Arguing from a legal perspective, the author notes that a physician may order X-rays, have the patient schedule an imaging examination AND pay for the procedure, and not permit the patient to have the X-rays because they are part of the medical record. Under contract law, however, the patient would own the images, the author contends. "The fact that the lab forwarded the images to the doctor does not result in conversion so that it becomes the legal possession of the physician."
The author also makes his case from a personal perspective, having been denied insurance coverage because the words "sleep apnea" appeared in his medical records send to the insurer. The author at one time had undergone an examination and his wife mentioned to the physician that he snores loudly. The physician wrote "sleep apnea" in the notes, but never talked about the condition, diagnosed it or treated it. With reluctance, the physician's office let the author examine his records and when he found the words "sleep apnea" with no supporting documentation he protested the insurer's denial of coverage. "The insurance company took their presence in my record to mean that it was a validated diagnosis. I objected, filed a complaint, but it was useless."
The Discussion Board entry, "PHRs: A Chance to Get it Right," is available here.