INFORMAL QUESTIONS

I am frequently asked medical questions at social events. Am I establishing a clinician-patient relationship by answering these queries? Is there a way out of this without sounding rude and paranoid?
—Felix N. Chien, DO, Newport Beach, Calif.

There is no easy answer to this uncomfortable situation. Case law dictates that a clinician-patient relationship is often established in informal settings, such as “curbside consultations.” The test is: Did the clinician give advice to the patient based on facts specific to the patient’s case? Perhaps the best response to such questions starts: “I am not your clinician, of course, and I don’t know all the facts. In general, though, I have found that cases of [insert a disease or condition] are best handled by....” Cautious clinicians will be even more circumspect, asking the patient to “come to the office where I can take a full history.” Experience shows that the general public labors under the delusion that clinicians are interested in the details of their personal medical problems. Free informal consultations are part of the burden of being a clinician.
—David S. Starr, MD, JD (112-4)

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