Who owns your Xrays?

February 23, 2006 12:44 PM

Legally, who owns your X-rays? Weird dentist bullshite...

My mother and I both left our old dentist, not feeling he was really doing his job. My mother just went to a new dentist and in order to save her the money on new xrays, he called her old dentist to ask them to send her latest xrays to his office. The dentist refused. His office personnel said they don't give the xrays to anyone. They belong to them. They said they would send a photocopy of the xrays, at $5 per Xray. The new dentist was furious. He said the Xrays are not the dentist's, but belong to my mother. I am going to go to the old dentist's office to get the xrays myself. But, I want to be well armed, maybe even witha printout of current California law regarding the release of the Xrays, and whether they can charge for any of this. I have never had this problem with any Xrays I've ever had taken. This is a matter of principal more than anything. I refuse to pay for something that rightfully belongs to me. So, who owns the Xrays? What are my options? Anyone know what the relevant law, if any, is on this?

posted by joaniemcchicken to health & fitness (32 comments total)

I'm sure you paid a pretty penny for those x-rays (regardless of whether or not your insurance covered it) - those x-rays are yours.
posted by meerkatty at 12:53 PM on February 23, 2006

HIPAA guarantees rights to your own medical records. I'm not sure if X-rays are included in the definition of medical records, though. This PDF outlines some basic information about it. It does say that you can be charged for the service of copying them, though.
posted by zsazsa at 12:53 PM on February 23, 2006

That just seems like assholery on the part of the old dentist. Does he claim that he owns her medical records as well?

I would contact the Dental Board of California and see what they say.
posted by bshort at 12:54 PM on February 23, 2006

I googled up to quick references that suggest the dentist owns them. One was an FAQ for a (drum roll) dentist's office, and the other was some free legal advice-type forum. The questioner lived in CA.
posted by cairnish at 12:56 PM on February 23, 2006

I would imagine that he wouldn't want to part them on the assumption that if the patient sued him for malpractice he wouldn't have the originals to back him up. It makes sense to charge for a copy, $5 isn't outrageous.
posted by JJ86 at 12:59 PM on February 23, 2006

HIPAA guarantees rights to your own medical records.

Yeah, once you say HIPAA he'll hand 'em over. As far as copyright law goes, since you paid for em, you have a pretty good claim (IMO).

On the other hand HIPAA is a very draconian, incomprehensible beast of a law that is very much on the side of the patient. To the extent that it may not even be legal for hospitals to report you to credit agencies if you don't pay your bill (I'm not sure, but most people aren’t sure either)

Just tell him it's a HIPAA violation and they'll probably give it to you.
posted by delmoi at 1:01 PM on February 23, 2006

My looking turned up the California Patient's Guide which in turn refers to California Health & Safety Code 123110.

In short it seems X-Rays are the dentist's property, although they are required to provide copies at a reasonable fee. That much I gleaned through a look at anything mentioning X-Rays, but closer reading might reveal more.

(paging bilabial who knows all things dental)
posted by contessa at 1:03 PM on February 23, 2006

I've had to get originals of x-rays from radiologists before, after a move. If your dentist needed to use the x-rays in court he could just subpoena them from you. Maybe your new dentist could contrive a reason why he absolutley needs to see the originals.
posted by Sara Anne at 1:04 PM on February 23, 2006

This happened to me in California, too. I was informed by Dentist #1 that I was entitled to copies, but they were obligated to hold onto the originals. So, I had to pay a fee and wait a few days to get the copies, which I picked up and then delivered to Dentist #2. I forget how much it cost, though.

By the way, Dentist #1 said I had 13 cavities. Dentist #2 said I had no cavities. So, the copying cost more than paid for itself. I hate dentists.
posted by _sirmissalot_ at 1:11 PM on February 23, 2006

As far as copyright law goes, since you paid for em, you have a pretty good claim (IMO).

Copyright is the right to prevent others from making copies, derivative works, etc. It is not relevant to (either for or against) the question of the ownership of the original, physical documents.
posted by DevilsAdvocate at 1:24 PM on February 23, 2006

A negative photograph or slide belongs to the photographer (absent some contract saying otherwise), even if you are the sole subject of said photograph.

The dentist is doing exactly the same thing. I suspect they belong to the dentist, but he is required to allow you access to them, due to their rather special nature.
posted by teece at 1:30 PM on February 23, 2006

Well, this sucks. After reading all the pertinent law, it seems the old dentist is correct. Our new dentist, however, says it is common courtesy to send the Xrays, he has done this many times himself. I will just pay for new Xrays for my mother. Then write a nasty letter to the old dentist. It seems we were right to leave. His level of patient care was subpar, and this just confirms it.

Thanks for your help, everyone.
posted by joaniemcchicken at 1:31 PM on February 23, 2006

I hate dentists.

