I contacted the resident internal medicine doctor at the hospital and asked if he would be interested in becoming my primary care doctor (PCP). My note briefly described my experience with health studies and my two prescription drugs. He wrote that it would have been an honor to be my PCP, and came across him as professional, modest and sincere. A new relationship between the doctor and the patient was formed, and I contacted my existing doctor’s office to arrange for the transfer of my medical records, which immediately announced that I should be dissatisfied and go to a new doctor. I also shared with the resident doctor’s confidential information from my medical records and a copy of one of my professional presentations at a health conference.
Then the department administrator contacted me to say that the resident doctors are not available every day of the week for the clinic and not even here when they do their medical operation. In addition, the protocol of the Department of Internal Medicine would not allow the resident doctor to write me a prescription for use without labels. Finally, she was concerned that in the past I had ordered and correctly interpreted my own blood tests. The administrator's attitude reflects one of the main claims of Americans to the health care system: the system comes to them and requires that they receive medical services in a certain predetermined structure for which the object is accredited, but which eliminates any potential for individual treatment in accordance with individual patients. necessary.
Almost the administrator did not conduct enough "careful consideration" to get the facts. I do not need to see my PCP every day or even monthly. My record shows that I saw my acting doctor once in a calendar year, and I saw the previous doctor before him once every 15 months. Therefore, the administrator based his decision on his ignorance of the facts.
She also mistakenly states that the facts relate to the prescriptions of sniper drugs by resident doctors. One of the drugs we are talking about is Clomiphene. Both the resident doctor and the attending professor at the faculty at the training hospital advised me that they would be ready to write me (out of the label) recipes for this drug, and the attending physician actually called for one of the drugs at my request. Similarly, the Department of Obstetrics and Gynecology (OB-GYN) advised me that their doctors, both living and visiting, prescribed patients with clomiphene. Therefore, residents of family medicine and OB-GYN (both primary health care units) can write prescriptions for Clomiphene, but the “protocol” does not allow patients from internal medicine (as well as primary care) to write prescriptions without a prescription. What is the rule? Are residents of Internal Medicine too stupid or too naive to understand the benefits of medicines that are not true?
Finally, I planned for my resident PCP to order and interpret blood tests every time I visited him. The administrator could have known this fact if she had bothered to call or write me before going to the conclusion and interfere with my relationship between the doctor and the patient. I categorically reject the director’s paternalistic view of medicine, in which she promises that she should protect resident doctors from patients who order or interpret their own blood tests. These resident doctors are young professionals who have completed medical courses; they do not need paternalistic supervision from the department administrator, telling them who they can and cannot invite patients.
Almost the overwhelming number of patients who visit the doctors of this therapeutic hospital want to know what to do and how to feel. I am the complete opposite; I take personal responsibility for my health and manage it, which is actively defended as part of health care reform. Having a more equal, cooperative relationship with my PCP works for me, and this seems to be the real reason for the intervention of the administrator. Studies show that medical negligence is reduced by using a non-paternalistic model of medical services. This fact of reducing the risk of litigation encourages more health systems across the country to switch to a non-paternalistic model.
LEGAL ANALYSIS
I. Formation of the relationship between the doctor and the patient
The first question that needs to be addressed is whether the link between the physician and the patient has been formed on the basis of this fact. When I receive confidential information about two illegal drugs that I take, this act will be similar to the prospective client who approaches the lawyer with the facts of his case to see if the lawyer will help him. Addressing a lawyer in this way does not create a relationship between the lawyer and the client. However, a lawyer is guided by the ethical duty to protect the confidentiality of information that a potential client has. Similarly, the resident physician was required to comply with the ethical obligation to keep confidential information that I shared with him.
When a lawyer responds to a potential client, “I agree to accept your case” or “I will be your lawyer,” or words to that effect, then a relationship with the lawyer and client is created, and the protection provided to the client & 39; information rises to the level of privilege of a client advocate protected by the constitution. In this case, when the resident doctor responded that he would be honored to be my PCP, we have the offer and acceptance that make up the contract. Accepting the offer could be interpreted as my offer to be his patient, which he accepted, or his offer to become my PCP, which I accepted.
But the proposal and acceptance - only two of the three necessary elements for the conclusion of the contract. The third essential element is the exchange of views expressed in Latin as quid pro quo. In this case, there were several separate exchanges of considerations that complete the formation of the contract and thereby make it applicable in court. Consideration is defined as any action or some transfer of the subject from one side to another, for which the receiving party does not have the legal right to consider the matter differently. There is no requirement for accounting to have an intrisinc value. For example, the transfer of scrap paper may be justified, which makes the contract binding and enforceable.
