When Is a Patient-Physician Relationship Established?

The patient-physician relationship is often termed as a fiduciary relationship, which means it is based on mutual trust and confidence.

It is established by the mutual consent of both parties. Though some attorneys believe that relationship is formally established as soon as the name of the patient is entered in the appointment book following a telephonic conversation, a vast majority opines that it isn’t usually sufficient to form the relationship.

Generally, the duties created by the relationship arise when a physician accepts a patient, undertake to examine, diagnose, or treat him/her or agrees to do so.

When a physician grants an appointment to the patient for a specific consultation treatment, procedure within his/her area of expertise, the duties created by the relationship may arise even before their first meeting. However, if upon seeing and examining the patient, the physician believes that the proposed treatment is beyond his/her area of expertise, he/she should refer the patient to a concerned healthcare professional who can provide the treatment. Once the treatment begins, a relationship is established and abandoning the patient without providing him/her sufficient time to find a qualified provider may land in the physician in legal trouble.

Duties Created by the Relationship

Once the physician and patient formally enter into a relationship, a legal contract is created in which both physician and patient are obligated to perform some duties.

According to the American Medical Association, the physician owes the patient a duty to

  • Maintain confidentiality of patient’s private information
  • Obtain the patient’s consent before providing his/her confidential information to a third party.
  • Inform patients the truth about their diseases or conditions. (Exceptions are allowed in cases where the physician believes that the truth may be medically or emotionally harmful to the patient

Following the establishment of a relationship, the physician is obliged to either continue care for the patient or properly terminate the relationship. As a result of the breach of his/her legal duties created by the relationship, the physician may be sued by the patient for medical malpractice.

Under the relationship, the patient is obliged to

  • Provide his/her medical history to the physician
  • Follow the treatment plans developed by the physician.
  • Meet all the financial obligations

Termination of Relationship

Once the patient-physician relationship is formed, it continues to exist until it is terminated with the consent of both the involved parties, the physician is dismissed by the patient for any reason, the physician ends the relationship while providing patient adequate time to find alternative care, or the patient no longer needs physician’s services.

Conclusion        

The patient-physician relationship  is comprised of four elements – trust, knowledge, loyalty, and regard. It obligates the physician’s to place the welfare of the patient above his/her interest, to make a medical decision on behalf of the patient and take all necessary steps to ensure the patient’s welfare.  

In other words, the patient-physician relationship defines ethical and legal standards for the physician’s duties on his/her handling of the patient.

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