Outside doctors’ waiting rooms and offices, diseases don't disappear. Can physicians ever turn a blind eye?

This September, the Today Show highlighted how a Chicago-area pediatrician played a major role in one woman’s cancer diagnosis, who was not her patient. The woman told TODAY that she had visited the pediatrician’s office on account of her three children, who were patients. Interactions became more personal when the doctor told the woman she didn’t look right and encouraged her to set up a doctor’s appointment of her own. The woman was diagnosed with leukemia soon after. Now in remission, the woman told TODAY she feels lucky.

Mom, 40, diagnosed with cancer after kids’ pediatrician noticed she didn’t “look right.” TODAY.com.

 

While the success story draws applause, it also begs the question of whether other providers should be on the lookout to do the same and to what extent doctors may be responsible for treating people outside of their practice, particularly those who are not their patients?

 

An ethical or legal decision?

 

The answer to the questions may have both ethical and legal components. When it comes to treating people in emergency scenarios, there are some legal standards that doctors are held to. In diagnostic situations, ethics may dominate conversations, as the law is less clear.

Kristen Fuller, MD, former emergency room doctor, physician, and MDLinx board medical board member, points to The Good Samaritan Law as a guideline for how doctors can gauge their responsibility to the general public in emergencies. The law outlines some of the things that doctors can or cannot be held responsible for in emergency scenarios not involving their workplace or their patients. 

Under the Good Samaritan Law in New York, a licensed physician will not be held legally responsible for “acting or failing to act” in spontaneous emergency scenarios for people who are not their patients and for which they are not acting with compensation or as a volunteer. This does not apply to scenarios during their employment hours and could be debated if they are shown to be acting recklessly.

“If you are a physician and you see your patient in a public setting having a medical emergency, you render care to stabilize the patient” until emergency personnel arrive, Dr. Fuller says.

Under the act, you can also render care to someone who is not your patient, although you will not be held legally liable if you do not.

Ilan Shapiro, MD, pediatrician and chief health correspondent, and medical affairs officer at AltaMed Health Services, says that he has witnessed emergency scenarios outside of his practice. On some of these occasions, he feels the need to intervene and acts on it, he adds.

“When a police officer or firefighter is not on duty, they usually will react to an issue in the community, and it's the same way with physicians,” Dr. Shapiro says. “Being a doctor is a way of life.”

 

Emergency scenarios versus diagnostic situations

 

Rules surrounding emergency and diagnostic situations are very different, Dr. Fuller explains. The Good Samaritan Law does “not mean” that doctors should “diagnose melanoma on your patient if you see a suspicious mole when you see your patient outside of the office in public,” she adds.

“I have learned to strictly separate work and personal life,” Dr. Fuller says of her personal boundaries. “If I have a close friend or family member I am concerned about, I will urge them and may even nag them to seek care, but at the end of the day; I cannot be responsible for the whole wide world.”

 

Respecting boundaries on both ends

 

If you are nervous about a person’s health, you may feel obligated to act immediately. However, it is important to factor in patient boundaries and the importance of a professional, private setting to discuss health conditions.

Boundaries are important for the other person, as well.

“It is not advisable or ethical to give medical advice or treatment to anyone except for your patient in an office setting,” Dr. Fuller says. “You can recommend a member of the general public seek medical treatment for a nagging cough or suspicious back pain, but you ethically cannot go beyond that; at that point it is up to the person to seek medical advice.”

The pediatrician credited on TODAY did not officially diagnose the woman with cancer, but strongly encouraged her to set up an appointment. 

Dr. Shapiro describes his duty to patients and the public as a “delicate balance of ethics.” 

He adds that he tries to present with a welcoming and safe persona and let patients know they can come to him when they are in need – but with a strong preference for in-office visits.

“There could be situations where we need an intervention so that the patient is safe, including the family and community members so they can lead a healthy life,” he adds. “It's good to give your patients information, but also be clear that having health-related conversations in a non-professional space is not the best setting. If they need more information in a private setting, I invite them to visit my clinic.”