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Many states allow third parties (e.g., relatives and nannies) to consent to a minor’s medical treatment, as long as the parent’s/guardian’s authorization is already in place. Clinicians are sometimes tempted to bend the minor consent rules when the adolescent is older or when the patient comes in with a relative who appears to be a caretaker, even though that caretaker does not have legal standing to consent to the adolescent’s medical treatment. Consider the conflicting interests of the parties in the following case.

Physician advertising is controlled by state and federal laws and regulations. Violating these regulations can lead to medical board discipline and fines, can complicate the defense of liability claims, and may not be covered by medical liability insurance policies. State laws may also allow patients to sue the physician for damages if they were injured by the false or deceptive advertising.¹

To “indemnify” or to “hold harmless” means to insure another party’s risk. Indemnity clauses appear in a wide variety of business contracts, including those between physicians, their groups, and the hospitals in which they treat patients. When a physician signs a contract to join a medical group, and the contract has indemnification language, the physician may be agreeing to take responsibility for the group’s malpractice liability if both are named in a lawsuit. Consequently, physicians should be wary of signing any contract with an indemnity/hold harmless clause.

In the following case, the group’s medical director over-utilized medical assistant (MA) externs for cost-saving purposes. Because he did not understand how his plan was putting patients at risk, he was resistant to negative input from his colleague. The physician conflict exacerbated the inherent risks of the externship program.

Like other people, physicians and clinical staff members may commit crimes and engage in other noncriminal activity that can expose their healthcare employers to liability and regulatory violation risk.¹ Therefore, it is important to have processes in place to conduct background investigations on any staff member involved in patient care and practice operations, even those with personal references from current clinicians or staff.