Medical Records

[Poppy]

Do French Doctors have to keep medical records for patients or because we usually receive a copy of most things xrays, blood tests etc are we expected to keep our own. Is there any legislation to cover this?

[idun]

One of my french Doctors kept some details, the other would get copies of anything he had asked us to get done, and what he did with them, I have no idea, so I always took our copy in.

That for me is the best of french health care, one's responsibility for one's own health records.So you keep them.

My problem in the UK is that I do not get my copies so have taken my eye off the ball. I won't in future, and I have asked for this information recently, and was more or less told that I wouldn't understand what it said........... to which I said that I doubted that 60 million french people were all brighter than me and manage perfectly well getting copies of every last test and what I they were saying was nonsensical.

And taking my eye off the ball, twice in the last year I have been give medication I am allergic to, so the doctors or dentists keeping these records doesn't work. And I doubt that a UK GP has enough time to plow through my records everytime I go in, my french GP spent more time with me and didn't have to.

[Poppy]

Thanks for your reply Idun. I do agree that it is better to have control over your own medical records and to be proactive re your own health care both in France and UK. I have had to jump up and down in both countries.

I am having 'difficulties' with a travel insurance who will not payout until they receive a doctors report. The medical assistance company, myself and cancer support  have been trying for 4 weeks to obtain medical records from our  french doctor but I don't think they exist. It is an English policy supposedly designed for Expats but if a Doctors report is necessary then it is perhaps not suitable.

[NormanH]

My Doctor has a fully computerised record of things including results and letters from Specialists, but I have all my test and Xray results also.

He prints off the necessary parts when he sends me to a new specialist

At the same time my cardiologist has given me a ring backed folder with all relevant details to take to the consultations

There is a proposal to have a personal medical history for everyone accessible from the Carte Vitale, but for the moment it seems to have hit a brick wall. The idea is to avoid lots of duplication and to have vital details to hand in case of emergency ..

[idun]

Poppy, I suppose I am being thick, but I don't quite understand your problem.

Was your claim made when you were using your policy in France??

If so, I would have taken all my medical reports to my french GP and he would have written a letter to the insurance company.

Also, have you contacted the insurance company about this, and asked how they deal with the differences as things are done differently in different countries.

[Poppy]

Idun, we are french resident and have an annual worldwide travel insurance policy taken out with an english company but under their expat terms.

We are in Spain at the minute and husband was admitted to hospital with severe back pain. Tests show he has broken his back in two places. Spanish doctor says it might be result of hormone and radiation treatment given for prostate cancer last year. On renewal of annual policy we declared prostate cancer and paid a hefty premium.

Without a report from doctor the insurance are refusing to pay the hospital bill and want 3000 Euros upfront for ambulance repatraition.

We rarely visit the doctor but have contacted him as have cancer support as we need to get back for cancer follow up appointments on 4th Feb. Doc says he will send reports but nothing so far and I think this is because they do not exist. Insurance co refuse to acknowledge country differences and refuse to pay out without Docs report. As well as trying to sort this immediate personal problem I do feel I need at some stage to highlight the problems with expat travel insurance.

[idun]

Won't the spannish doctors report do? In stating that the patient came in with severe back pain and was found to have a broken back. Why would your french doctor have anything to do with this, surely it is down to the spannish doctor to say that he has a broken back. As your husband did not know he had it before, then surely this is just for the current medical expense and not an on going investigation as to how or why he has a broken back....... if you see what I mean. Wouldn't it be just the same if he had slipped on a banana skin  in Spain..........and broken his back?

I am still confused. The spannish doctor can only state the facts of his current situation and should not be speculating about cause.

[Poppy]

Yes Idun we have been through all the banana skin argument etc. Spanish doc did want to do a bone scan to confirm it might be osteoperosis as a result of cancer treatment but Insurance Co said emergency treatment under terms of policy ceased with broken back diagnosis. Even though they haven't agreed to pay out a penny. Husband is now in Spanish hospital receiving no treatment because they do not think they are going to get paid. Looks as though we will have to pay and discharge him voluntarily which will probably whipeout any slight chance we had of recoverring costs. Then we will have to try and get home on the bus.I know it sounds unbelievable but I am telling the truth. Once home I will submit complaint to Insurance Ombudsman and I obviously need to get evidence to prove and let others know that these expat policies are worthless.

