First Appointment May Give Rise to Physician-Patient Relationship

December 3, 2010, 4:06 PM

Although there is no obligation for a physician to accept anyone who seeks his/her services as a patient, once the patient is accepted for an appointment, there is certainly some support for the proposition that a physician-patient relationship has been created, particularly given the patients expectations after scheduling the appointment. Virginia courts will consider whether the patient has entrusted her treatment to the physician and whether the physician has accepted the case. Notably, in one Virginia Supreme Court case, where the defendant granted an appointment at a designated time and place for the performance of a specific medical service within the defendants expertise, the Court found it sufficient to allege a consensual transaction giving rise to a physician-patient relationship and a duty to perform the service contemplated.

By contrast, in another case, even though there was no direct contact with or consultation about the patient between the patient and an on-call attending physician at a teaching hospital, the Court strongly considered whether a physician-patient relationship was created. Ultimately, the Court determined that the on-call attending physician had not accepted responsibility for the patients care given the lack of active participation in the patients treatment or diagnosis.

However, a Court could very well find that an appointment constitutes sufficient participation, giving rise to a physician-patient relationship and associated liability. The physician has a right to withdraw from the relationship, but only if the patient is given a reasonable opportunity to acquire the needed services from another physician. Accordingly, if the physician does not want to accept the patient, he or she should be definitive in the decision and decline any opportunities to become involved in the patients care, keeping in mind any obligations under Emergency Medical Treatment and Active Labor Act (EMTALA) or Medical Staff Bylaws and regulations. --Mary Beth Sherwin