectively relevant? And my final question (I promise) is: Was I mistaken in thinking that patients had some type of authority in deciding what information a doctor is allowed to include in their personal history? I have had friends claim that they have asked their physician not to include certain personal information and the doctor obliged their request.
Yes, if you transfer to a new doctor, your medical records will get obtained by your new doctor...but only for doctors that you inform him of. There isn't a centralized repository where your doctors are listed, such that any future doctor will know about any past doctor.
They will only know what you tell them, though failing to tell them everything can effect your treatment and if your doctors find out that you are withholding information, they can release you too.
Each doctor has their own license. They are entrusted to make decisions concerning the prescription of drugs. It is not illegal for a doctor to not want to prescribe medications to someone that uses illegal drugs. Nothing against you, but statistics show that those that use illegal drugs are most likely to abuse or sell prescription medication. This doctor may simply not like that statistic and can choose to refuse to work with people that use illegal drugs, even one as common and accepted as marijuana.
Your medical history is a combination of two things....stuff about you and stuff about your doctor. The doctor can include in their records everything they did related to your treatment. That is your medical history, but you are not in control of what goes in it. You can certainly remove a document from it, for your own purposes, but you can't change the medical history that the doctor retains or provides if they are asked for a complete medical history.
Your friends mentioned that their doctors obliged their request. Your doctor may to, but there isn't any legal obligation to scrub your records at your request.
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