Little has been written about physicians' attitudes toward patient record requests. We had predicted that physicians would not welcome such requests and would respond to them defensively. Of the 280 physicians at a university affiliated medical center included in this study, 67 per cent thought that patients were motivated to ask for their hospital charts because they wanted more information or further treatment. Only 16 per cent of the physicians said that the requests were prompted by litigious motives, and 23 per cent thought that they came from the need to obtain secondary gain. A majority of the physicians, 62 per cent, viewed the requests as an opportunity to treat or educate, but 83 per cent felt that reading the hospital record could be harmful to patients. The financial and interpersonal aspects of patient education through a response to chart requests are discussed in the final section of this article.