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April 21, 2008

When does a consultant become "your" doctor?

In Bacon v. Martin, et al., the Court of Appeals was forced to address this question and not for the first time.  It concluded that no doctor-patient relationship was created by the entry of an order for consultation, followed by a telephone conference between physicians.

In this and several prior cases, the Michigan courts have held that a doctor does not assume any responsibility to a patient, merely because the treating doctor calls and asks for advice.  In this situation, the sole responsibility for adequate care lies with the treater; by the same token, he or she has not complied with the standard of care if the standard of care requires a formal consultation with another specialist.  In short, the consulting specialist must actually become involved in the patient's care in a documented fashion and will not be held responsible for giving "off the cuff" advice to a treater.  While this rule makes sense, generally, it can lead to problems if the informal advice enables a treater to provide care that he is not competent to manage--and which should be provided through a formal consultation with the appropriate specialist.

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