An adverse effect is a consequence likely to occur if granting direct access to an
individual’s medical records is expected to cause:
A disruption of the doctor-patient relationship;
An interference with the individual's medical treatment or management; or
A negative effect on the individual in some other way.
If an adverse effect is likely to occur, do not release the medical records directly
to the individual. If an adverse effect is not likely, you may release the medical
records directly to the individual.
EXAMPLE 1 - Adverse effect not likely
John Doe has diabetes. The medical record indicates that the prognosis is good with
treatment involving medication, diet, and exercise. In this example, an adverse effect
is not likely.
EXAMPLE 2 - Adverse effect likely
Jim Doe has a mental health disorder. The doctor notes some aggressive behavior tendencies
in Mr. Doe’s record. Direct access to the doctor’s report may provoke Mr. Doe to threaten
the doctor or other members of the doctor’s staff. In this example, an adverse effect