"Curbside" consultation and informal communication in medical practice: a medicolegal perspective

In assessing whether a consulting physician is liable as a result of an informal ("curbside") communication, courts examine all of the facts and circumstances to determine if a physician-patient relationship existed. Merely answering a colleague's question or performing a curbside consultation may not give rise to a physician-patient relationship; hence, there is no liability. When duty of care can be established, a physician may be liable for medical malpractice. Infectious diseases physicians with contractual managed-care roles may have an unrecognized duty of care and may actually be at increased risk of liability. Physicians are also under duty to act as any reasonably prudent person would act on the basis of any foreseeable risk of injury to others. In general, physicians should encourage formal consultation when expert advice is sought because a more reliable and complete exchange of information occurs before an opinion is rendered in this setting. While informal interchange between colleagues is often of educational benefit, consultants should avoid giving specific advice about a patient whom they have not examined, answer queries in general terms, and consider keeping a written record of the interaction.