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Can a physician, who does not intend to accept a patient, be responsible for adverse outcomes?
Ordinarily, a clinician can decline to treat a patient because a physician-patient relationship is consensual. If the patient reasonably believes, however, that an examination was for therapeutic purpose, the establishment of a physician-patient relationship could be implied.
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A patient was being treated for a leg injury at a university-affiliated hospital. A staff clinician, who was at the clinic seeking case histories to present at a teaching conference, noticed that a resident clinician was examining the patient's leg for treatment. The staff clinician stopped to look at the patient's leg and remarked to the resident clinician that it looked as if the leg should be amputated. He then went on his way. He did not use the patient in his lecture and never saw the patient again. Subsequently the patient's leg was amputated. The patient sued several physicians, including the clinical professor, for negligence over the consultation that resulted in the amputation of his leg. The staff clinician contended that he did not have a duty to the patient because a physician-patient relationship had not been formed and he had never intended to treat the patient.
The clinician did not treat, nor did he intend to treat, the patient. In addition, he was not the supervisor of the resident treating the patient. The patient, however, might have reason to believe that the resident referred to the clinical judgment of the staff physician, and that the physician's comments were intended to benefit the patient. Therefore, it is important for a clinician to clearly define his or her role, relationship, and responsibility at the beginning of any given case.
The staff physician is liable because he did not clearly define his role.
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