Recently, when my family moved, my husband and I were faced with finding a new pediatrician for our son. After much careful research and discussion, we chose one that felt just right. Since my son is in the throes of the immunization months, I knew I needed to get his records transferred from our previous pediatrician quickly. I had already secured a Request for Records form at his last appointment. I diligently filled it out, requesting that the records be sent to our new doctor, and sent it off.
I was quite surprised and dismayed when, several weeks later, I got a call from my old pediatrician’s office, explaining that I’d need to pay $20.50 ($0.75) per copy to have the records sent. Thankfully, I have $20.50 to spend. However, that was beside the point. The point was, I didn’t understand how the office could possibly hold my records hostage, could to send them even to another doctor unless I paid out of pocket. And what about the families for whom paying this charge would be a hardship? How could they manage their records if their doctors refused to send them even to other doctors free of charge? In the past, I’d always expected to pay for copies if I was requesting records for my own personal use. But requesting that records be sent directly to another doctor? That seemed out of line. “Is this legal?” I asked the office manager at my old doctor’s. She assured me it was.
I’m sure I’m not alone when I say my struggles with the healthcare system have been varied and frequent. See here for an example. But this time, I decided to do something about it. It was only later that I realized that the process I’d gone through felt very similar to one I’d taught students when I was teaching them to write persuasively. Here are a few tips I gleaned from my real-life persuasive writing experience.
1. Write from a place of strong emotion. It can’t be said enough times, this is why we encourage students to choose their own topics. I was MAD, and boy, can anger be a great motivator to get a job done.
2. In order to persuade, do your research. I wasn’t sure yet what or to whom I wanted to write about my issue. But I knew I couldn’t just write, “To Whom It May Concern, It really stinks that I had to pay to have my son’s records transferred from one doctor to another. Signed, Angry Patient.” I had to gather information so I’d have something to support my argument.
I began a grassroots research project. That is, I posted a query on Facebook.
I got a widely varied host of responses. Some people suggested I just pay the money and be done with the worry. Others shared in my outrage. One helpful respondent suggested that the law varied state to state whether offices could hold records hostage in this way. She suspected that if my new office had requested the records, the old office might have had to give them up, free of charge.
I delved into a fury of web searching, where I scanned websites from the US Department of Health’s page on HIPAA to pivate blogs to about.com. I discovered that while charging for medical records is perfectly legal under HIPAA, but that it’s typically considered bad form to charge patients when sending the records to another doctor. From headaches.about.com: “Doctors will usually send a copy of your records to a new doctor at no charge, as a professional courtesy.”
3. Figure out what you want and who can help you get it. Write them. First, of course, I had to decide what I wanted. I decided that what I wanted was to help other families to have a way to share medical records with their new doctors without having to pay for them. I wanted this to happen in a broad sense, legally, but I would settle for this happening in a smaller sense, with my old practice adhering to the more courteous practice of sending records to another office free of charge. I decided to both write a letter to my old practice explaining my stance, and to submit a compliant via the US Department of Heath and Human Service’s website.
4. Consider an alternate point of view. Though at first I was annoyed with some of the responses I got on Facebook that were less than supportive of my plight (one saying something about the patient needing to cover the cost of copies, no matter where the copies were going), I did force myself to consider them. I did think about the time and cost implications on medical office of patients asking for records to be sent all over the place, constantly. I did my best to address this point of view in my letter, which helped me (I hope) to temper my response and connect with my audience, thus hopefully making it more likely that I would get results.
5. Know that the act of persuasive writing itself may be just as satisfying as getting the desired results of the persuasive writing. Okay, almost as satisfying. Though I don’t expect to ever hear from my old doctor’s office or that the law under HIPAA will change overnight, at least I had my say.
Anna is a staff developer, literacy coach, and writer, based in New York City. She taught internationally in places such as Sydney, Australia; San Pedro Sula, Honduras, and Auckland, New Zealand in addition to New York before becoming a staff developer for the Teachers College Reading and Writing Project at Columbia University (TCRWP). She has been an adjunct instructor in the Literacy Specialist Program at Teachers College, and teaches at TCRWP where she helps participants bring strong literacy instruction into their classrooms. Anna recently co-wrote Bringing History to Life with Lucy Calkins, part of the 2013 series Units of Study in Opinion, Information, and Narrative Writing (Heinemann). She has been a researcher for Lucy Calkins, contributing especially to Pathways to the Common Core (Heinemann, 2012) and Navigating Nonfiction (Heinemann, 2010).