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Accessing your medical records

The United States spends 17.1 percent of gross domestic product on health care, more than any other country. In 2012, this equated to $8,745 per person and $2,500 more than Norway, the second highest. Other so-called developed countries averaged $3,500 per person although, of course, one has to take into consideration the value of money and other factors.

One assumption that immediately springs to mind is that given all the cash we splash, surely American health care is the best in the world, right? But sadly, by many objective parameters it is not. Please understand, I am not knocking the United States for the sake of it. Like most of my readers I am an American, but unlike most of you I chose to be an American, and it is not as though I came here as a persecuted refugee or from a lesser-developed country, so I think I can speak with some degree of perspective. Politics should play no role in health care, and like a chair there should be four legs:

  1. A well-informed and motivated patient;
  2. A doctor who is able, affable, and available;
  3. A health care system that treats people with expedience and respect;
  4. A pharmaceutical, medical device, and biotech industry that is encouraged to innovate and rewarded for doing so.

My rant today is about an element of health care here that represents a failure of the first three points. But maybe, just maybe, we can do something about it.

The Health Insurance Portability and Accountability Act (HIPAA) was passed by Congress in 1996 and has many elements that impact your health. For example, signing forms at the doctor’s office that address privacy? HIPAA. Standing behind a line at the pharmacy? HIPAA. Not getting timely access to your medical records? HIPAA.

The key word there is your medical records. Let’s say you go to one doctor, have lab work done somewhere else, and an X-ray or two at yet another facility and circumstances dictate that you need to see a different clinician. It’s a simple matter, you would think, to ask the new doctor to grab your prior records, lab tests, and X-ray results. Good luck with that. First, U.S. health care systems are transitioning to what are called EMR systems—electronic medical records—but the problem is each of the many systems do not speak to one another. Classic. Can you imagine if your GPS did not speak to the autopilot? What use would that be? Or if ATC decided one day that all transmissions would be in Portuguese. Fine if you are from Lisbon but for the rest of us, not so much.

The second big issue is that for a doctor, lab, or any place to duplicate and send records, it is sometimes a major effort and a bill for $300 pops up. That’s nice—a bill for giving you what is rightfully yours to begin with.

But the final and craziest part of these shenanigans is that under HIPAA the transfer of information has to be done in 30 days. Admittedly some states are better; California mandates it get done in five days. But hang on a moment, these are your records! What if you need them faster, for instance to get your flight physical sorted or for regular health care decision-making? Makes no sense, right?

This is why I am heartily encouraging every single one of you reading this to consider developing your own PMR—personal medical record—that you control. Each time you see a doctor or have any test done, enter the details and keep it up to date. You do it with your pilot's log, your mechanic does it with your airplane. Why not do it with your health?

I enjoy coming up with alternative meanings for abbreviations so if you follow this advice, maybe HIPAA could stand for health involved pilots are awesome!

Jonathan Sackier

Dr. Jonathan Sackier is an expert in aviation medical concerns and helps members with their needs through AOPA Pilot Protection Services.
Topics: Pilot Protection Services, AOPA Products and Services

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