Litigation Management

Medical Record Acquisition: Locating Healthcare Providers (Part I)

By:	Elizabeth B. Juliano
	Karen A. Ness

As noted in the previous issue of The M.I.M. Reporter, the success of obtaining medical records in a timely fashion depends, in many instances, on the accuracy of healthcare provider information documented in the completed interrogatories/questionnaires. This first in a series of two articles will detail resources available for locating these providers and, more importantly, the records in their custody.

To effectively manage time and contain costs in record acquisition, the paralegal should first define a standardized protocol for locating physicians and/or hospitals. Upon receipt of plaintiff-provided answers to questions regarding healthcare providers, a thorough review must be performed to determine the relevance of all information garnered. In most medical litigation, the paralegal will be selective in deciding which medical records to request. A brief consultation with a medical information management specialist can yield significant dividends in targeting only pertinent medical documentation and avoiding unnecessary expense associated with the acquisition process.

In the usual situation, the paralegal will be prioritizing the healthcare providers in order of importance for record receipt. The highest priority should be given to those healthcare providers most intimately connected with the alleged complaint or the incident identifying the alleged complaint. As further discovery transpires, it may or may not become necessary to locate these documents.

Earlier it was recommended that a tracking mechanism be developed as one component of a case management program. During the search for demographic information on a healthcare provider, it is important to document the steps taken, the parties called, and the names of any contacts. This information is always useful for future reference as well as documentation in the event that the provider falls into the category of "unable to locate".

Reference Media

Four basic choices are available to locate healthcare providers: hard copy references, electronic formats, direct telephone contacts, and professional boards/associations. Hard copy references are directories which detail information about physicians, group practices, hospitals, clinics, healthcare systems, and other providers of care. Electronic references consist of CD ROMS and the Internet. Examples of telephone contacts include directory assistance, former partners in a group practice, the successor of a physician's practice, and medical staff offices. Medical and professional specialty organizations constitute the final reference resource.

Hard Copy References

One of the best sources of hospital and healthcare systems information is The Hospital Phone Book, compiled by U.S. Directory Service [USDS]. The cost is approximately $119.95 and may be obtained by calling 800-521-8110. The directory is published annually and is divided into three major sections. The first section provides information on zip codes, state abbreviations, area codes, and healthcare help and hotlines. Section two is a listing of hospitals by state and city and provides, in addition to name, address, and telephone numbers, the type of facility and the bed capacity. The third section is an alphabetical listing of all 7,300 facilities.

Another good resource for hospital information is the Official National Hospital Blue Book published by Billian Publishing Inc. The cost is approximately $249.00 and may be ordered by calling 800-533-8484. The Blue Book also is an annual publication, and in addition to hospital information organized by state, there is a section identifying healthcare systems and affiliations. This reference is very helpful in that mergers and acquisitions many times create a name change of which a plaintiff may be unaware. The Blue Book offers detailed information about various departments within the facility which is useful in identifying the director of Health Information Services [Medical Record Department]. Additionally, there is a listing of medical schools and a glossary of healthcare/hospital-related terminology.

Physicians who are presently practicing medicine and some recently retired physicians can be located in the Directory of Physicians in the United States, published by the American Medical Association. The four-volume directory contains 723,000 listings and may be obtained by calling the AMA at 800-621-8335; the cost is approximately $545.00. The directory contains Medical Doctors (MD) and Doctors of Osteopathy (DO). This resource is also available on CD ROM at approximately $745.00.

Telephone Resources

Locating physician demographic information is challenging when the physician is retired, deceased, or has relocated. Many physicians sell their practice upon retirement and, if the patient continues his care under the successor, the new practitioner will assume custodial responsibility of the patient's medical record. Some retiring physicians will not sell their practice, and, by law, should notify each patient that his/her medical record will be destroyed if not requested within a certain timeframe. This sometimes results in medical records being stored in a retired physician's home or a storage facility. This is where detective work is sometimes necessary. If the city of residence or last known residence is available, the paralegal should try directory assistance, requesting both business and residential listings. On occasion, a relative with the same last name may be located who is able to provide direction as to the location of the retiree and/or the medical records. Out of date reference books such as telephone directories, hospital and clinic directories sometimes provide clues, or at least a starting point.

Within the answers to interrogatories, one can usually determine the hospital(s) where a physician maintained privileges. The medical staff services department within a hospital can be a wealth of information regarding physicians with current and past privileges.

Associations and Boards

National, state, and local medical boards and professional associations are excellent resources. All states have medical boards for medical doctors and osteopathic physicians, in addition to those boards which are restricted to medical specialties. The telephone numbers for these boards can be accessed via directory assistance. In preparing to contact a medical board or association, verify the complete accuracy of the physician name(s). Additionally, when an inquiry involves several physicians, it is advisable to combine the names under the auspices of one larger request.

Every licensed physician in the United States can be found in the database of the American Medical Association; telephone number 312-464-5000. A physician need not be a member of the AMA to be included. If the designation of a physician is known to be Doctor of Osteopathy, the American Osteopathic Association, telephone number 312-280-5854, may be contacted for demographic information. If the person completing the questionnaire indicates having been treated by a physician many years ago, one should be sure to relay this information to the board or association so that archives may be searched as well as current available data.

Conclusion

The investigation of healthcare provider demographic information is fairly easy when a protocol and database of information have been established, especially in the search for physicians. Upon finding a good source of information, be certain to document the name of the contact person, the hours of business, and any special requirements. The more expeditious the search, the shorter the turnaround time in obtaining medical documents.

Look for an upcoming issue of The MIM Reporter for tips on using CD ROM references and the Internet as further sources of provider information for the acquisition of medical records.

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