100%(3)3 out of 3 people found this document helpful
This preview shows page 296 - 298 out of 338 pages.
Generally, once the practitioner-patient relationship has been established, a patient canterminate the relationship at any time, but a practitioner must provide a patient withreasonable notice and ensure there are other healthcare options open to the patientprior to terminating that relationship. A "reasonable" time allowed for the patient to findanother practitioner will depend on the specialty, community size, and accessibility ofsimilar practitioners. In the meantime, the practitioner should be accessible for acute andemergent situations. Mueller recommends practitioners send termination notices bycertified mail with returned receipt and document the notification process in the patient'srecord.214Advanced practice registered nurses are often unsure whether to notify patients whenthey leave a clinic. There are currently no laws or rules that guide APRNs. Generally, inthis situation, patient notification by an APRN would depend upon various factors suchas the employment status of the APRN. If the APRN is in independent practice thenhe/she must ensure that patients have access to care as noted in the above paragraph.If the APRN is an employee of a company and shares patients with the physician oranother APRN, the APRN may not elect to notify patients of his/her departure. As amatter of fact, there may be some risk in trying to notify patients as the physicianprobably views all of the patients as the physician’s patients. Taking information from thepractice to notify patients of your departure without explicit written permission to do sowould be viewed as a HIPAA violation and unprofessional conduct by the Board ofNursing.A Breach of DutyLeidig and Brockway define a breach of duty as any violation or omission of a legal ormoral duty. The neglect or failure to fulfill the duties owed to the patient in a just andproper manner may be found to be a breach of duty which can contribute to allegationsof improper performance.215cxviDakers, L. Establishing the physician-patient relationship. TMLT Reporter. July/August 2000. Accessed:. 286
In most cases, an expert witness is hired to determine whether an act or omission waswithin the scope of practice of the practitioner and if the practitioner deviated from theestablished standard of care. In Texas, an expert report and a copy of the expertwitness's CV must be submitted to each party involved in the lawsuit within 120 daysafter the filing date that the original petition included the defendant. Texas law requiresthat "this report is written by a qualified medical expert and will provide a fair summary ofthe expert's opinions as of the date of the report regarding applicable standards of care,the manner in which the care rendered by the physician or health care practitioner failedto meet the standards, and the causal relationship between that failure and the injury,harm, or damages claimed." A judge may grant one 30-day extension.