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Sale of Records to Non-Doctor Stuns Patients : Most states have no law to prevent such deals. While files may appear vulnerable, health care facilities work hard to protect the information.

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SPECIAL TO THE TIMES

Dr. Donald Miller’s patients were not the only ones shocked when he sold his meticulously kept records of their care to a local businessman for $4,000.

Equally surprised were doctors and medical records professionals here and around the nation who learned that South Carolina and most states have no law to prevent it. (The sale would have been illegal in California.)

“I think they got caught with their britches down,” said Bob Rogers, who bought the records at a June 22 auction.

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The sale raised fears that the highly valued intimacy between doctor and patient could easily be breached.

“It makes you wonder who’s going to be reading your record in 10 years,” said Linda Pirkle, one of Miller’s former patients. “A patient will share everything with a doctor. What about people who’ve told Dr. Miller they had an abortion or have AIDS or a woman who got pregnant by someone other than her husband?”

Rogers, who owns a car leasing company, an auto junkyard and a body shop, buys items at auctions all the time. The 10,000 file folders and Miller’s office on Main Street in this northwestern South Carolina community, which cost Rogers an additional $92,500, seemed like just another good deal--and it apparently was. Rogers has since sold the records and leased the office to another doctor.

But medical authorities say this was the first time a non-doctor has possessed a complete set of medical files, although non-doctors handle records all the time. With tens of millions of medical records in existence and millions more generated every year, many hospitals store older files in their own warehouses or contract for storage with moving companies. Couriers transport files between hospital and storage routinely.

Yet, doctors and health care facilities traditionally go to great lengths to protect the information, which belongs to the patient, and the records, which belong to the doctor or the facility. Storage areas are off-limits to anyone but those directly employed in medical record-keeping. Even doctors cannot read files without authorization from patients or attending physicians.

The rule of thumb, according to Karen Wager, who chairs the Health Information Education Department of the Medical University of South Carolina, is “if in doubt, don’t give it out,” even if that means irate doctors or patients.

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Miller, 42, said he considered his deal with Rogers an arrangement for storage. He had a doctor buyer first, but the deal soured, and Miller felt no choice but to sell at an auction because he was due to begin his new job in Michigan.

“Everybody under the God’s sun thinks I’m sitting over there at night reading those records,” Rogers, 57, said after his purchase, explaining that he never had any interest in reading the records.

“I wanted to do something for the community and make a buck, too,” he added.

Since Miller’s sale, the American Medical Records Assn. in Chicago has been studying state laws to see if more protection is warranted. In California, such a sale could not have taken place unless Miller had obtained written permission from each patient, a spokesman for the American Medical Assn. said.

The AMA considers records an asset that may be sold, yet admonishes doctors to keep files secret or lose their license. Perhaps twice in two decades have doctors lost licenses for breach of confidence, and both were flagrant abuses; doctors publishing information about patients in books, the spokesman said.

But Pirkle believes only her name should have been sold, not an inventory of her ailments.

Pam Wear, the executive director of the 31,000-member American Medical Records Assn., said as computers become commonplace in medicine, impenetrable security codes will assure privacy. And computerized records are easier to store, eliminating the need for off-site storage and transportation of records.

Meanwhile, back in this mill town-turned-suburb, Rogers accomplished what he intended. He made $6,000 selling the records to a Jacksonville, Fla., doctor, who will also lease the building at above-market rates.

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“It’s another day, another dollar for me,” he said.

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