Rights of Physicians

 (Take note of the last paragraph. Very important)

 

I finally found it. I've been looking all over the internet on the specific Rights of Physicians, but for some weird reason, it isn't anywhere. All I keep seeing are the Rights of Patients. But I finally found it...not on the internet, but in my old book on Medical Jurisprudence by Solis (which, good thing, my dad kept along with his law books collection).

 

Reason I've been laboring over this is coz I recently had an incident with an American patient who refused to be examined and treated for his eye injuries, and instead kept on insisting that I refract him and replace his broken pair of glasses. I refused to give in to what he demanded, explained the necessity of a complete ophthalmologic examination especially in the setting of a blunt trauma to the eye secondary to mauling, and the possible complications arising therefrom. He became arrogant and belligerent, to the point of making debasing comments against me in my clinic, even debating with me the pharmacodynamics of topical versus systemic antibiotics.  He claims he is also a doctor (which I doubt) and that he knows more than I do...and claims that from what he knows and feels, there was NOTHING WRONG with his eye (even though he had an obvious black eye, and the entire whites of his eye was red). I remained cool, calm and professional, though, deep inside I was seething and felt like giving him another black eye...or worse...given that I'm usually very hot tempered when I'm provoked in a setting where I know I've done absolutely nothing wrong...and considering, too, that I'm definitely not one to back down from a fight. 

 

So the incident has left me pining for some sort of payback (which of course I won't really do :P). I just have this urge to know what my rights as a Physician are. Though, I know I did the right thing by not giving in to his demands and holding fast to what I knew to be the correct route of management for his case, I still wonder about what other actions I am entitled to. Given the nascent state of my practice, I know I'm bound to meet and experience a host of other patients and situtations, and I need to be prepared to deal with them appropriately.

 

THE RIGHTS OF PHYSICIANS

 (taken from Medical Jurisprudence by Pedro P. Solis, 1988)

 

1.  Right to Choose Patients

 

We are not obligated to accept or render medical treatment to any patient who solicits our service, even when there are no other physicians in the vicinity or area. However, based on the Code of Ethics, we cannot claim on this right in the setting of an emergency, UNLESS the emergency is such that if we were to administer treatment, we ourselves would be put in danger, in which case we are not liable if we refuse to respond to the said emergency. If we did respond to an emergency, the scope of our service would be, at the very least, to initiate First Aid. Referral to a more qualified physician or emergency service can then be done after the patient has been stabilized.

 

2.  Right to Limit His Medical Practice

 

We have to right to limit the practice of our profession to our chosen specialty. We cannot be compelled to manage cough and colds when we choose to practice only within our specialty. We have the right to limit our practice to our clinics or the hospital, and thus refuse to make house calls. We have the right to refuse a particular mode of treatment if it goes against our conscience, morals or religion. We have the right to refer to a more qualified physician if the patient's case is unknown to us.

 

3. Right to Avail of Hospital Sevices

 

I am not very clear about this, but from what's written, it seems that we can bring patients in need of hospital facilities to any government hospital, even if we're not accredited by the hospital, "...a government hospital may not curtail the right of a duly licensed physician to use the facilities of the hospital provided he complies with the rules concerning internal discipline and those designed to enhance better public service..."

 

4.  Right to Determine the Appropriate Management Procedure

 

We, as physicians, are given full authority to determine the diagnostic and treatment procedure to be administered. In a physician-patient relationship, the Doctrine of Superior Knowledge is in effect, which establishes that the physician has superior knowledge over his patient, and thus, the patient just follows the instructions or orders of the physician. These management decisions are, however, subject to the patient's enlightened, informed consent. If, after careful explanation of the necessity of treatment, its benefits, as well as its possible adverse effects, the patient refuses to give consent, we may politely terminate the relationship, and we should not be held liable for doing so.

 

5.  Right of Way While Responding to the Call of Emergency

 

6.  Instruments and Library in the Practice of the Profession May Not be Subject-matters of Execution of Judgement

 

7.   The Right to Hold Certain Public or Private Offices Which Can Only be Filled by a Physician

 

8.  Right to Certain Services Which Can Only be Performed by a Physician

 

9.  Right to Membership in Medical Societies

 

10.  Right to Compensation

 

"The right of the physician to demand compensation for his services is based on the physician-patient contractual relationship...if a physician renders service to a patient, there is presumption that it is for reward and to rebut the presumption, the patient must prove that the physician agreed that his services would be gratuitous."

 

"Unless there is a specific contract to cure, a physician is entitled to be paid for his services irrespective of the result.  Payment of a medical fee is, as a general rule, not contingent on the result. Mere dissatisfaction with the result of treatment will not defeat the demand for compensation of physician."

 

***

 

I hope this helps my fellow MDs avoid getting cornered by manipulative, belligerent patients. We need to know our rights as physicians so we can act and defend ourselves adequately and appropriately should a situation arise. 

 

(written January 30, 2012)