Last week I invited a local pediatrician to connect with me on a physician social network. I thought it would be cool to see how it might improve our ability to stay in touch and share information. In a return email she was enthusiastic but qualified it by saying that she wouldn’t want to be held liable for anything that she said.
It raises an interesting concern: Can a physician be held accountable for rendering an opinion in a clinical scenario casually presented in a physician network?
Water Cooler Risk
The question of liability for casual dialog is interesting, but not a new question. Doctors have been talking for years. At lunch conferences, in hallways, and in surgical lounges – the curbside is a way of life for all of us. Good physicians, after all, almost never work alone.
Let’s leave social networks out of this for a moment and talk about liability of water cooler dialog. Can a doctor be held accountable for offering casual guidance over coffee? The medical malpractice attorneys I’ve consulted on the matter have suggested that a plaintiff must prove that the physician has a duty to the patient in question. And that duty only comes through the establishment of a relationship. Or, in other words, it must be shown that the doctor is responsible and obligated for the patient’s care. And in the case of the curbside consult there is no duty on the part of the doctor interrupted during his coffee break.
While it can get more complicated, this is apparently why we see so few physician defendants arising from casual dialog.
Virtual Water Cooler Risk
So then should physician networks give doctors pause? We shouldn’t see web 2.0 dialog on iMedExchange (in beta), Sermo or Ozmosis as anything different than a surgical lounge curbside or advice solicited from your partner. Physicians, online and off, are doing what we’ve been doing for hundreds of years: sharing and talking.
It should also be understood that physicians have a responsibility to understand the rules of casual clinic dialog in any setting. The ultimate responsibility to any patient lies with the treating doctor. And if the treating doctor is uncomfortable with a situation a formal consult is in everyone’s best interest, especially the patient.
It’s Not the Message, It’s the Medium
Open communication among physicians is critical for the dissemination of medical information. As technology advances and physicians evolve in how they interact, it’s critical that we not confuse the message with the medium. At some point the courts will test the limits of physician dialog on physician networks. And hopefully fear of legal retribution won’t hobble these new forms of interaction which stand to improve the quality and efficiency of patient care.
So if you are concerned about dialog on a medical web 2.0 platform, you should be just as concerned with dialog around the water cooler.