Public Health Law Map - Beta 5 - Medical and Public Health Law Site

disagreement and the options for care.
Patients retain the right to choose their physicians and their care. In some cases, the
patient will choose to follow the advice of the attending physician. If so, the
consultant should document any disagreements and the patient’s choice and then
formally withdraw from the case if the disagreements are important enough to
warrant this decision. With a hospitalized patient, the consultant should file an
incident report if he or she believes the patient is at risk. If the patient chooses to
follow the advice of the consultant, the consultant should be prepared to act as
attending physician for the patient. If the consultant cannot act as attending
physician, both physicians should be ready to assist the patient in finding another
physician who meets the patient’s needs. Neither physician should abandon the
patient.
d) Recordkeeping
Consultants are held to the same standards for recordkeeping as attending
physicians. All pertinent information—history, physical findings, consent, test
results, and contacts with the patient—should be reflected in the chart. In addition,
the consultant should provide a written consultation report to the attending
physician. The consultant’s report should be complete and understandable and
avoid the use of abbreviations and specialty jargon. A PPD, for example, is an
intradermal test for tuberculosis infection to an infectious disease physician, but
postpartum depression to a psychiatrist. Distinguishing the two is very important in
a postpartum patient suffering from fatigue. Consultants create unnecessary legal
liability when their recommendations are not clear and understandable.
e) Public Duties
The practice of medicine encompasses specific duties to the public and society.
These duties apply to all physicians, attending and consulting. Every jurisdiction in
the United States requires the reporting of certain infectious diseases and certain
types of injury that may result from a criminal act. A radiologist who sees
suspicious injuries on a child’s X ray has the duty to report these findings to the
child protection agency. The consultant’s duty to report is independent of previous
reports by the attending physician. The consultant should not be a party to any
agreements by the attending physician not to comply with the reporting laws.
4. Institutional Consultants
Physicians whose specialty requires a hospital- based practice are often practicing as
consultants without realizing it. The contracts under which they practice in the
hospital make them formal consultants for most of the patients admitted. The
consultations are done as a matter of routine, often without the patient and physician
ever seeing one another. Nevertheless, the consultations and the accompanying
charges for service establish a physician–patient relationship, with all its
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