A contract is a binding agreement between two or more persons. A physician has a legal obligation, or duty, to care for a patient under the principles of contract law. The agreement must be between competent persons to do or not to do something lawful in exchange for a payment. A contract exists when the patient arrives for treatment and the physician accepts the patient by providing treatment. An example of a valid contract occurs when a patient calls the office or clinic to make an appointment for an annual physical examination. Assuming both physician and patient are competent and that the physician performs the lawful act of the physical examination and the patient pays a fee, all aspects of the contract exist.
There are two types of contracts, expressed and implied. An expressed contract can be written or verbal and will specifically describe what each party in the contract will do. A written contract requires that all necessary aspects of the agreement be in writing. An implied contract is indicated by actions rather than by words. The majority of physician-patient contracts are implied contracts. It is not required that the contract be written to be enforceable as long as all points of the contract exist. An implied contract can exist either by the circumstances of the situation or by the law. When a patient complains of a sore throat and the physician does a throat culture to diagnose and treat the ailment, an implied contract exists by the circumstances. An implied contract by law exists when a patient goes into anaphylactic shock and the physician administers epinephrine to counteract shock symptoms. The law says that the physician did what the patient would have requested had there been an expressed contract.
For a contract to be valid and binding, the parties who enter into it must be competent; therefore, the mentally incompetent, the legally insane, persons under heavy drug or alcohol influences, infants, and some minors cannot enter into a binding contract. Medical assistants are considered agents of the physicians they serve and as such must be cautious that their actions and words may become binding on their physicians. For example, to say that the doctor can cure the patient may cause serious legal problems when in fact a cure may not be possible.
Termination of Contracts:
A broken contract or breach of contract occurs when one of the parties does not meet contractual obligations. A physician is legally bound to treat a patient until:
1) the patient discharges the physician
2) the physician formally withdraws from patient care
3) the patient no longer needs treatment and is formally discharged by the physician