Whether you are a referral coordinator or a medical assisting professional, knowing when the standard of care has been met within the process of a referral from a primary care physician to a specialist is valuable. I recently received the following question on that matter:
When referrals are processed in an [outpatient] setting from a patient’s [primary care physician] to a specialist, at what point is the legal standard of care met? Is it when [the primary care physician] gets a written response from [the specialist] ([e.g., “the patient] is scheduled on this date at this time”)? Or [is the standard of care met] when the [primary care physician] receives an actual chart note from the referred specialist?
… Also, are the rules the same for follow-up [on] diagnostic orders?
My legal opinion is that the standard of care for the primary care physician has not been met until (1) the primary care physician receives official notice that the patient has been seen by the specialist or (2) the specialist has declined the referral. As I see it, the primary care physician has a legal duty to take appropriate action vis-à-vis the patient if the specialist does not agree to see the patient.
Moreover, until actual results are obtained, the order is still considered to be in process.
The same legal principles would apply to diagnostic orders.