Legal Relationship of the Patient and Physician

A patient’s relationship with her physician is complex, not only from the standpoint of her health care but also in the many legal implications that arise from such a relationship. A person who seeks care from a licensed professional is entering a contract with that professional. Once a relationship between the patient and the physician is established, the parties have entered a contract. The contract is the agreement by the physician to provide services and the patient to pay for services, either out of her own pocket or by using a third-party payor (health insurance). Failure of either party to abide by the contract is a breach of contract. The patient must pay for services, and the physician must provide services. In addition, if the physician fails to attempt to provide continuous health care to a patient, such as by moving to another city or retiring without forwarding medical records, such an action is considered abandonment and is a form of breach of contract. Because medical care of patients must be continuous, it is the responsibility of a physician to provide care or offer an alternative, such as forwarding medical records to another physician.To enter a contract, individuals must be competent adults or emancipated minors. Minors can enjoy the same rights and responsibilities as adults, including being responsible for their own debts if declared independent by a court. Teenagers who are married or parents commonly can become emancipated minors and, therefore, enter into contracts. In such situations, responsibility to pay for services is that of the minor, not a parent or guardian.
It is the responsibility of everyone in the physician’s office to follow legal and ethical principles that safeguard a patient’s privacy and physical safety and keep a patient informed regarding her health care. The medical assistant acts as an agent of the physician by representing in actions and words the intention of the physician. Recognition of the physician’s responsibility to supervise her medical assistants is called respondeat superior. This Latin phrase translates to “let the master answer,” which means that if a medical assistant injures a patient, it is the responsibility of the physician to make restitution, or monetary compensation for the injury. Respondeat superior is a form of vicarious liability, in which the employer is responsible for the actions of an employee. For example, if a bus is in an accident, injured passengers seek restitution from the bus company, not the individual driving the bus. Although responsible for her actions as a professional, a medical assistant who accidentally injures a patient is not the liable party—the supervising physician is.

Medical Practice Act

As an agent of the physician, the medical assistant must act within the laws of the state when performing health care procedures, maintaining medical records, and disclosing personal medical information to third parties for treatment, payment, or operations. All 50 states have a Medical Practice Act, which is a statute, or law, that regulates the practice of medicine. Failure to follow her state’s Medical Practice Act can result in the medical assistant committing a tort. A tort is a wrongful act for which a patient can request compensation or other legal remedies (but does not involve a breach of contract). Harm associated with a tort commonly results in a lawsuit. Although harm caused to the patient may be unintentional, penalties can be severe and can range from suspension or revocation of a physician’s license, monetary fines, or imprisonment for more serious violations. Following legal and ethical standards of care protects the medical assistant and the physician as well as the patient.