In Arizona, a “traditional” physician-patient relationship begins when the physician agrees to treat the patient, not upon scheduling an appointment or submitting forms. Most physicians meet, examine, and agree to treat the patient during the first appointment. The formation of a traditional relationship activates the physician’s duty to act reasonably and prudently to protect the patient from harm. This traditional relationship, however, is not the only relationship that activates the duty.
Arizona plaintiffs have successfully demonstrated a “sufficient relationship,” although not necessarily a “traditional” physician-patient relationship, to activate the same duty of care. The facts in cases alleging a duty of care brought about by a “sufficient relationship” include interpreting chest x-rays and performing employee annual physical examinations, life or disability insurance examinations, and independent medical examinations. In those cases, the courts have determined a sufficient relationship triggers the physician’s duty to act reasonably and prudently to protect the patient from harm. This includes notifying the patient and/or referring physician of results requiring follow-up or further treatment but not providing actual care and treatment. “Sufficient relationships” might even include informal opinions or curbside consults.
Consider defining patient relationships and clarifying your duty:
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- Classifying patients as prospective/pending new, active/current, and inactive
- Storing prospective/pending new patient records separately from active/current and inactive patient records
- Converting prospective/pending new patients and records to active/current patients and records once the physician agrees to treat
- Including notice and disclaimers on forms or in the patient portal notice or informed consent that:
- submission of a form or information does not establish a physician-patient relationship
- the physician will not review the form before the prospective patient’s first appointment
- prospective patient forms and information are maintained and destroyed in accordance with the practice’s record retention and destruction policy and applicable laws and regulations
- prospective patients who do not reschedule missed appointments within a reasonable
- Documenting communication of results to a referring physician and/or patient
The content of this publication or presentation is intended for educational purposes only; is not an official position statement of Mutual Insurance Company of Arizona (MICA); and should not be considered or relied upon as professional, medical, or legal advice or as a substitute for your professional judgment. Consult your attorney about your individual situation and the applicable laws. The authors, presenters, and editors made a reasonable effort to ensure the accuracy of the information at the time of publication or presentation but do not warrant or guarantee accuracy, completeness, or currency of such information. As medical and legal information is constantly changing and evolving, check for updated information and consult your attorney before making decisions.