Accepting patients

What is the name of your state? Michigan

Does a doctor have an obligation to treat a patient once an appointment is scheduled or may the doctor refuse to treat/examine the patient once they arrive at the office but before being seen?

cptnoid said:

What is the name of your state? Michigan

Does a doctor have an obligation to treat a patient once an appointment is scheduled or may the doctor refuse to treat/examine the patient once they arrive at the office but before being seen?

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My response:

Where are you getting the idea that a doctor must treat a potential patient? The only time a doctor MUST treat a patient is when the patient is in immediate danger of death; i.e., only obligation is to stabilize the patient, and transport to a hospital.

But, if you're not in danger of immediate death, and have no money or insurance, it's "out the door" you go!

IAAL

Accepting when is it binding?

It strikes me that scheduling a patient for a visit (on a computer system so documentation is present) may in part establish a physician-patient relationship. Or I guess my question could be when do you establish that relationship -- walking in the office, after filling out the patient medical history questioner, after being seated in the exam room and talking with the medical assistant, or only after talking with the doctor?

cptnoid said:

It strikes me that scheduling a patient for a visit (on a computer system so documentation is present) may in part establish a physician-patient relationship. Or I guess my question could be when do you establish that relationship -- walking in the office, after filling out the patient medical history questioner, after being seated in the exam room and talking with the medical assistant, or only after talking with the doctor?

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My response:

What does filling out papers or sitting in the waiting area, or in the examination room, have to do with physician/patient relationship? The answer is nothing. The "relationship", whether it began or not, can end just as quickly as it began; e.g., all the doctor needs to say, "Ms. Jones, if you have no money to pay for my services, then I must ask you to leave."

The paperwork is a mere formality in terms of knowing the type of problem and the historical background of the potential patient. It's not a "ticket to free services".

No money? The "relationship" ends. PERIOD.

IAAL

I am unsure then

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.

I am not a lawyer, and am not from Michigan, but I do work for a doctor...regardless of appointment , paperwork, or even ability to pay, we have the discretion to accept a patient or not - there are so many variables - I am very curious to know the circumstances surrounding this 'incident"....shoot even MacDonalds reserves the right to refuse service...even if you order a Big Mac!

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.

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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

we have also refused "service" to people who have decided they do not need to fill out the appropriate paperwork, have been abusive towards the staff, who have made appointments under false pretences, or even do not have all their insurance or claim information in order. Of course the bottom line is we want to make sure we will be paid for our services. One cannot expect to go to the grocery store and say hey - I'll catch ya later on that bill.....why pepole think they can do that at a doctor's office is beyond me. Anyway just my 2 cents!