[idun]

How could they do that?  Sounds like the Insurance Ombudsman needs contacting.

I am now wondering if you are in a public hospital in Spain. According to the NHS web site they are free of charge with an EHIC. And I do know that one is supposed to be careful to avoid private (and expensive) hospitals/clinics in Spain.

[Poppy]

Have gone through policy procedure page 5 para 6 line so and so and informed them I will be referring case to Insurance Ombudsman but it seems to make no difference.

OH was in accordance with  emergency policy procedure admitted to nearest hospital which was a private hospital but once emergency was declared over was transferred to public hospital

 

Insurance have agreed to pay private hospital but only after receipt and review of french doctors report. Because admission to public hospital is no longer classed as an emergency there will also be fees payable. Similarly insurance will not pay for repatriation until they review french doctors report.  Holiday has now finished so I have to pay additional hotel costs for me and as hospital is miles away from hotel with no public transport also have to pay huge taxi fares. it really is a nightmare.

 

Private hospital, public hospital non emergency and repatriation are supposed to be covered under the policy but this is not the case in reality. I am obviously trying urgently to sort this problem  for ourselves but in the long term I will research and warn others about taking out expat travel insurance

[Russethouse]

What about trying our consulate? Might they have some weight with the company?

Are they trying to establish that it was not a pre existing condition ? And should they establish that, or hear to their satisfaction from the French doctor, will they then assist?

I'm so sorry to hear of your plight.

[NormanH]

I hadn't realised the situation from your first question, so I simply answered about medical records without appreciating the full circumstances.

I assume as French residents you have  health cover in France, either by working, by paying into the CMU or from a S1

Surely you are covered by the European health card for travel out of France? (EHIC if on an S1 from the UK CEAM if from France as in the first two)

https://www.nhs.uk/NHSEngland/Healthcareabroad/EHIC/Pages/about-the-ehic.aspx

This should cover at least part of the costs

• The EHIC will cover any medical treatment that becomes necessary
  during your trip, for example because of either illness or an accident.
  (In an emergency you can dial the European emergency number 112 from any
  telephone or mobile phone).
• The card gives access to reduced-cost or free medical treatment from state healthcare providers.
• It includes treatment of a chronic or pre-existing medical condition that becomes necessary during your visit.

On the records side, if your husband was treated in a French hospital your French GP will have a 'compte rendu' of the treatment. If he hasn't got it the place where he was treated may be able to provide a copy   a 'double' (pronounced doooble)

This is the whole point of the system of a 'médecin traitant' (a GP) who co-ordinates your 'parcours de soins" (treatment plan)

Excuse me for being indiscreet, but what is your French like? It isn't possible that these records don't exist, but perhaps you aren't asking in the right way or for the right things.

Back problems are known to follow prostate cancer in some cases. I posted a thread in August last year about the treatment I had for a compression fracture of the back after Prostate cancer.

http://services.completefrance.com/forums/completefrance/cs/forums/2763620/ShowPost.aspx

This must be terribly worrying for you. If you need any practical help such as phoning to chase up your records send me a pm.

[Sprogster]

idun, absolutely standard practice with travel medical insurance for the insurance company to ask your primary care physician to complete a medical report questionnaire, before considering a claim. The reason being is that travel medical insurance, unlike other insurance cover such as life insurance, is obtained without the upfront need for a medical or check as to your medical history, and therefore the insurance company are totally dependent on the customer making a full and frank disclosure of all past and present medical conditions. However, when you make a claim at that point the insurance company will check up on the customers medical history with your doctor and if it comes to light you have failed to disclose a previous or existing health condition, even if not connected to your claim, your insurance will be void.

That is why if you have annual travel insurance, you must update the insurance company with any changes in your health, even if they occur after the policy was taken out.

Unfortunately, everyone wants the cheapest possible travel insurance, but then find out they are not covered as most insurance companies nowadays manage claims by outsourcing their handling to third party companies who are financially rewarded for finding ways to minimse payouts!

French doctors are of course required to keep details as to every patients medical history (patients are given copies), as not to do so would be unsafe when prescribing medicines for example, if a doctor in ignorance precribed a medicine that could dangerously interact with another medication already taken by a patient, or other pre-existing medical condition. You cannot expect a patient to have that expertise! Also without your medical history, it would be impossible for a doctor to complete a medical questionnaire in relation to a patient taking out or claiming on medical related insurance, such as critical illness policies.

