I am not sure that this is a legal question. But I am concerned about legal ramifications.
Jane Doe has been seeing Dr S—- for decades. While an OB-GYN specialist, Dr S—- is a “whole body” physician and treats his patients for more than just OB-GYN issues. Dr S—- treats hypertension, cholesterol, asthma, GERD, etc, usually quite successfully.
Recently, Jane’s third party insurance required her to see a primary care physician for a physical. This doctor referred her to a cardiologist. The cardiologist chose to change Jane’s blood pressure meds. When Dr S—- heard about this, he told Jane to ignore the cardiologist’s recommendations and remain on the regimen Dr S—- prescribed. Jane does not know what to do and has asked my advice.
I am concerned about counseling one way or the other and what legal issues that could arise.
Every situation these days can result in legal issues.
Pharmacy Law Source has seen this conflict in practice as a pharmacist, but it has always been resolved in favor of the condition/specialist. For PLS, a doctor not submitting to the specialist’s recommendation is a matter of first impression.
While the gut reaction is to counsel a patient with a specific condition to follow the counsel/recommendation of a specialist for that condition, , let’s advise the following:
–speak to both providers
–get the basis for their choice of medication to handle Jane’s health issue
–ask Jane about her concerns. Her confusion is understandable
–document who you speak with and what is discussed
–when making any advice to Jane, indicate that you are exercising your professional judgment and no personal feelings toward either practitioner
So, what happens if you advise Jane to follow the cardiologist’s recommendations and Dr S—- drops her as a patient? This is not a basis for suing you (though people have tried to sue for issues with even less of a basis).
So, what happens if Jane follows advice from you and suffers an adverse health event from changing medication/remaining on the same medication? This lawsuit might get off the ground but is unlikely to succeed with the proper exercise of professional judgment and documentation.
So, what happens if the practitioner who “loses” this argument reports you to the Board of Pharmacy? The BoP is more than likely to take no action with the proper exercise of professional judgment. and documentation.
However, especially in the last two scenarios, pharmacist may need to hire legal counsel to defend her actions/advice. The time, effort, and cost of this could be a major inconvenience, even if the end result is very likely to be no legal ramifications.
What about the options of either telling the docs to figure it out or telling Jane to make her own choice? The former is a good idea but the question asked indicated the practitioners stuck by their choices of medication and refused to do anything else. The latter is a less viable option as it leaves a confused patient with nowhere to go.
Pharmacists are often put in the middle of issues today and left to resolve them. Here, this inability to resolve the issue between the practitioners is an unwarranted imposition on the pharmacist. While legal issues are not a great concern, pharmacist should still tread carefully in helping to resolve this.