Image authorization for the chart only: how to explain it
Almost every image conflict in a practice starts with a simple mix-up: the patient thought the photo was for the chart and it showed up in a post. Or the professional took "you may photograph" to mean "you may use it however you like". The way out is to name the two purposes at the very start and show that the clinical photo has a narrow purpose.
What is the clinical chart photo?
It is the standardized record of the face, made to document the starting state, plan the procedure and compare progress. It has controlled light, distance and expression, and the standard is in standardized clinical photography. It is part of the patient record, has restricted access and a retention period set by the rules that apply to your professional registration.
The promotional photo is something else: it thinks about audience, narrative and public. It requires its own consent, as in image authorization for promotion.
| Feature | Clinical photo (chart) | Promotional photo |
|---|---|---|
| Purpose | Document and follow the case | Show the work to an audience |
| Who sees it | Team involved in the care | Anyone, within the limits of the channel |
| Consent | Explanation and record of clinical use | Specific written authorization |
| Can it be refused? | Yes, with a discussion of the impact | Always, with no consequences |
| Period | Per chart retention | Set in the document, with revocation |
| Editing | None | Only what is planned and authorized |
How to explain it in 30 seconds?
This sentence settles three things at once: it defines the purpose, closes the door to a parallel use and anticipates respect for a future refusal.
What to record?
Practical tip: include an "authorizes promotion? yes / no" field, but in a document separate from the procedure's informed consent. When both are on the same paper, the patient signs "the package" and the freedom of the consent becomes questionable. The image use consent template separates the purposes and can be a starting point, always with legal review.
Can I send the patient's photo by WhatsApp?
This is where data leaks most. Sending the clinical photo to a personal device, a group or a colleague without clinical need goes beyond the original purpose. If you need to discuss a case with another professional, tell the patient, send the minimum necessary and, preferably, through a secure channel. The LGPD (Brazil's data protection law) treats health images as sensitive data. See the summary in consent and LGPD for photos.
What if the patient asks: "Can I have a copy?"
Generally yes: the patient has the right to access information in their own chart, within what the applicable rules provide. Agree on the channel and the deadline, and record the delivery. For the specific case of patients asking for their own photos, see patient who asks for their own photos.
How does Harmy fit in here?
The frontal photo used in Harmy is also patient data. It is sent to a third-party AI to generate the projection, with the professional's consent in the app, and the face contours are calculated on the device and are not stored. When explaining the chart, take the chance to say that the projection is a conversation tool, not a promotional one. The simulation is illustrative and does not promise results.
By explaining the difference well, the patient understands that your care with their image is part of caring for them, and that usually increases trust rather than reducing it. And if the promotion conversation never happens, that is fine: the clinical photo did its job.
How long to keep it and how to discard?
The retention period for the chart, and for the photos that are part of it, follows the rules that apply to your professional registration, and may differ between councils. Instead of memorizing a number, write into your workflow: who is responsible for retention, where the file is kept, how backup is done and how disposal is recorded when the period ends. Confirm the exact period with your council or legal advisor.
When the patient asks to delete the photos before the period ends, the answer is not automatic: the chart has its own requirements, and the request may be met only in part. Explain this calmly, instead of just saying "I can't". The case is covered in patient asks to delete the photos.
What to do when the patient asks about future use of the photo?
Answer with the rule from the start: the clinical photo stays in the chart and only changes purpose with new consent. If the practice changes its policy (for example, moving to a new storage system), tell patients and update the document. Transparency about the image's path is what sustains trust over the years.
Frequently asked questions
Does a chart photo need the patient's authorization?
A clinical photo is a health record and must be explained to the patient and documented. The exact form of consent and the retention period follow your council's rules and the LGPD, so align it with your legal advisor.
Can I later use the chart photo for promotion?
Not without a specific promotion authorization. The original purpose is clinical, and using the image for another purpose requires new consent.
Can the patient refuse the chart photo?
They can refuse, and you decide whether you can manage the case without it. The refusal and the conversation should be in the chart.
Who has access to the chart photos?
Only those involved in the care, with controlled access. The patient should know where the image is stored and how to ask for a copy.
Harmy images are illustrative simulations generated by AI from the patient's photo to support the conversation between practitioner and patient. They are not a promise of results. Indication, technique, product and volume are solely the decision of the licensed practitioner. This content is for information only and does not replace a clinical assessment.