[Russethouse]

Norman, I don't know about French EHIC's but UK ones do not include repatriation

You have made a very generous offer, really kind of you.

[Poppy]

Russethouse - Thank you for your good wishes. I have contacted the Consulate but they are unable to help.

Norman - Thank you so much for your helpful post. I did follow your 'adventures' last year, hope all is well with you now. My french is good and have spoken to our Doctor several times. He says he understands urgency of situation and each time he says he will forward info to Insurance Company but nothing materialises. I am certain he does not have any records for us and hopes we will give up eventually.

Sprogster - Our Insurance was not cheap and we have declared everything and updated Insurance Co during term of policy. We did all this to avoid being in the situation we now find ourselves in. However if the Insurance Co insist on medical history which doesn't exist ...... Please everyone if you have travel insurance double check that your Doctor has your medical history.

The insurance are certainly trying to find ways to minimise payout, the goalposts are moved every five minutes. Latest is that because it is now 3 weeks since MRI scan then before repatriation my husband will have to be reassessed as fit to travel in ambulance.  We will have to pay for this assessment even if claim is validated and Insurance pay for repatriation. I have a diary full of similar things and they are completely unphased that I am referring the case to the Insurance Ombudsman.

Due to todays sting in the tail I think we will have to do a voluntary discharge and get away from this silly situation. The important thing is to get my husband home to check the cause of the back injury.

[NormanH]

The important thing is to get my husband home to check the cause of the back injury.

I agree with you. Last year I had what is known as a 'tassement vertébrale', which is a compression fracture of the spine.

There are several possible causes apart from direct injury such as from a fall.

One is osteoporosis, and another is  secondary bone cancer which has spread from the primary prostate cancer.

Knowing this I contacted the  radiologist who had treated me and he arranged a MRI scan, and subsequent biopsy of the spine to check for cancer.

At the same time they did the procedure I described in the other thread,  which consists in injecting a plastic cement in to  damaged vertebrae to support them. I now have considerably less pain.

Happily for me the biopsy was clear, as I hope it will be for Mr P, but he should have it checked as pain in he back after prostate cancer is a warning sign even if it is very unlikely to be cancerous.

In terms of getting the treatment in Spain paid am I to take it that you don't have a EHIC card?

As RH says it doesn't pay repatriation, but it should cover the MRI and treatment.  That after all is the whole point of a European wide system.

[idun]

Sprogster, sorry but that is nonsensical about french doctors records. In reality everytime one visits a GP one can take a form to a new doctor and ask them to join their practice and send it into the secu. You do not have to take medical records with you and they do not 'get them' from the previous doctor either. And you do not even have to 'register' with new practice, just find a doctor and just pay extra. They make make a note of what they have prescribed, or not, but will not be shared with the next doctor one sees.

Sounds bordellic, well the french medical system seems to do fairly well

in international surveys.

And as I have said previously, the muppets in the UK WITH ALL THEIR RECORDS KEEPING AND UN NECESSARY STAFF, still managed to poison me twice in the last year, giving me medication that I was allergic to, TWICE!!!!!!!![:@]

 The french system worked for us, so I have no

complaints. AND I was never given medication that I was allergic to more than once.

Re the insurance companies, well, they need educating. They are making assumptions about another countries methods of working which obviously do not conform with their blinkered ideas. IF they are to issue insurance policies to expats, then surely 'they' the insurance companies should be aware of different health systems, if not, then they are not actually doing the work that they have been paid to do, ie to cover expats whilst holidaying.

[Sprogster]

idun, you may be out of date, as the younger French doctor I go to has introduced computerised records. Although I expect that in deepest rural France things might not be as sophisticated and that's if you can find a doctor as there is increasing shortage in rural France.

The problem is that fraudulent claims on travel insurance policies are so endemic these days, that unless there is a way the insurance company can verify your recent medical history in the event of a claim, you are not going to find suitable cover. The only alternative would be having thorough medicals for the insurance company before a travel policy was granted, with all the expense that would involve. If like me you have had a medical for French life assurance you would know what I mean!

