Case and Commentary
Jan 2005
A. Scheduling a follow-up appointment within two weeks to answer the patient's questions is the preferable option and is supported by Opinion 10.01 "Fundamental Elements of the Patient-Physician Relationship" that describes the relationship as a "collaborative" one in which the physician provides "information and guidance…with courtesy, respect, responsiveness and timely attention….
B. Dr. Stevens should avoid making adherence to treatment a condition for Mr. Jones's access to his physician. Opinion 10.01, "Fundamental Elements of the Patient-Physician Relationship" (2) states that the patient "has the right to make decisions regarding the health care that is recommended by his or her physician." To refuse Mr. Jones access implies that his right to health care depends on his adherence to Dr. Stevens' advice.
C. Asking Mr. Jones to wait three months to address his concerns should be avoided. Mr. Jones's telephone calls fall within the accepted behavior of one who is in the role of patient, eg, bringing medical concerns to the doctor who assesses the concerns, provides information to the patient and, if necessary, determines a medically appropriate treatment plan in collaboration with the patient. Opinion 10.01, "Fundamentals of the Patient-Physician Relationship," (1) speaks to the patient's right "to receive information… and guidance…as to the optimal course of action." In addition, failing to respond ignores the patient's "right to courtesy, respect, dignity, responsiveness, and timely attention to his or her needs."
D. Referring Mr. Jones to a diabetes educator is acceptable under Opinions 3.03, "Allied Health Professionals" and 3.04, "Referral of Patients," which affirm that physicians often work "in concert with allied health professionals." The principles that govern this collaboration assert that the referral must be made for the good of the patient and must be to an allied professional with appropriate training and licensing for his or her specific practice. The primary care physician has the obligation to cooperate with other providers in order to maintain the patient's "right to continuity of health care."
