A patient undergoing treatment from a doctor expects that the doctor will maintain good communication with the patient and that the doctor will continue the treatment until it is no longer needed. Failing to do either violates the medical guidelines patient-physician relationship.
Establishing a Patient-Physician Relationship
Doctors are required to follow certain guidelines when treating patients, but usually these guidelines do not begin until the patient and the physician are in an established professional relationship. Doctors cannot be held liable for medical malpractice unless a patient-physician relationship has been established.
Establishing this relationship can be a complex process, but usually the relationship is established when a doctor agrees to treat the patient, including examining the patient or diagnosing the patient. Most doctors are free to choose their patients; they are not legally bound to treat everyone. Once a doctor begins treatment, the patient becomes the doctor's responsibility.
Emergency room doctors face an exception to the rule. Doctors working in ERs are required by the Emergency Medical Treatment and Active Labor Act to treat all patients in emergency health situations. This means that even patients without healthcare or identifying information that need emergent care must be treated at ERs.
Once a physician-patient relationship is established, either may end the relationship, with certain limitations. The patient can freely end the physician's duty, but the physician must follow certain steps to end their duty to the patient including giving the patient enough notice and referring the patient to another doctor if needed.
To prove abandonment, patients need to prove that:
- A doctor-patient relationship existed, and
- Healthcare treatment was unreasonably discontinued, and
- The termination of the treatment was against the patient's wishes or was done without the patient's knowledge, and
- The healthcare provider did not refer the patient to another practitioner or arrange for different appropriate care, and
- It was reasonable to assume that the patient would be harmed by termination of care, and
- The patient suffered an injury as a result of the terminated care.
Doctors and healthcare professionals have a duty to continue to help patients for as long as necessary once a doctor-patient relationship is established.
When Doctors Abandon Patients
Doctors are required to see treatments through until the end unless the doctor is discharged from duty by the patient. Doctors cannot singlehandedly end treatment without proper notice to the patient.
Patient abandonment scenarios include:
- Refused treatment for missed medical bills
- Premature discharge
- Failing to provide care for a patient post-surgery
- Incomplete instructions provided by the doctor when discharging the patient
- Failing to follow up with a patient about important appointments
- Failing to schedule appointments for the patient in a timely manner, allowing the patient's condition to seriously worsen
- Inadequate staffing of a healthcare facility
- Inadvertent abandonment, like forgetting to schedule a follow-up appointment for a patient because the patient was lost in the system due to a computer problem
- Transferring the patient to another doctor without providing all the necessary information to the other doctor
If a patient is abandoned by the doctor and suffers a serious injury, the doctor can be held liable.
Scenarios that are not considered patient abandonment include:
- A doctor properly referring their patient to another doctor with better skills to treat the patient
- Patients violating physician rules or failing to follow physician's recommendations and instructions
- Inappropriate behavior by the patient that results in the physician ending the doctor-patient relationship
When a physician does choose to end the physician-patient relationship, they should continue to treat the patient for a reasonable amount of time to give the patient a chance to find another doctor.
Duty to Communicate
Doctors also have a duty to their patients to communicate with them in a timely manner. Failing to do so could result in injuries to the patients and malpractice charges, including patient abandonment.
Patients need to be able to make educated choices about their health based on information from their doctors. If a doctor orders a diagnostic test that comes back positive but fails to communicate the results to the patient or does so months after the test, the patient can suffer as a result of missed opportunities for treatment or from incorrect treatment paths.
Patients are more than the sum of their illnesses; doctors are required to empower patients to make their own informed decisions about healthcare. Withheld or incomplete information can cause injuries to the patient. For example, a small irregularity on a test may seem scary and serious to a patient, even though the doctor understands that the irregularity is not harmful. Without an explanation from the doctor, the patient might seek treatment that causes more harm than good.
Doctors can provide reasonable communication to patients by:
- Listening to the patient
- Using language the patient can understand (not scientific jargon)
- Verifying that the patient understands the information
- Being available for patient questions
- Showing empathy and compassion for the patient
There is no medical guideline that dictates that doctors cannot use scientific jargon with patients. However, if a doctor explains important follow-up care steps using language the patient does not understand, resulting injuries will be the responsibility of the doctor.
Doctors should put themselves in the patient's positions and think about what the patient needs to know and might want to know, and doctors should always ask patients to confirm they understand important information presented to them.