The initial disclosure of confidential information from my medical record constitutes sufficient attention. Secondly, the fact that I and the doctor each of us began to schedule an appointment for me to see it is also taken into account: none of us had a preliminary legal right giving us the right to this action of another person. Thirdly, when we continued to correspond after the proposal and acceptance, with additional information sent back and forth, an additional review was conducted. My translation of the resident physician — a copy of one of my professional presentations — was the fourth case study. Finally, my request to transfer my medical records to the resident doctor’s clinic resulted in an explicit legal dismissal, based on the assurance that the contract could be executed.
If a lawsuit was filed to enforce this contract, I am confident that the lawsuit will cancel any attempt by the lawyers of the training hospital to reject the lawsuit based on the absence of a contract. The defendant may try to argue that the contract cannot be formed because the resident doctor does not have a license. According to the website http://medical-dictionary.thefreedictionary.com/resident+physician, “the resident doctor is a graduate and licensed doctor who is trained in a specialty, usually in a hospital.” The status of resident licensing will not prevent the formation of a compulsory contract, as we have in this case, for treatment in controlled residents. clinic.
In court, we would put a number of questions: 1) Is the resident a graduate of medical school? Yes! 2) Was our conversation focused on treating health care? Yes! 3) Does the resident see other patients (whether controlled or not controlled) in a resident clinic? Yes! 4) Are resident services provided for the US government and private insurers as doctor services (not student assistants or doctors)? Yes! 5) Did we both use the term PCP in describing our relationship? Yes. 6) Did the resident help me in obtaining medical supplies to see it? Yes! With these answers, any court will recognize if it looks like a duck, swims like a duck, and charlatans like a duck, then it is a duck. Therefore, the defendant’s licensing argument will be considered a red herring and will fail. In the same vein, the courts noted “it is axiomatic that the relationship between the doctor and the patient may arise due to the short time and be limited to the unique circumstances presented in the transmission situation”. Sterling v. Johns Hopkins Hosp., 145 Md. App. 161 (Md. Ct. Appendix 2002). It does not matter how long the doctor sees the patients or how short the contact with any patient is, the relationship between the doctor and the patient can be formed.
The choice of PCP and other medical decisions are “basic” private decisions. The fundamental principle of confidentiality jurisprudence, as applied to other types of personal affairs, is that the most directly interested person has the right to independently carry out and implement a secure decision independently and to exempt from paternalistic government intervention. See, for example, Zablocki v. Redhail, 434 US 374, 54 L. Ed. 2d 618, 98 S. Ct. 673 (1978) (marriage decision); Moore v. East Cleveland, 431 US 494, 52 L. Ed. 2d 531, 97 S. Ct. 1932 (1977) (decision to live with extended family members); Griswold v. Connecticut, 381 US 479, 14 L. Ed. 2d 510, 85 S. Ct. 1678 (1965) (reproductive choice). I would like to argue that the constitutional right to privacy also protects autonomy when choosing a PCP among the wide range of available doctors, selects which medicines I want to prescribe, and choosing which laboratory tests I want to order to monitor my health.
In 2005, the Supreme Court of Arkansas gave the best statement in American court practice about the increased status of doctor-patient relationship. The court noted that the doctor-patient relationship is unique. “The loss of this relationship, even temporarily, causes irreparable damage to the doctor and patient. The law does not have an adequate remedy, because loss is the loss of a one-time opportunity. ” Baptist Health v. Murphy, 362 Ark. 506 (Ark 2005)
The court noted that the hospital violated the rules and regulations of the Arkansas Department of Health for hospitals by not following a policy that defended the choice of the doctor and patient chosen by the doctor. “We interpret this as meaning that otherwise a qualified physician should have provided access to his patient to treat his patient, if this is what the doctor and the patient want. Or, stating in another way, the hospital cannot deny the services of a patient’s doctor if the patient is already visible by the doctors in the hospital. Baptist Health v. Murphy, 362 Ark. 510-511 (Ark., 2005)
Based on reading Baptist Health, I will now send a copy of this article to the State Department of Health to determine if the teaching hospital violated any of my government regulations requiring that medical centers licensed in Tennessee have a policy or sub-legal Acts that respect the patient have the right to choose their doctor. If so, then the training hospital violates these rules.
Ii. Tennessee Compulsory Intervention Statement
Code Anne. Paragraphs 47-50-109 are entitled: "The purchase of illegal contracts - damage." The administrator diligently interfered in my relationship with the doctor and the patient and pretended that the resident doctor did not perform his services under our contract. Therefore, she achieved a violation of this contract. The administrator will claim that she performed her duties exclusively, but this is not a reason for interfering with the existing relationship between the doctor and the patient.
Although Tennessee jurisprudence does not have a concrete argument, courts across the country vaguely see and express disapproval of employer intervention in the doctor-patient relationship. For example, the US Supreme Court stated: "The ethical objection was that the employer's intervention ... makes a tripartite question about the relationship between the doctor and the patient ... and not the patient, it serves two masters with conflicting interests." States v. Oregon State Medical Soc., 343 US 326, 329 (US 1952).
