Legally, a physician–patient relationship is formed when the physician exercises
independent medical judgment on the patient’s behalf.
judgment is a vague term that is defined by the facts of the given situation. It
may involve making a diagnosis, recommending treatment, or implying that no
treatment is necessary. As a legal concept, the key is reliance: Did the patient
reasonably rely on the physician’s judgment?
A physician may exercise independent medical judgment explicitly or implicitly.
A physician who evaluates a patient and establishes a differential diagnosis
recognizes that he or she has exercised independent medical judgment. Legal
problems usually arise from the implicit exercise of medical judgment. If a
physician is not aware of initiating a physician–patient relationship, he or she
may injure the patient through inattention. The implicit exercise of medical
judgment is best understood through a discussion of common practice
situations in which medical judgment is at issue. Since telephone calls pose the
most difficult problems in determining whether a physician– patient
relationship has been formed, they serve as a useful model to discuss these