Their request seemed simple enough: the patient and his wife, both in their 70s, wanted a copy of what I’d written in their medical file. During their visit, I had watched them refer to a well-thumbed collection of doctors’ notes and medication lists, so when they asked for a copy of my note just before leaving, I assumed it would simply be added to the others.

But when I mentioned the request to one of the nurses outside the exam room a few minutes later, her eyes grew wide.

“Oh no, you can’t do that,” she said, shaking her head. “I don’t think it’s legal.” The other doctors and nurses, attention piqued, moved closer to listen. “Send them to medical records,” she urged. “He can sign the release papers there.”