Implementation of the 21st Century Cures Act took effect in April 2021, specifying that clinical notes are among electronic information that must not be blocked and must be made available free of charge to patients. Despite the laudable intentions of the Cures Act, we believe its implementation is already causing unintended consequence for clinical care or research procedures. These regrettable consequences stem from patients’ misunderstanding of the medical record. To illustrate, let us reflect on the following example.

Early in April 2021, we provided anesthesia care for a young woman whom we considered to be clinically unremarkable with a history significant only for anxiety and who underwent a minor procedure. A size 3 laryngeal mask airway was placed and removed because of unacceptable air leak, at which point blood was noted and the laryngeal mask airway...

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