The concern is not limited to access of the full records. The concern extends to any incidental expression of identifiers, especially those sent via insecure side channels such as SMS or email.

In most cases this forms a compliance matter rather than an open attack vector, but it nevertheless remains that one has to answer any question along the lines "did you minimise the privacy surface?" in the negative, or at least, with a caveat.

And that’s why some people are rabid about “no SELECT *”.

Email is not secure but sending an email with a link to "Information about your appointment" is fine. If that link goes to `/appointments/sjdhfaskfhjaksdjf`, there is no leaked data. If it goes to `/appointments/20251017lkafjdslfjalsdkjfa`, then the link itself contains PHI.

Whether creation date is PHI…I could see the argument being yes, since it correlates to medical information (when someone sought treatment, which could be when symptoms present.)