The trusting relationship between a highly trained service-oriented person and a client seeking services is considered a fiduciary relationship. In health care, an "agreement" for treatment is a contract in which there are 3 parts:
Some patients will need to be reminded that the contract requires them to be responsible for the “consideration” or bill. Any arrangement with a third party to pay the bill is a contract between the patient and the third party. The physician has a right to hold the patient accountable for payment.
Terminating the physician-patient relationship must be done properly or it can be considered the breaking of a legal contract. The patient can choose to terminate the relationship with a physician at any time. However, the physician can only terminate the relationship if there is just cause. For example, the patient must have been noncompliant with treatment recommendations, repeatedly missed appointments, or refused to pay for services.
Abandoning a patient is a serious charge and could lead to charges of an intentional tort.
The patient must be notified in writing by certified mail, return receipt requested when care will no longer be provided. The patient needs to be given a reasonable length of time to find alternative medical care. There is no set time limit for a “reasonable length of time,” but most experts agree that 6–8 weeks is sufficient. The return receipt and a copy of the letter must be filed in the patient’s chart. A patient may terminate the relationship at any time.
The relationship between medical assistant, physician, and patient all include trust, honesty, and caring. Many offices give out a sheet detailing the rights and responsibilities of both parties to make sure certain expectations are clear and consistent. In some states, the Patient’s Bill of Rights must be posted in all health care facilities.
The patient/physician contract should not guarantee a cure or specific treatment outcome. It merely promises a treatment plan and personalized care that will be documented completely and accurately. It is understood that the physician will provide alternative coverage on days off and request consultations when indicated and referrals when needed. In exchange, the physician will select working hours, location of practice, and the type of patients to treat. She should expect timely payment of bills and personal time off. The patient has a right to honesty and complete information about his diagnosis, treatment, and prognosis. The patient has a right to confidentiality and a standard of treatment that does not reflect discrimination based on race, gender, age, sexual orientation, ability to pay, religion, color, or nationality. The patient has a right to decline to participate in teaching or research projects. The patient is responsible for disclosing all information relevant to his medical condition, being compliant with appointment and treatment plans, and accepting the consequences for refusing treatment. The medical assistant’s duty is to respect all patients without regard to race, religion, sexual orientation, national origin, age, or gender, and to skillfully perform duties designated by the physician employer with concern for the dignity of the patient.