As a future physician, im wondering...is it illegal to give free medical advice to masses of people? I'm considering doing some probono work, open to people of all financial statuses. What are the risks involved in doing something like this, considering current (and potentially future) malpractice laws?
Is Giving Free Medical Advice Illegal
- Thread starter DrBB
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What do you mean by advice? One on one counseling or like podium advice to the masses?
One on one counseling, ie someone comes to me with a specific problem and I give them advice
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Okay, but just because you're doing it for free doesn't let you give substandard care. If based on an email you tell someone it looks like they have some harmless rash and it turns out to be skin cancer, you're still going to be liable for damages from that.
If you take people into your care, you have a fiduciary responsibility to give them an appropriate level of care. I'm not sure anyone is doing email clinic.
I mean, maybe it would be possible for some things, but it would have to be pretty limited practice, because you cannot really do any physical exam, labs, etc.
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You're advice better be: go see a doctor or come into the clinic so i can take a look at it.
Obviously the advice I would give online would be seriously limited...Im saying a lot of people use the Internet as a source of free medical advice...my service would be the same in terms of answering simple questions for people, but it would be coming directly from a physician rather than from many various online resources such as webmd and medscape
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As far as I know there is no specific law saying you can't provide free medical advice via whatever means, but you are opening yourself up for all sorts of malpractice claims which can only be minimised by bringing the patients into a clinic and doing an examination/work up. And seeing patients in clinic costs money. So if you can cover the running costs without charging patients and be adequately qualified to do the job, then you are set for your probono work.
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You're advice better be general rather than tailoring it to the specific person. Example: Explaining the ABCDE risk factors of skin lesions. Tailoring it opens you up to liability as some could contsrue your interaction as establishing doctor patient interaction, and you'd need to document said interactions in the event of a suit.
It is more trouble than it is worth. Either volunteer at an established free/low cost clinic or be content in your service to the patients of your normal practice who don't pay their bills normally.
It is more trouble than it is worth. Either volunteer at an established free/low cost clinic or be content in your service to the patients of your normal practice who don't pay their bills normally.
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I think it's an interesting question. There's more and more telemedicine being used in academic and community centers. For example the rural hospital I work at has agreements with cardiology and neurology to do video conference consults when needed. It's not exactly what the OP is asking about but it's an emerging field.
Here are the problems I would worry about:
You would have a lot of potential liability problems, i.e. if you diagnose someone incorrectly or if you advise them to do something and it goes wrong you can get sued. Your exam is limited due to the medium. Just because you're doing it for free does not mean you are protected. Juries may look at you more favorably if you're working for free in a charitable setting but that's up to chance. Most Good Samaritan laws do not cover you if you've accepted a duty to act by putting yourself in a free clinic or the like. For example volunteering to do sports physicals for kids carries liability because you agreed to do it.
State licensing is an issue. If you are licensed in a particular state and a person accesses your internet site from a state where you are not licensed and you advise them I suspect you would be practicing without a license in that state.
HIPAA would be an issue. Your system would need to be secure enough to prevent people from easily accessing PHI about users you have treated.
It's interesting. I don't know how viable it is. But it's interesting.
Here are the problems I would worry about:
You would have a lot of potential liability problems, i.e. if you diagnose someone incorrectly or if you advise them to do something and it goes wrong you can get sued. Your exam is limited due to the medium. Just because you're doing it for free does not mean you are protected. Juries may look at you more favorably if you're working for free in a charitable setting but that's up to chance. Most Good Samaritan laws do not cover you if you've accepted a duty to act by putting yourself in a free clinic or the like. For example volunteering to do sports physicals for kids carries liability because you agreed to do it.
State licensing is an issue. If you are licensed in a particular state and a person accesses your internet site from a state where you are not licensed and you advise them I suspect you would be practicing without a license in that state.
HIPAA would be an issue. Your system would need to be secure enough to prevent people from easily accessing PHI about users you have treated.
It's interesting. I don't know how viable it is. But it's interesting.
Are you really doing anyone a service by giving them poor quality, vague care over the internet? If you think that is OK, you probably shouldn't be in medical school, but rather a DNP program.
There is an online clinic run by an insurance corp and NP's in my area, it's not free but it is cheap.
If you really want to help people, volunteer at a free clinic they always need help and supplies.
