Medical Care Law

Chapter 8 - The Physician-Patient Relationship

Highlights

The law of all health care practitioner-patient relationships is based on the physician- patient relationship.

The core of the physician-patient relationship is the exercise of medical judgment.

Consultants also have a legal relationship with patients.

Good Samaritan laws protect physicians who stop at accidents.

Contracts with health plans restrict the health care practitioner's right to choose the patients they will treat.

Introduction

Managed Care And The Professional Relationship

Establishing The Relationship

Explicitly Accepting the Patient

Exercising Independent Medical Judgment

Telephone Calls

Private Office Walk-In Patients

Informal Consultations

Financial Considerations

Assisting at Accidents

Good Samaritan Laws

Emergency Care in the Office

Referral And Consultation

Obtaining a Consultation

Requesting a Consultation

Patient Choice

Using Consultants Properly

Documenting a Consultation

Referral

Duty To Refer

Duty To Refer to a Nonphysician

Referring to Institutions

The Duty To Find Care

Continuing Care

Liability for Improperly Managed Referrals

Being a Consultant

The Consultant-Patient Relationship

Tests and Procedures

Informing the Patient

Recordkeeping

Public Duties

Institutional Consultants

Radiology

Pathologists

Cardiology

Limited Duty Relationships

Specialty Care

The Treating Specialist

Occupational Physician-Patient Relationship

Contractual And Statutory Duties To Treat

Emergency Medical Treatment and Active Labor Act

Americans with Disabilities Act

MCOs

Expectation Of Continued Treatment

Terminating The Relationship

Abandoning Patients

Patient-Initiated Terminations

Physician-Initiated Termination of Care

Documenting The Termination

Telemedicine And Internet Medicine

Traditional Electronic Physician-Patient Relationships

Licensure Issues

Interstate Enforcement Issues

Trade Regulation Issues

Practicing Telemedicine

The Telemedicine Physician-Patient Relationship

Being the Local Contact

Being the Remote Consultant

References

Suggested Readings

General

Telemedicine