cptnoid said:
A physician can not easily terminate a physician-patient relationship by just saying good-bye. Supposedly written notification and 30 day period must be given during which emergency care must be provided. By your reply I must surmise that only until the physician has examined, and rendered a diagnosis/treatment that a physician-patient relationship exists. Short of that telling the patient good-bye at any point prior would not establish a relationship or liability for malpractice.
My response:
As soon as the doctor goes into the examination room, the relationship begins. However, the presumption is being made by me that the patient's ability pay has already been determined before the patient even goes into the examination room; e.g., cash for the visit prior to going into the examination room has been paid in full, or confirmation of the patient's insurance coverage has been made.
If the patient hasn't paid cash, or has no insurance, the doctor can walk up to the counter where the potential patient is located, and if need be, tell the patient that he can't see him/her without payment being made and paid now, or guaranteed through insurance. At that point, no physician/patient relationship has been created. All that's gone on up to this point is "business" and whether the doctor wishes to enter into a contractual, business, relationship or not. This part has nothing to do with medicine or the practice of medicine. It has only to do with "money".
IAAL