Oh, now -- they're not all the same -- ask around, go to one with a favorable recommendation. My last visit, thought I'd be going on to the endontist again, but the pain receeded. However, I have an x-ray of the pain area, which my dentist gave me for the endontist to see.

Once the agony of the chair is finished, I love my dentist -- I can eat again!
posted by Rash at 1:36 PM on February 23, 2006

a girl i work with was supposed to take a CD of mouth x-rays from her dentist to the hospital for a procedure, but on the way she took them home and h4x0r3d them so now she's got a copy! let's all mark that down in our 'useful tips' folder.
posted by soma lkzx at 1:55 PM on February 23, 2006

Indeed, they are not all the same. My first dentist made me hate dentists. But I've got a new one now, and I actually enjoy going to his office. I get good advice, great care, and the people there are really fun to talk to.

You did the right thing in leaving this jerk of a dentist behind.
posted by teece at 1:59 PM on February 23, 2006

Can you copyright your body?
posted by luriete at 2:50 PM on February 23, 2006

How does one pronounce HIPAA in case I ever need to sound like I know what I'm talking about?
posted by artifarce at 3:53 PM on February 23, 2006

How does one pronounce HIPAA

Like "hippo", the homicidal water beasts, but with an "ah" at the end.
posted by meehawl at 3:59 PM on February 23, 2006

FWIW, I worked as a clerk in the radiology of a hospital for a while. Yes, the patient does not "own" the x-rays, and we can charge to make and send copies. However, it's a pretty common curtesy to loan out patient's files to other doctors. Maybe it's different for dentists, or maybe this guy is just being petulant.
posted by muddgirl at 4:30 PM on February 23, 2006

hipaa=health insurance portability and accountability act of 1996.

fun fact...every doctor's office, dentist's office, insurance office, etc., has to have a privacy officer. ask for your rights in writing (they actually have to give them to you before they can see you) and then jot down the privacy officer's name.

go home and fill out a request that they not use your information for anything other than your own personal care. use the privacy disclosure form to figure out what they reserve the right to do with your information and put in writing that you don't want them to do it.

get the privacy officer to sign it. if they won't, then eh, either live with it or find another doc. if they do, then you have a right to not get your information used for studies and shit....and i have a feeling that they will, cause they want to avoid losing customers and they don't want to look bad in front of the other customers.

also...many doctor's office's don't actually know who their privacy officer is....bad sign.
posted by taumeson at 4:51 PM on February 23, 2006

Yeah, call the state dental board. Ask them what they consider a reasonable fee for copies of dental x-rays. Then demand copies at that price from the jerk dentist, mentioning HIPPA, and tell him you'll be talking with the state dental board again if he doesn't comply. Throw in a couple of polite "I'm astonished at this kind of unprofessional behavior"s if you want; they'll probably help. Talking with the assistants rather than the dentist himself might be useful, too.
posted by mediareport at 5:52 PM on February 23, 2006

$5.00 for each set of x-rays or for each individual film? Because if it's for each set, that's damn fair. Considering the dentist has to pay someone about $20.00 an hour for about 15 minutes worth of work, and about $1.00 worth of supplies, and if mailing, another $.50...

The dentist I work for only uses double film packets just for this reason, every x-ray exposes two pieces of film, making a copy to give to patient instantly. And of course with digital technology now, a mouseclick should give an instant copy to the patient, if requested.

But yes, absolutely, X-rays are the doctor's property. Some will give originals to the patient, but it is very foolish to do so. It leaves them unable to defend themselves later.
posted by Jazz Hands at 8:03 PM on February 23, 2006

fun fact...every doctor's office, dentist's office, insurance office, etc., has to have a privacy officer.

That's not entirely accurate. Some medical providers aren't "covered entities" because they don't file insurance information electronically and are thus exempt from HIPAA rules.

As far as copyright law goes, since you paid for em, you have a pretty good claim (IMO).

A work has to be published to have a copyright (although "published" has a pretty liberal definition).

Also, and I'm not entirely sure on this, an X-Ray isn't copyrightable because it's not really the expression of anything. It's a diagnostic test. Although it's similar in nature to a photograph, it has roughly the same expressive nature as a throat culture, and I really don't think you'd get far trying to copyright a Q-Tip.
posted by super_j_dynamite at 10:15 PM on February 23, 2006

As far as I understand it, you own your medical record, which includes the information content of those X-rays. However, the dentist/practitioner owns the silver emulsion (or digital media) on which those X-rays were recorded, and can charge a "reasonable fee" to reproduce them.
posted by ikkyu2 at 10:23 PM on February 23, 2006

Someone else definitely can't copyright or patent your medical record or anything derived from your treatment or care without your express written consent.

