—We appreciate the comments of Dr Fox and share his concern regarding the potential for the current managed care environment to redefine physicians' duty of care to include situations outside the traditional physician-patient relationship. Specifically, we also are concerned about the possibility that a consultant under contract with a managed care organization may be subject to litigation by giving informal advice to another participating physician regarding the care of a patient enrolled in the same plan. Fortunately, the circumstances of the case cited by Fox1 were sufficiently different than those surrounding most curbside consultations that the verdict in favor of the plaintiff cannot be invoked to encourage future litigation involving consultants who give informal advice to their colleagues. First, the defendant was the de facto assigned primary caregiver (not a consultant) for the plaintiff under the health care plan agreement. Second, as the gatekeeper, the defendant implicitly assumed major
Manian FA, Janssen DA. Medical-Legal Aspects of Curbside Consultation-Reply. JAMA. 1996;276(20):1635–1636. doi:10.1001/jama.1996.03540200021016
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