For most of the history of American medicine the record belonged, practically speaking, to whoever held the filing cabinet. This article explains how that changed, first through a federal access right that most patients still do not know they have, and then through a statutory prohibition on interfering with the flow of electronic health information. It covers what a patient may demand, in what format, how fast, and for what fee, and what happens when the request is refused. It then covers the information blocking framework: who it applies to, what counts as blocking, and the eight exceptions that do the real work. It closes with the confidentiality regimes that overlay the access right, the practical failure modes on both sides, and how a records dispute is actually resolved.