A recent famous case involved a haematologist who developed an immortal cell line that produced useful antibodies from a surgical sample of a human splenic lymphoma. The dead patient's family sued, and the judge found in their favor; the haematologist had no right of ownership to this guy's tumor.
posted by ikkyu2 at 10:25 PM on February 23, 2006

I would definately say the dentist owns them. Take for instance getting photography shots professionally made -- the photographer owns the shots, not you. You are paying for prints to keep for yourself. I took a wallet-size shot of myself to go get image-scanned at a copy shop before I had a scanner, and they told me I needed written permission from the protrait studio to duplicate that image because they own it, not me. Your cost pays for the processing of the film and production of copies, not for the actual image itself.
posted by vanoakenfold at 11:48 PM on February 23, 2006

Having gone to school to become a medical records professional, I actually know an answer to a question on AskMeFi.

You the patient own the information in the medical record. That data about your health and it is yours and your privacy rights cover the usage of that data. (For my specifics on your rights, google HIPAA - The Health Information Portability and Accountability Act.)

However, the facility (or in this case the dentist) owns the physical copy of that data. They have the right to charge for duplication of the record because if they had to do it for free they'd go broke. It is up to the individual state to set limits on what facilities can charge for duplication. Some states have them, some don't so you'll have to research that depending on your state.
posted by Apoch at 12:35 AM on February 24, 2006

Contessa, thanks, I do manage a dental office and I AM NOT A DENTIST. I am in Florida, so take this with a grain of salt, but I'd like to confirm most of the above. Some dentists will charge a fee for copying xrays and it is perfectly legal to do that. And they may be able to defend copying costs that seem high. Make sure yor new dentist takes duplicates, so you basically have two sets of "originals," one set gets mailed to your insurance company when you need major work (please do not read that as any kind of encouragement to run out and get dental insurance) or forwarded to your new dentist should you ever move. The other set is for your dentist to keep. In florida we are required to hang onto everything for at least 7 (yes, seven) years after our last encounter with a patient. Even if they died. So this dentist clearly does not want to hand over his only copy.

Now, did you tell whoever you spoke to on the phone that you were departing this schmucks practice because he was a schmuck? If so, make nice. They are playing tit for tat. If not, the dentist either being managed in a beastly way and doesn't know it, or the dentist himself/herself is being a total prick. So again, be nice.

Now, at our office we much prefer to get brand new xrays on every patient because we know exactly how our machine exposes the film, and we know who changed all the chemicals and when, and sometimes we get "copies" that are mounted upside down in the (here's where I prove that I'm not a dentist) little mounting thingy, so they're impossible to read without a whole bunch of turning and squinting.

And, these FMX sets stop being clinically useful after a not very long period of time.

Anyway, I'm glad you feel your situation has worked out ok, if not perfectly.
posted by bilabial at 5:22 AM on February 24, 2006

A work has to be published to have a copyright
- super_j_dynamite

"Copyright protection subsists from the time the work is created in fixed form. The copyright in the work of authorship immediately becomes the property of the author who created the work."
"This protection is available to both published and unpublished works."
posted by medium format at 5:33 AM on February 24, 2006

Well, this sucks. After reading all the pertinent law, it seems the old dentist is correct.

What you need is to find a "new" dentist, I mean a "new media" dentist. Mine now uses digital x-rays. It goes from camera to computer in one step and she just emails me a digital copy of I want one. Simple and straightforward and the issue of who owns the physical copy is moot.
posted by Taken Outtacontext at 6:20 PM on February 24, 2006

I would definately say the dentist owns them. Take for instance getting photography shots professionally made -- the photographer owns the shots, not you.

That depends on your contract with the photographer. Some will be happy to sell you the negatives and all rights to the image. Others will just sell you a print. Ask before you buy.
posted by PeterMcDermott at 2:55 AM on February 25, 2006

luriete: Can you copyright your body?

No. It is not an "original work[] of authorship." No one (or no one cognizable for legal purposes) made choices about how to arrange your body to express an idea. You could copyright parts of your body that you did arrange expressively, such as tattoos or similarly complex body modifications. The body itself is not copyrightable.

The only copyrightable element in the x-rays is the photographer's choice of how to arrange the subject, the x-ray machine, and the film. Since those choices are basically dictated by the functional requirements of a particular type of x-ray, it seems very unlikely that the x-rays would be copyrightable by anyone. (If the dentist took the x-rays, he would be the default copyright holder if there were a copyright, unless you had some other arrangement with him.) It is possible that some x-rays would contain the necessary originality (interesting angles, development techniques, choices of subjects, etc.) but for a day-to-day garden variety x-ray, it seems unlikely.

Whatever rights the patient and dentist have in these x-rays come from some place other than copyright.
posted by grimmelm at 7:08 PM on February 25, 2006