Malpractice Consult

December 2, 2005

Liability for referrals

Q. An orthopedist I often refer patients to is very slow in sending me reports afterward. He typically follows a patient for many months without keeping me informed at all about the person's progress. What should I do?

Explain to him that it's a potential liability for both of you if he fails to keep you informed about the treatment, medications, or recommendations he provides for your patients. Point out that your ability to communicate with and treat your patients depends on getting such information from him in a timely manner, and that not having it can create a danger for them.

Q. When a patient asks me to refer him to a specialist I don't think is competent, what should I do? Can I insist that the patient see the one I prefer?

A. No. A patient has a perfect right to choose any physician he wants. If you disagree with his choice, you can explain why you prefer a different special-ist-without criticizing the one he wants or saying why you don't trust him. You might suggest that the patient compare the two specialists using criteria such as their experience with the specific procedure or condition involved, their academic affiliations, and their board certification. (Explain what that means, if necessary.)

Q. A specialist I often refer patients to always sends me lengthy reports of his exams. But instead of signing them, he rubber stamps them, "Dictated, but not read." Is that a liability problem?

A. It may be for the specialist, but not necessarily for you. This type of disclaimer doesn't protect the specialist if his report contains errors that result in an injury to the patient. A misstated lab result, exam finding, or medication recommendation could be a disaster in court, however, since that "dictated but not read" disclaimer could be cited as evidence of his haste or inattention. On the other hand, the plaintiff's attorney might ask you, "Why did you rely on a report you knew might be inaccurate?"

Physicians are responsible for the accuracy of their dictated reports-whether they review them or not. That's why you should always review them for errors or omissions. Malpractice carriers cite examples of cases that ended with big judgments for the plaintiffs because of undetected transcription errors.

The author is a risk management and loss prevention consultant in Cloverdale, CA. He can be reached by e-mail at lossprevention@earthlink.net
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This department answers common professional liability questions. It isn't intended to provide specific legal advice. If you have a question, please submit it to Malpractice Consult, Medical Economics, 5 Paragon Drive, Montvale, NJ 07645-1742. You may also fax your question to 973-847-5390 or e-mail it to memalp@advanstar.com
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