[NormanH]

As I pointed out above there is a médecin traitant:

Les principales missions de votre médecin traitant sont les suivantes :

• vous assurer un 1er niveau de recours aux soins,

• participer à la prévention, au dépistage, au diagnostic, au traitement et au suivi de vos maladies,

• vous orienter dans le parcours de soins coordonnés,

• informer le
  médecin correspondant
  des délais souhaitables de prise en charge compatibles avec votre état de santé,

• rédiger le
  protocole de soins
  si vous êtes atteint
  d'affection de longue durée,
   

• élaborer et intégrer dans votre dossier médical personnel la synthèse
  des informations transmises par les différents professionnels de santé
  consultés,

• vous apporter toutes les informations permettant d'assurer une
  permanence d'accès aux soins aux heures de fermeture du cabinet

It is therefore unbelievable that he would not have received the 'comptes rendus' of various treatments

Whether he has filed them, lost them, or can't be bothered to find them is another thing

This does not contradict the fact that you also have your own records, results etc, and the French have their 'carnet de santé' from birth with it all written down

[Poppy]

Yes Norman I am sure Doc has received 'comptes rendus', what he has done with them is another matter. I do have copies of everything but that doesn't help at all in the present situation.

Yes Idun I totally agree with your last post. I am convinced Doc does not keep medical records. Regarding the policy not fit for expats, yes that is part of my case to be submitted to the Ombudsman.

Sprogster they will not find any fraud in my claim or my declarations.

[idun]

Sprogster, I'll stick by what I said the first time. Even in cities, one can change medecine traitante at will and legally...........and for all as NH suggests, information should be passed onto  consultants, I do not believe that information is passed between toubibs when one changes.  Also, no one has got to be registered, 15% of french people are not registered with a medecine traitante. They get reduced refunds if they send in their feuilles, and in fact they don't have to do other than pay their doctor....... up to them whether they want reimbursing. And yet, they can see a doctor at  will....... as can you, you simply pay up.

Sometimes people who have things wrong with them, which they prefer their family not know about, can go and see any Doctor or specialist and simply pay and their record would not be available to their GP at all.

As NH said, as you have gone through the system, then your GP should be able to send you the information required. Have you actually spoken to them Poppy?

[Sprogster]

Poppy, in no way am I implying they wold find anything wrong and would apologise if I gave that impression. I was only trying to explain why medical records are so important these days where medical insurance is concerned.

[Poppy]

Sprogster, no offence taken. I was like you trying to warn people to check that their doctor has records. Also because of the third degree checks being applied by the Insuarnce Companies -declare everything. Don't think mine met their target last year.

[NormanH]

I know that you have taken out travel insurance and you need these things for that, but can't the treatment be paid for at least in part by the EHIC?

Even if you don't have the card with you you could be covered.

 You are covered for travel from the date of application (if you

made your application via our telephone application line or online).

If you travel and you do not have your card with you, and treatment

becomes medically necessary during your visit, you may be issued with a

Provisional Replacement Certificate (PRC) to prove your entitlement to

the EHIC. This will be sent directly to the place of treatment.

To apply, call the Overseas Healthcare Team on 00 44 191 218 1999

(Monday to Friday, 8am–5pm). It's a good idea to save this number in

your phone.

To get a PRC, you will need to provide your name, address, date of

birth and National Insurance or NHS number (CHI number in Scotland or

Health and Care Number in Northern Ireland).

https://www.nhs.uk/NHSEngland/Healthcareabroad/EHIC/Pages/about-the-ehic.aspx

As for repatriation that can be covered by  the card company if you used one to book tickets.

This is certainly the with my Mastercard from Crédit Agricole

Bénéficier d’assistance médicale rapatriement en France et à l’étranger (4)		*	*	**	**	***
Bénéficier d’assistance juridique à l’étranger (4)		*	*	**	**	***
Bénéficier d’une assurance accidents de voyage

[mint]

Poppy, I haven't wished to post anything because I do not know anything about the issues involved.

I do want to say, however, that I hope you find a solution soon and that your OH will get all the help that is available.

Here is a case that I have just read about and I thought of you immediately.  I know it's only the DM but some of the things mentioned might have some relevance for you.

All the very best to you both.

http://www.dailymail.co.uk/money/holidays/article-2269693/23-000-medical-shocks-family-father-coma-cruise-ship-travel-insurer-refuses-pay-up.html