There is an online clinic run by an insurance corp and NP's in my area, it's not free but it is cheap.
If you really want to help people, volunteer at a free clinic they always need help and supplies.
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The answer to this is simple. You can do anything for free but it doesn't change the standard of care you need to meet, remove liability, licensure requirements or require the ancillary services you need to meet the stanadard of care to also work for free.
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I think it's a bad idea to do internet consults for the most part -- but there are some states where you're protected by law providing indigent care.
In Alabama, where I am currently, physicians who work pro bono (free clinic style) cannot be sued unless they are grossly negligent in the care delivered (a much harder standard to meet than a typical civil case). Whether that would cover you doing it by e-mail is another matter entirely, but at least in theory if you were doing it pro bono you would at least have a higher standard in order to be sued. That said, I'll back what the other posters have said: work at an established free clinic -- volunteer one night a week or two nights a month or whatever. Much better use of your time.
In Alabama, where I am currently, physicians who work pro bono (free clinic style) cannot be sued unless they are grossly negligent in the care delivered (a much harder standard to meet than a typical civil case). Whether that would cover you doing it by e-mail is another matter entirely, but at least in theory if you were doing it pro bono you would at least have a higher standard in order to be sued. That said, I'll back what the other posters have said: work at an established free clinic -- volunteer one night a week or two nights a month or whatever. Much better use of your time.
Dude! 71 posts and you're already being a douche and pulling the "you shouldn't be in medical school" card? Nice!
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I've always been curious about this. If you complete a residency in say, psychiatry, are you allowed to work in a free clinic as a general physician? Are there routes you can take to get certified in something like family practice without doing another residency?
I would like to work in primary care in a pro bono capacity, but given the state of the field I think I would rather earn my living in another part of medicine.
I would like to work in primary care in a pro bono capacity, but given the state of the field I think I would rather earn my living in another part of medicine.
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I general yes if you are licensed you can work in any clinic, free or not. To get paid you usually have to be boarded to get medicare and insurers to pay you. In a free clinic you could practice without being boarded if the clinic management allowed it.
The downsides of this are significant. First you will not be delivering the quality of care for primary care issues that a doc trained in primary care would. Second you will have additional liability because you will be practicing outside of your area.
In situations like this it is usually better to volunteer your time in your specialty. That's where you'll be able to deliver the best care and charity clinics are always hurting for specialist input anyway.
Here's an old thread from Family Medicine where this issue was discussed at length.
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Awesome. Thanks a lot, DocB
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It's illegal. The gubmint does not want people helping each other for free.
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They did it on House...
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Someone please correct me if I'm wrong, but if you accept medicare or medicaid as payment in your clinic isn't it illegal to not charge a patient for services?
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I've seen neurologists (epilepsy specialists) at the Cleveland Clinic video conference. It was absolutely fascinating to watch to whole process unfold. But the key here is that it is physician-to-physician consultation. That is, there is a local doctor-in-the-loop who cares for the patient on the other end. In effect this is an "e-curbside consult". "Direct-to-patient" via the web, as you mentioned is a whole different matter, legally and ethically.
Other examples of telemedicine include Cardiac holter monitoring services, but once again, I believe the results are ultimately interpreted by the ordering physician.
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The 'free' part isn't what should worry you. Free clinics and street medicine teams have been doing that for a while now. But you are still responsible for everything else in your care as others have pointed out.
As for general knowledge for the masses, this too is possible, but caution is needed. There are a ton of medical blogs out there, not to mention people like Dr. Oz, who give out advice to the masses. The key there is that it's generally benign in nature, not directed at specific patient populations, and usually has some disclaimer that "this is not medical advice. seek a doctor for medical problems." You don't lose freedom of speech just because you have an MD, but you are more likely to be sued.
So in summary: yes you can do it if done right, but start with a legal consult and be cautious.
As for general knowledge for the masses, this too is possible, but caution is needed. There are a ton of medical blogs out there, not to mention people like Dr. Oz, who give out advice to the masses. The key there is that it's generally benign in nature, not directed at specific patient populations, and usually has some disclaimer that "this is not medical advice. seek a doctor for medical problems." You don't lose freedom of speech just because you have an MD, but you are more likely to be sued.
So in summary: yes you can do it if done right, but start with a legal consult and be cautious.
