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I’m going to be brief on this point because I think it’s pretty obvious. From a legal perspective, the plaintiff’s attorney has the burden of proving, in order to prove any medical malpractice claim, any negligence claim, the first thing they have to prove is a doctor/patient relationship. And in 99 percent of our cases, there’s no question about that. In this situation, that’s a big question because you have to remember in a telephone consultation many of the people you’re calling aren’t the primary care physician who know the patient but someone who doesn’t know the patient, someone who hasn’t seen the patient’s record, who hasn’t seen the patient’s imaging, who doesn’t know the patient, doesn’t know the patient’s history, doesn’t know the patient’s ability to communicate history, doesn’t know anything. And so they can give a general answer in a vacuum and say this is my advice to you, Dr. Emergency Room Doctor, if you have a patient with XYZ circumstances, you should investigate and consider ABC tests and diagnoses. Is that a doctor/patient relationship? And then the end result is that there is an entry in either the emergency room record or somewhere in the hospital chart or even in a primary care outpatient record that says, ‘I consulted with Dr. Cohen. And after consultation with Dr. Cohen and discussion of this, that and the other thing, I did this at her advice or with her agreement.’ And you can guarantee that I am then going to be a defendant in a lawsuit if and when there is a lawsuit. And so the question of whether this creates a doctor/patient relationship is a really important one. Certainly, I would think that most physicians would be disinclined to give advice about a patient that they never saw, never met and couldn’t examine over the phone for no pay. So making this a real consultation has the challenges of how much information is provided, what are the limitations of the ability to provide a consultation, and whether or not you’re gonna get paid for it. So I think that, while it’s an important concept that’s deeply rooted in the practice of medicine—I mean, we get curbside consults. we get that from long before cell phones and e-mails were available, we get that concept that’s deeply embedded in best practices from the notion that patients get best care by the input from the most good, experienced minds and clinicians. And so you want to encourage that for best practices, but you also want to from a legal perspective be careful about making clear to the person you are calling, whether I’m just calling to run a scenario by you or whether I’m really consulting you about a particular patient whose sitting in Exam Room 2 down the hall or in the emergency room. So thank you very much.
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