Should You Give Informal Medical Advice?

Here's a familiar scenario: You're at a dinner party or a community meeting
and an acquaintance walks over to you and asks you to take a look at a
bothersome rash, or wants to know whether the headaches he's been
experiencing are anything to worry about. You wonder: (1) should you offer a
professional opinion? and (2) could you be held liable if the advice is
wrong?
The answer to question 1 is, only if you proceed very carefully and follow
the guidelines listed below. The answer to question 2 is, Yes, you could be
held liable. Once medical advice is proffered whether in the office, over
the e-mail/phone, or in a friend's dining room, a doctor-patient
relationship is established, as is a duty of care. That duty is what makes
you a potential defendant.
The second element in a malpractice case is departure from the standard of
care, which requires you to act as a "reasonable physician in your
specialty." The standard of care rule applies whether the advice is formal
or informal, and whether or not you charge a fee. (Standard of care criteria
are less stringent if you're acting as a Good Samaritan. But even then you
have to be careful not to leave the patient in worse condition than you
found him.)
If you think a friend or relative won't sue you, think again. Court records
are full of such cases. To reduce the likelihood that a casual request for
medical help will come back to bite you:
* Treat relatives and friends who need clinical advice with the same
professional expertise and judgment as any other patient. That is, use
similar diligence, knowledge, and research.
* Document the encounter. If a record doesn't already exist, create one. In
most medical liability lawsuits, a complete medical record is your best
defense. You'll also need a record of your actions if the friend or relative
complains to your licensing board.
* Ask the person to come to your office if you need to review records or
examine him/her.
* If you agree to supply a second opinion, first get a compliant request to
obtain, review, and evaluate records of prior treating physicians.
To bill or not to bill? That's up to you. If you want to waive payment as a
gesture of friendship, fine. But most patients who are covered by health
plans will be happy to give you their insurance information.
If you're not comfortable with the idea of treating acquaintances or friends
due to social, financial, liability, and other considerations, you might
consider drafting an office policy that all people whom you know socially
must be treated by other members of your group. Practitioners can tell
informal advice seekers that they'll be glad to recommend physicians in the
community. This is especially wise if the query is outside your area of
specialization. [ME]