In America, under the Health Insurance Portability and Accountability Act (HIPAA), patients are to be always allowed access to their entire and full medical record, with the exceptions as follows:
- Psychotherapy notes, which can be withheld if it is deemed to be in the patient's best health interests.
- If the patient is in a Correctional Facility.
- Information pertinent to a legal case between holder of the PHI and the patient.
- Health Information obtained as a result of research, during the course of said research (this would include the patient's agreement to participate).
- Information obtained from someone else other than a healthcare provider where such release would endanger the patient or the person who provided the information.
- When information included in the record was obtained under promise of confidentiality from someone else, and revealing the PHI would reveal the confidant's identity.
- When release of the PHI would endanger the life of the patient or other person (subject to review).
Note that a couple of these are pretty bizarre and pertain only to very specialized circumstances. For instance, if you're in a law suit with your doctor, she doesn't have to reveal her defense notes to you. However, using this as a means of not revealing ANYTHING in your patient records would be illegal as well as ridiculous.
For the most part, and in most instances, the patient is entitled to a full review of their own medical records.
