If you’ve been practicing for years, you might be asking yourself how long you should hang on to old client files – especially if you have paper charts – and what’s the best way to get rid of them when the time comes.

OK, I have two confessions around this topic. First: During my 33 years in practice, I kept a physical chart for EVERY SINGLE CLIENT, even after switching to electronic notes about 15 years ago. I used the paper chart to keep Post-it note reminders to myself, client and insurance payment info, a copy of their insurance card, health plan correspondence, client emails, drawings, Christmas cards, etc.

My second confession? In those 33 years, I never took time to purge ANY of those charts. Nada. Zip. Zero. So, when I retired, you can only imagine how many file cabinets I had full of charts. At my home, in my office, in my garage.

If I had it all to do over, I would definitely do things differently. This article is my attempt to help you learn from my mistakes.

My Advice: 8 Tips

While you may not be nearing retirement, as clients end treatment it is a good idea to think about how you will dispose of the file when it comes time to do so. Some things to bear in mind:

1. File closed charts in a locked file cabinet, in a location and manner that makes a file easy to retrieve. I can’t tell you how often I had to retrieve charts after closing them.
2. Check your state law to see how long you must keep files. Keep in mind that the laws may be different for the charts of adults and of minors. If you aren’t sure about the law, check with your state professional association, your malpractice carrier, or do an online search for “health record retention law [your state].”
3. Organize closed charts with a mind for future destruction. Years before I retired, I started to file closed charts alphabetically in file drawers labeled with the year the chart was closed. That way, I knew when the minimum retention period had passed for these charts, I would be able to destroy all the charts in that drawer. Another option would be to label closed charts with colored tabs indicating the year they were closed or the year they could be destroyed.
4. Before destroying, take a quick look at the names on each file. You may choose to keep the records for some clients longer than is required, as I did, depending on the clinical or legal (or emotional?) aspects of the case. For some clients you might like to create and keep a treatment summary before shredding the notes.
5. Use secure disposal methods. I recommend hiring a professional shredding service, especially if you have a lot of paper charts to shred as I did. The service I hired came to my home and shredded on-site in their truck, so I didn’t have to do any work, and I could verify that they were properly shredded. If you are doing the shredding yourself, use a cross-cut shredder for the highest security, and try to shred regularly so you don’t build up a backlog like I did.
    
   If you have electronic records, contact your Electronic Health Records (EHR) company for information about options for deleting files.
6. Keep a destruction log, including date of destruction, description and dates of the destroyed records, and the destruction method used.
7. If you are closing your practice, consider how you will deal with record requests related to former clients after you leave. If you do not intend to handle these requests, arrange for another professional to handle them.
8. Expect feelings when shredding. It surprised me, but A LOT of emotions came up as I destroyed charts. Just reading the names of former clients brought up so many memories. And I felt sad as I handed over the only existing record of decades of my work, and of all these years of wonderful, private, intimate, tearful conversations. It felt like I was allowing all proof of these relationships to be erased, as if they never existed. But OK, yes, it was also wonderful to get back all that space in my filing cabinets and my garage!