Abstract: | In a recent decision, Commonwealth v. Kobrin, the Massachusetts Supreme Judicial Court ruled that a psychiatrist being investigated for possible Medicaid fraud did not have to turn over all of his notes concerning therapy sessions. The Court said that portions of the records reflecting feelings and impressions or the substance of the diagnosis could be withheld; however, information regarding drugs prescribed, electroshock therapy, or notes on the patient's condition and progress should be disclosed. Since increased access to medical records by insurers, investigators, hospital staff, and others has already eroded the right to privacy, the issues raised by this case are disturbing to psychiatrists who fear that wholesale disclosure of records may be mandated. They believe that such disclosure would adversely affect the doctor patient relationship and the psychotherapeutic process. |