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What is and is NOT the medical record?

  We have an interesting debate raging here: 
  Are tissue samples, x-rays, fetal monitor strips, ultrasound videotapes and
  the like which are external to the "medical record proper," but which contain
  information about the patient and the patient's treatment, part of the
  "medical record"?  If not, who has the right to say what will happen with
  them and who can have access to them?
  The research I've conducted so far has led to conflicting conclusions, and I
  wanted to know if anyone else has thought about it.