Records from a Pulmonologist

May 2, 2008 12:55 PM

I need to get from one pulmonologist all the information from a few CT scans so I can be seen by a different pulmonologist. What, exactly, should I ask for?

So, I had(have?) pneumonia and some related problems. I developed some strange breathing problems that my GP didn't understand, so about a month ago I got two CT scans and was seen by a pulmonologist (dubbed Pulmy1). At that time, Pulmy1 told me to get another CT scan in six weeks and see him one last time.

Problem is, Pulmy1 is a terrible jackass. He was brusque, rude, uninformative, and insulting. He did not do a good job, failed to examine me properly, and didn't do anything to inspire my trust. I really do not want to see him again. My GP agrees Pulmy1 is a total jackass. I still need to see a pulmonologist for my last check-up, after I get this last CT scan, so GP gave me a referral to see some other pulmonologist.

My GP suggested that what I do is get the CT scan under Pulmy1's prescription (is that what it is? I know he wrote something down, and I know his office has to fax something to the hospital for me to get the CT scan, but really, I don't know what I'm talking about), then ask his office to give me a copy of my files, and then just take those files to another pulmonologist. He also suggested I just tell Pulmy1's office that I'm going out of town or something, so I don't have to deal with any confrontation or anything.

That sounds like a good plan, and it seemed really easy back when the GP explained it to me! Now, however, I'm a little unsure what, exactly, I need to ask Pulmy1's office for. If I say "my records" or "my files," will they give me everything that the next pulmonologist would need to treat me? Considering that what really counts is this last CT scan I need to get, is there something specific I should ask for?

The GP also suggested that I could, if I wanted, just ignore Pulmy1's stuff, go straight to the next pulmonologist, and then get an order for a CT scan from him, if he deemed it necessary. Would this be a better plan?

posted by Ms. Saint to health (10 comments total)

Your new respiratory physician will be able to reassess you as long as you are able to give a reasonable history of your illness. However, it makes no sense to repeat the CT scan unless something has changed in terms of your symptoms since the first scan.

Just ask his office for a copy of your CT scan report and the original films on CD (they can just burn them onto a CD with a copy of the image viewer included). This is standard practice and shouldn't be a problem.

Then simply go and see the new doctor and take along your CT CD.

(I'm a doctor, for reference)
posted by inbetweener at 1:11 PM on May 2

ask his office to give me a copy of my files, and then just take those files to another pulmonologist.

do that. ask for your complete medical records. this will include test results, doctor's notes, copies of x-rays, etc. please note that many offices charge EXORBITANT fees to copy this and give it to you.
posted by misanthropicsarah at 1:23 PM on May 2

So, you already had two CT scans and the pulmonologist has given you an order for a third? When you go to get the third scan, you could ask the radiology office or hospital (or wherever you get the scan done) to also send a copy to the new pulmonologist. You can also ask them to send the films if he/she needs those as well. As far as getting the previous records and films, just ask the first doctor's office as has been said above. You may need to contact the facility that did the scan for the actual films.
posted by curie at 1:56 PM on May 2

Doctors are required to give you any of your records that you ask for, and share them with your other doctors upon your request/authorization. This is routine for the office staff to deal with and probably won't even come to the doctor's attention.

If you really need to avoid any possibility of confrontation, you could ask Pulmy2's office to request the info they need from Pulmy1
posted by winston at 2:41 PM on May 2

Have your new doctor's office request all your records and reports from the old doctor: it works faster this way. A doctor's request is rarely ignored or put off.
posted by francesca too at 3:03 PM on May 2

If Pulmy1 is at a hospital, you will need to get the records from Medical Records/Patient Information, whatever. Otherwise, it's the office. Either way, you will need to send, either in person or over a fax machine, **a signed release form**. You can either have them sent to Pulmy2 or yourself. They are allowed to charge you a reasonable fee.

As you only saw him once, it shouldn't be that many records anyway. You want 'a copy of your chart, including office notes, pulmonary function tests, any bloodwork you had done by his order, and the reports from the CT scans.'

Go and get your next CT. The MDs office should have already done all the paperwork for it. He'll see it, but you don't care. Your CT scans should be put on CD. The office may not do this - the place that will do it is the place where you had the CT done. Ask when you get the second one done. If it was at a hospital, ask at the medical records department who does it. At our hospital, we have a separate place ('the file room') that will put your CTs on CD. You will need to pick it up and most offices request you hand-deliver them. In the hospital I work in, we don't have CDs ready except in emergencies until the next business day, but I think that's largely due to volume.

Now - records. Be nice to the receptionists in the office, if he's got an office. They are the ones who will actually send your records out. If they fax them straight to your new doc, it's a lot easier. Winston's right in that Pulmy1 might not even know. It all depends how mean you are on the phone. Nice people and people who know what they're asking for, and who send over their signed release over the fax soon after calling, for example, get faster service.
posted by cobaltnine at 3:04 PM on May 2

Another option: Go meet your new Pulmonologist. Beforehand tell them where they can find your CT scans. Unless the original pulmo. does the CT's in his office there's no reason they won't just request the films from the radiology suite or hospital and they'll be sent by courier to the office within a day or two.

As for your records, the idea of avoiding a confrontation is silly. Your original pulmo won't even blink, if he even hears about it. Call his office and request them, pay any applicable fees, and ask to pick them up in person, then hand carry them to your new appointment.
posted by docpops at 9:02 PM on May 2

And it's your GP's job to run interference if necessary so you can see the new doc, btw.
posted by docpops at 9:03 PM on May 2

The best way to do this is to speak to the radiology group that runs the CT scanner. Pulmonologists look at your CT scan, but they are not officially involved in reading or billing for that study. They refer to radiologists, a different kind of doctor, for that work. Many diagnostic radiologists never see or speak to a patient so the patients are not even aware that they are in the loop.

The radiology group is obligated to provide you with a copy of your scans and the radiologist's report of these. In some states you can be charged a nominal fee, like $5 or $10, for the CD media that the scans are on, or the silver emulsion used in order to generate the duplicate film. You, however, own the "information" that was generated during the performance of the CT scan, including the information part of the images that were generated and the information contained in the radiology report that the radiologist generated.

Get the films and the reports, and take them in hand to your new pulmonologist. I assure you that that is the best way.
posted by ikkyu2 at 1:23 PM on May 3

I agree with ikkyu2. It's really a third party (the hospital/facility and its Radiology department) in most cases like this that have the material you need to request (CT scans on a CD and radiologists' reports). Pulmy1 probably documented a note with his initial opinions on your case and may have records of pulmonary function tests or blood work. These pieces of information would probably be obtained from Pulmy1's office but you don't necessarily have to deal with Pulmy1 directly. Just call his/her front desk and tell them you'd like your records and see where that goes.

Personally, I would hold off on a repeat CT scan if you're planning on seeing a new doctor. It may well ultimately be helpful depending on the circumstances, but I'd say it's safer to accept a possible delay in an interval CT in the hopes that Pulmy2 might not even want another CT. These things do expose you to a fair degree of radiation, so it's certainly worth avoiding if a physician you come to trust feels they're unnecessary. It's even possible that Pulmy2 might not trust the place you got all these CT's from previously and will ask you to go to his preferred imaging center despite even getting a third study.
posted by drpynchon at 5:59 PM on May 3