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The State

The fundamental legal relationship is between the physician and the state and federal governments. In the United States, most of the law governing medical practice, exclusive of payment issues, is state law. The legal status of physicians is created by state law. (In contrast, the licensing of pilots is a creature of federal law.) It is the state laws that allow the practice of medicine and restrict it to physicians. While this monopoly is frequently taken for granted, there is no legal principle that would prevent a state from allowing a nurse or a layperson to practice medicine.

The physician owes the state certain duties in return for the right to practice medicine: the duty to protect the public health, the duty to practice competently, the duty to practice within the constraints established by the state laws, and the duty to help ensure that other physicians maintain proper standards of medical practice.


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