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TherapistMarryAnn, Therapist
Category: Mental Health
Satisfied Customers: 5838
Experience:  Over 20 years experience specializing in anxiety, depression, drug and alcohol, and relationship issues.
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Please help me think through the following before my next

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Please help me think through the following before my next visit to my doctor.
Issue: patient access to medical records and process notes (for psychiatric patients) is restricted. This is what is being done. The laws have a loophole for this. I have been checking. And, when I request my records from previous psychiatrists, they deny access, they send summaries, short summaries instead.
Here is my situation: I want to see my psychiatric record and my doctor’s process notes (psychotherapy notes). I want full access. What is my current doctor going to say about my record and her notes? I really want full disclosure, but I suspect I won’t get it. Here is what I am going to say: what do you think of this situation?
I will try the following:
1. You (my doctor) could say to me: these are my notes. You keep your notes about me, and I don’t get to see them, and I keep my notes about you, and you don’t get to see them.
(But there is still a problem. There is still a difference. She is not being professionally observed. I am under observation. Therefore…)
2. After 4½ years, I want to understand, learn, know more – from what you see about/in me. Can you honestly sit there, look me in the eye, and tell me, honestly, that I know everything you are saying in your notes? Is there anything, anything at all, that I don’t know? I want to know everything. How would you feel – via empathy – how would you feel, if you were in my shoes? Would it be okay for me to watch you, study you, analyze you, and then keep my conclusions a secret? Would that be acceptable? Of course not.
3. I want us, together, to go through sections of your notes – and not just selections you approve because they are less “sensitive!. I want full disclosure. You demand it, expect it of me. So I should expect it from you. How would you feel if I came to your office and announced that I would share only 50% of my situations with you? You might say: okay, your loss. But I don’t do that. Don’t do that to me.
4. We are supposed to be equals – with mutual respect! You have said this over and over again! How can we possibly be equals if you keep information hidden from me?
5. Look, I respect you. I have a great deal of admiration for you, as you know. So respect me. Help me learn about me. I have more than just a burning desire, as a professor, to know as much as possible. I have more than that! I have a clear, indisputable, right to know.
6. I don’t care what Dr. (x) has said about me. I don’t really care as much about what Dr. (y) says about me. But this is different! You are different. My interaction with you has been on a much deeper, longer, and more profound level.
7. I have a Ph.D. from Columbia University. I am as educated as one can be! You must respect me! Please don’t insult me and don’t treat me like an inferior!

Hi, I think I can help you with your question.

I think you make some very valid points. Here is what seems to work about what you said:

How would you feel in my shoes?- this makes your doctor think about how you feel and possibly empathize with you.

Can you tell me anything in your notes that I don't know that you feel would help me?- you say this in general in your points. It would help to give the doctor options of sharing the information verbally and find a way to help you with it.

You ask for my full disclosure. I would like the same.- puts you and the doctor on equal footing. Plus it is a very valid point all by itself.

Sharing the notes encourages mutual respect- helps point out the trust issue between doctor and patient.

What doesn't work:

Any emotional response- i.e. you must respect me, don't treat me without respect, don't do that to me again, etc.- when you become emotional, it's too easy to reduce you, as a person, to someone who is illogical.

You analyze me so I should see my notes.- the idea is good, but it phrasing it that way makes it seem you are looking for an excuse to see the notes.

Expecting to go through the entire pages of notes line by line.- no doctor has the time or inclination to run through the pages and pages of notes they have. Plus sometimes they just jot down a random thought that may not mean anything when they say it. They are not going to want to share that.

You have a very well thought out argument. Although the law is on the doctor's side, you do make credible points about why you should see your notes. It is definitely worth the try.

I hope this helps,


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