Psychiatrists frequently refer patients for further treatment and/or evaluation, to both medical providers and non-medical providers. As you know, patient referrals should be made to a suitable provider for legitimate treatment reasons.
Courts have held that a negligent referral may be a basis for liability under general negligence principles. A negligent referral may occur when the referring physician knew or should have known that there was a likelihood that the specialist would act below the standard of care.1 The plaintiff has the burden of proving this. When determining whether a negligent referral occurred, courts use a “reasonable person” standard, i.e., would a reasonable physician have made this referral? Keep in mind that in addition to a potential for a legal basis for liability, negligent referrals may also violate ethical standards.
After referring a patient to another provider, the psychiatrist also needs to be mindful of potential liability for failing to properly follow up with the patient and/or parent/guardian, and the referred to provider. The referring physician should ensure that the patient actually saw the specialist, and that all reports are received and acted upon.2 Remember to obtain patient and/or parent/guardian consent prior to contacting the referred to provider.
Risk Management Tips When Making a Referral
- Be objective and do not over inflate the specialist’s qualifications
- Never make a referral strictly for monetary gain and avoid referrals that may trigger anti-kickback laws
- Make clear to the patient and/or parent/guardian that the provider referred to is independent from your practice, that you do not supervise or are not in partnership with the referred to provider
- Ask yourself, does the referral meet the “reasonable psychiatrist” standard? Would a reasonable psychiatrist in the same situation make this referral?
- Follow up with both the patient and/or parent/guardian, and the provider referred to and make sure all reports are received and read
- Crane, M., “Legal Pitfalls When You Refer Patients,” Medscape Nurses, http://www.medscape.com/viewarticle/828402 (Last accessed 8/3/15).