Creation of the Physician-Patient Relationship

December 1, 2010, 10:10 AM

The Supreme Court of Virginia has addressed what is required to give rise to a physician-patient relationship. In one case, the issue was whether an on-call attending physician at a teaching hospital owed a duty of care to a patient, based on the physician-patient relationship, where there was no direct contact with or consultation about the patient. While on-call, the physician was not physically present at the hospital, but she was available to answer questions for treating residents and interns. The patient was admitted to the hospital and treated while the physician was on-call. However, the physician was never consulted or called about the patient. After being released, the patient was readmitted the following day and for the first time saw the physician. The patient ultimately died, and the patients estate alleged that the attending physician was on-call and therefore had a duty to supervise and was responsible for medical care given while she was on-call.

The Court concluded that absent a specific agreement, there is no duty imposed upon an on-call physician unless the physician accepts the patient, consults with a physician about the patient, or is summoned for consultation or treatment. The Court noted that direct treatment is not necessarily a prerequisite to the creation of a physician-patient relationship. However, evidence that an on-call physician (in a teaching hospital) has accepted responsibility for a patients treatment in some way is necessary. In applying these principals, the Court determined that the on-call physician had not accepted responsibility for the patients care. Principally, the Court relied on the following factors in making its determination:

  1. The physician did not treat the patient.
  2. The physician did not participate in any way in treatment decisions for the patient.
  3. The physician was not consulted by any other physician regarding the patients condition.

The Court did not show a willingness to find a physician-patient relationship without some active participation by the physician in the patients diagnosis or treatment. Even a physicians status as on-call in a quasi-supervisory role does not create the duty based upon a physician-patient relationship, absent the physicians active participation in treatment or diagnosis.

This discussion is simply one example of how little is required to create a physician-patient relationship. Importantly, simply being on-call is not enough. In the next post, I will discuss how one appointment can also give rise to a physician-patient relationship. - Mary Beth Sherwin