Maintaining Professional Patient Relationships

The physician-patient relationship plays a central role in medical care. The American Medical Association’s Code of Medical Ethics describes the practice of medicine and related clinical encounters as “fundamentally a moral activity that arises from the imperative to care for patients and to alleviate suffering.” In simple terms, it explains that a physician-patient relationship exists when a physician serves a patient’s medical needs. The AMA further explains that the relationship is built on trust and the physician’s responsibility to use sound medical judgment and prioritize and advocate for patient welfare.

To promote stronger physician-patient relationships, the American Academy of Family Physicians Division of Medical Education recommends that providers:

• demonstrate empathy;
• ask about other treatments the patient may be using;
• discuss lifestyle issues;
• provide clear instructions; and
• give special attention to difficult patient encounters.

Although the definition of the physician-patient relationship and the associated responsibilities sound straightforward, the manner in which these interactions play out in clinical settings and beyond are often far more complex.

For example, physicians are often asked by close friends, relatives or colleagues for medical advice, treatment, or prescriptions both inside and outside of the office. Although the American Medical Association advises against this (except in emergency situations or when there is no other alternative), the practice continues to occur and poses unique liability risks. Over the years, we’ve seen a number of lawsuits related to such issues, and defense is often hampered by sparse or nonexistent medical records. See our recommendations for treating patients with whom you have a close relationship.

In today’s digital age, the physician-patient relationship can also be affected by virtual encounters. Healthcare providers often use websites and social media platforms to inform the public of their services and promote engagement. However, these interactions are not always positive and sometimes include negative online reviews or complaints. When this arises, healthcare providers must keep privacy rules in mind and be aware that direct responses may risk disclosure of protected health information. These tips will help you successfully and appropriately respond to negative online reviews.

At times, it may also be necessary to discontinue patient relationships. A physician may choose to do this for a variety of reasons, including non-compliance with treatment, failing to keep appointments or inappropriate behavior. However, properly discharging a patient from care can be complex. To avoid allegations of abandonment, providers should consider establishing a formal process for discharge. See more of our recommendations here.

MLMIC’s Risk Management Consultants are available to assist insured physicians and facilities in their ongoing efforts to identify and address areas of concern related to the physician-patient relationship. For guidance regarding a specific situation, please contact MLMIC’s Risk Management Department at (800) 275-6564.