HIGHLIGHTS
Medical care practitioners have many legal relationships.
The attorney–client relationship is fundamentally different from the
physician–patient relationship.
Few attorneys are experts in all aspects of medical care law.
Medical care practitioners must learn to be active participants in
managing their own legal problems.
Legal clients must request preventive law if they want more than
symptomatic treatment for their legal problems.
Introduction
Medicine and law are uncomfortable bedfellows. Traditionally, it was the
acrimonious nature of medical malpractice litigation that shaped the views of
medical care practitioners toward law and lawyers. Now this is mixed with the
hostility they feel toward government agency regulators who are often seen as
making reimbursement and facility management overly complex. More
fundamentally, the professions are similar in that both deal with intensely
personal and life-affecting matters, but very different in their professional
paradigms. This leads to tension whenever they come into conflict, and requires
considerable effort for medical care practitioners and attorneys to work
together. The result of this uneasy relationship is that medical care
practitioners do not make effective use of legal services and take unnecessary
legal risks. On the legal side, attorneys often give advice that does not
properly address the special nature of medical practice.
Medical care practitioners must understand the basics of the law if they are to
avoid legal problems. They do not need to become lawyers, or to understand
the law in the same way that lawyers understand the law. In some narrow
areas, such as Medicare reimbursement, they must know more law than all but
the most specialized medical care lawyers do. In most areas, medical care
practitioners just need a well- informed layperson’s knowledge of the law as it
regards medical practice in general and their practice area in specific. The goal
is not to have medical care practitioners act as lawyers. They should be able to
recognize when there is a potential legal problem and whether they need
expert legal advice to manage the problem.
This section introduces the basic legal relationships involved with providing
medical care services. These are important to understanding the subsequent
materials because legal rights and duties depend on the context of the legal
relationship between the parties. For example, the legal relationship between a
physician and a nurse depends on whether the physician employs the nurse,
whether the physician and the nurse are employed by the same corporation,
whether they have separate employers, and, if so, on the legal relationships
between their employers.
Medical care practitioners must also understand how to work with lawyers. As
professions, law and medicine share many characteristics: the expectation of
confidentiality; a fiduciary duty to put the client/patient’s interests first; and a
concern with matters of great personal and societal importance. The
professional norms of law and medicine are very different, however, and health
care practitioners must understand this difference if they are to work
successfully with lawyers.