Q: I was at my sons Little League game when a neighbor asked me for advice on her childs vision loss, but she didnt want to bring him in just yet. Can I be held liable for giving out free advice if the case turns bad?

Yes, you can, says Michael Harris, O.D., J.D., of the University of California Berkeley School of Optometry. Your liability hinges on whether a doctor-patient relationship has truly been established. Once a doctor-patient relationship is established, then the doctor is liable for making an appropriate diagnosis and providing an appropriate treatment regimen, he says.

If you agree to take a look at the child, then youre no longer just a nice neighbor. Youre being asked for your expertise in your professional capacity. And, your professional capacity extends beyond the door of your office.

Most practitioners just assume that because youre not in the office and the patient isnt paying a bill, then there is no doctor-patient relationship, Dr. Harris says. The doctor-patient relationship has nothing to do with whether fees are charged or bills are paid.

Rather, he says, it has to do with whether a reasonable patient would, under the circumstances, think that they are in a professional relationship. And, once someone asks you as a doctor of optometry to render advice, their assumption is

Should you take a look in Johnnys eye? Sure, but recommend a full exam, too.

the same as if theyre seeing you in your office.

So, how do you handle the situation without looking like a rotten neighbor?

You may reply without incurring legal obligations as long as you make it clear that the response is hypothetical and not an effort to actually diagnose, prescribe for, or otherwise manage the individual case involved, says John G. Class, O.D., J.D., of the University of Alabama at Birmingham School of Optometry. A practitioner should conclude any discussion of a case with the comment that an examination is always needed to determine a patients condition, and that an exam should be scheduled within a reasonable time frame.


Q: Ive been asked to participate in a glaucoma screening at our local health fair. Im worried that without proper equipment, I may miss something. What is my liability here?

Screenings pose no liability threat as long as they are clearly described as such, Dr. Class says. By definition, a screening does not detect all persons with the condition being tested for, and usually identifies individuals who are suspected of having the condition but may not.

Make sure that any advertising or promotion of the screening clearly states that it is not a substitute for a full examination, he says. Any information, results or other writing given to the subjects of the screening should include the same disclaimer.

We do screenings at various health fairs, and we hand out a form that indicates the limited nature of the screening, Dr. Harris says. The form also tells people that they need to see their own practitioner for a thorough evaluation and diagnosis.

Vol. No: 145:10Issue: 10/15/2008