NHS Scotland mailed households explaining its emergency care summary (ECS) and telling patients how to opt out of having their data available for download outside their GP practice.
As a result, 646 patients out of a population of five million (0.01 per cent) have refused consent for data extraction.
But when Wigtown GPs Dr Gordon Baird and Dr Mary Donnelly sent a personal letter to their 1,710 patients explaining the data extraction process and asking the same question, 326 - 19 per cent - withheld consent.
The Wigtown refusal rate is more than 1,500 times higher than in the whole of Scotland.
'We have misgivings about the consent process being adequate,' Dr Baird said.
'This is personal information and it's precious to people. They have a right to refuse and we have a duty to protect that right.
'The high refusal rate may be a rural phenomenon,' he added. 'In a rural area the chance of someone you know treating you and finding out about your medical history is much higher.'
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