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Dear Dr. Roach: On three different occasions, I have had to change doctors: once when I moved out of state, once when my doctor moved out of state and just recently when my doctor sold his private practice. The two first times, I asked for my personal medical records and received a complete file, including notes the doctor had written as to possible reasons for ordering some of my tests.

This last instance was different. The doctor sold his practice to another group of doctors. It was only by luck that I saw a small notice in a local newspaper that informed his patients that he was no longer in business and that records could be obtained at his old address. The office was closed for a week, but reopened with new doctors. When I asked for my records, I received a small package consisting of copies of forms and tests. It was much smaller and obviously a sanitized version of the originals.

Who owns my personal medical records, and who is authorized to see those records? I had assumed that payment for an office visit entitled me to ownership. Only I, other than doctor and staff, could decide who might view my medical information. When talking to insurance companies or a hospital, I have to sign a form in order to let even my wife hear or see my medical information. But now I know that my medical file is also with a group of doctors I do not know. I do understand that it might not be practicable to ship patient files between doctors, but what is the destination of original files? Is there a time limit in limbo before they are destroyed?

A.T.

Dear A.T.: In some states, the physician’s practice owns the actual medical record, but in most the law is not clear. In one state (New Hampshire), the patient owns the content of the medical record.

What is clear is that the authority to access your medical record is covered federally in the U.S. by the Health Insurance Portability and Accountability Act of 1996, which protects the privacy and security of your information. According to this act (called “HIPAA”), a patient is entitled to “inspect, review and receive a copy of his or her own medical records and billing records.” Also, you can have your entire record sent to another physician.

In most states, the practice or hospital MUST keep those records for a period of time: at least six years, in my state. For pediatrics, it’s six years after turning 18. According to the law, “A covered entity such as the medical practice may use and disclose protected health information for its own treatment, payment and health care operations activities.” Your information may not be disclosed outside of the very specific circumstances allowed by law, and the penalties for failing to keep your record private are severe.

You can learn more about your HIPAA rights at http://bit.ly/2lEDEF8.

Dear Dr. Roach: A recent column on dysphagia did not list myasthenia gravis as a possible cause. Seven months ago, my dysphagia became critical, and I was referred to a neurologist, who confirmed the diagnosis. With treatment, I now am able to eat soft foods.

M.J.A.

Dear M.J.A.: I thank M.J.A. for writing in with her experience. There are many causes of dysphagia, the sensation of difficult or unusual swallowing. Whether the problem is at the beginning or end of swallowing, whether it’s worse with liquids or solids, the time course of the problem and whether it is continuous or intermittent all are helpful in identifying the cause.

Email questions to ToYourGoodHealth @med.cornell.edu.

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