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<p>The duty of the physician is to provide competent, compassionate, and economically prudent care to all his or her patients. Having assumed care of a patient, the physician may not neglect that patient nor fail for any reason to prescribe the full care that patient requires in accord with the standards of acceptable medical practice. Further, it is the Board’s position that it is unethical for a physician to allow financial incentives or contractual ties of any kind to adversely affect his or her medical judgment or patient care. </p> <p>Therefore, it is the position of the North Carolina Medical Board that any act by a physician that violates or may violate the trust a patient places in the physician places the relationship between physician and patient at risk. This is true whether such an act is entirely self-determined or the result of the physician’s contractual relationship with a health care entity. The Board believes the interests and health of the people of North Carolina are best served when the physician-patient relationship remains inviolate. The physician who puts the physician-patient relationship at risk also puts his or her relationship with the Board in jeopardy. </p> <p><strong >Elements of the physician-patient relationship </strong ><br /> The North Carolina Medical Board licenses physicians as a part of regulating the practice of medicine in this state. Receiving a license to practice medicine grants the physician privileges and imposes great responsibilities. The people of North Carolina expect a licensed physician to be competent and worthy of their trust. As patients, they come to the physician in a vulnerable condition, believing the physician has knowledge and skill that will be used for their benefit. </p> <p>Patient trust is fundamental to the relationship thus established. It requires that: </p> <ul class="bullet"><li>there be adequate communication between the physician and the patient;</li> <li>the physician report all significant findings to the patient or the patient’s legally designated surrogate/guardian/personal representative; </li> <li>there be no conflict of interest between the patient and the physician or third parties;</li> <li>personal details of the patient’s life shared with the physician be held in confidence;</li> <li>the physician maintain professional knowledge and skills;</li> <li>there be respect for the patient’s autonomy; </li> <li>the physician be compassionate; </li> <li>the physician respect the patient’s right to request further restrictions on medical information disclosure and to request alternative communications;</li> <li>the physician be an advocate for needed medical care, even at the expense of the physician’s personal interests; and </li> <li>the physician provide neither more nor less than the medical problem requires.</li></ul> <p>The Board believes the interests and health of the people of North Carolina are best served when the physician-patient relationship, founded on patient trust, is considered sacred, and when the elements crucial to that relationship and to that trust -communication, patient primacy, confidentiality, competence, patient autonomy, compassion, selflessness, appropriate care-are foremost in the hearts, minds, and actions of the physicians licensed by the Board. </p> <p>This same fundamental physician-patient relationship also applies to mid-level health care providers such as physician assistants and nurse practitioners in all practice settings. </p> <p><strong >Termination of the physician-patient relationship </strong ></p> <p>The Board recognizes the physician’s right to choose patients and to terminate the professional relationship with them when he or she believes it is best to do so. That being understood, the Board maintains that termination of the physician-patient relationship must be done in compliance with the physician’s obligation to support continuity of care for the patient. </p> <p>The decision to terminate the relationship must be made by the physician personally. Further, termination must be accompanied by appropriate written notice given by the physician to the patient or the patient’s representative sufficiently far in advance (at least 30 days) to allow other medical care to be secured. A copy of such notification is to be included in the medical record. Should the physician be a member of a group, the notice of termination must state clearly whether the termination involves only the individual physician or includes other members of the group. In the latter case, those members of the group joining in the termination must be designated. It is advisable that the notice of termination also include instructions for transfer of or access to the patient’s medical records. </p> <p> </p> <p> </p> <a href="http://www.ncmedboard.org/position_statements/detail/the_physician-patient_relationship/" title="The physician-patient relationship">Visit Article</a>

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