Doctors Rights

May 31, 2016 Web Master

Much have been said about patients rights, but nobody talks about physicians rights. Dr. Rodel V. Capule, a
law professor and medico-legal expert specializing in medical malpractice, physical injuries, and food torts,
discusses that while patients come first, doctors have rights, too

By Mylene C. Orillo

Some doctors are starting to feel that the public at large has unfairly painted them as professionals without any
rights. We always hear about doctors duties and responsibilities, but when we enter the hospital, all you see are
patients rights posted at the hospital lobbies.
When a doctor is talked about, society refers to them as highly skilled professionals incapable of committing
mistakes. And the absolute expectations come from patients to discharge his duty at the expense of his rights, says
Dr. Rodel V. Capule, a law professor and medico-legal expert specializing in medical malpractice, physical injuries,
and food torts.

As doctors, they should be able to balance the expectations of patients and the exercise of their right adds Dr.
Capule. More often than not, doctors are always oppressed they get shouted at by unreasonable patients or their
relatives; and many times, they dont receive their professional fees in full.

Patient as captive consumer

Dr. Capule explains that in a physician-patient relationship, the patient is a captive consumer. There is no other
profession or business wherein one can dictate to a consumer what brand [s]he must buyhow fast [s]he must
consume it and how much [s]he must pay with the further condition to the consumer that any failure to fully comply
must be at the risk of [her] own health. [Magan Medical Clinic v. California State Board of Medical Examiners 57 Cal.
Rptr. 256 (Ct. App. 1967)]

Perhaps thats the reason why nobody talks about your (doctors) rights because this is the way the public at large
sees it. Youre the boss, and everything you say is followed by the patient. But doctors have rights, too! says Dr.
Capule.

Usually, physicians refer to the Medical Act of 1959, Hippocratic Oath, Philippine College of Physicians and
Philippine Medical Association Code of Ethics, but they dont specifically indicate doctors rights.

Most doctors have not even read the Medical Act of 1959, and while theres a pending bill in the Senate and the
Lower House trying to come up with a new medical act, unless its filed every year during the opening of the
Congress session, it will only be overtaken by a lot of political issues and buried in the archives.
Medical Act of 1959

The Medical Act of 1959 provides for and shall govern the standardization and regulation of medical education, the
examination for registration of physician, and the supervision, control and regulation of the practice of medicine in the
Philippines.

The Medical Act of 1959, Sec. 25 states the Rights of Respondents where the respondent physician shall be entitled
to the following: 1) Entitled to be represented by counsel or be heard in person, 2) To have a speedy and public
hearing, 3) To confront and to cross-examine witnesses against him or her, and 4) To all other rights guaranteed by
the Constitution and provided for in the Rules of Court.

Right of respondents, meaning you have a case [already]. But even without these, the Constitution will provide for
your rights as a respondent. But it doesnt indicate your right/s, but a regular course of your practice, explains Dr.
Capule.

The Hippocratic Oath, an oath taken by physicians, on the other hand, also has no mention of any right. However, it
did mention a curse to physicians: However, should I transgress this Oath and violate it, may the opposite be my
fate.

Its not about the right, but a curse. But whether you believe or not, I think it all boils down if you do your thing
properly. We dont have that kind of issue, although most of us have forgotten their Hippocratic Oath, laments Dr.
Capule.

In the PCP Code of Ethics, it only indicates that the parties may jointly waive their right to a formal hearing in writing
by opting to submit their position papers in lieu of a hearing [2.5.3. Sanctions and Procedure]. The parties shall be
accorded the right to have counsel present to assist them [2.5.3. Sanctions and Procedure]

I tried to review it and these talks about procedural rights in case you have a case or a case has been filed for you
to be dismembered or removed from the membership of PCP, but no specific rights, he says.

The right to refuse patients

In Dr. Capules practice, one of the most common issues or questions is, As a doctor, do I have the right to refuse
patients? Under the PMA Code of Ethics Section 2, Article II, Duties of Physicians to their patients, it states there
that a physician should be free to choose patients.

But if hes a primary physician, who will be the first contact with the patient, hes on deck or duty in the hospital, it
might be a source of liability. He will be called anytime PhilHealth member, it can also be a source of liability if the
doctor refuses him/her. But for company physicians, they have no choice but to accept the employee as their patient.
They cannot refuse him/her as it is a breach of contract.
 Dr. Rodel V. Capule, an attorney specializing in medical malpractice, physical injuries, and food torts and a law
professor in Legal

So when can you refuse?

If doctors fall under any of the above mentioned categories, their playing field is very narrow. Doctors should have
somebody to cover for them, especially if he/she is really not feeling well or tired.

It can be an internal arrangement. The important thing is theres somebody to attend to the patient, he says.

Doctors also have the right to refuse participation in the treatment. Dr. Capule cites: Conscientious objection implies
the acted responsibly in making it clear in a courteous way to the patient what the limits of his/her medical practice
are.

Right to be paid for services

Obviously, when a physician treats a patient, it has an enforceable claim for full payment for his services, but that is if
hes willing to go to court to file a collection case.

The good thing about doctors is at the end of the day, most still practice medicine not because theyre solely after the
money. Its our passion. But its your right. Once you render your services, youre entitled to a fee, but to a
reasonable one, he says.

Doctors can refuse a patient who has not yet paid their professional fee, but this is rarely done due to its
repercussions. It will definitely leave a bad image of the physician to his/her patients and to the community once
theyve learned about it.

As to the case of deposits, Dr. Capule clarifies that its not wrong to demand for a deposit. Whats wrong is if one
makes it as a precondition to render care or initiate treatment.

That part is limited by the law (RA 8344 Demanding of Deposits). Money down before I treat you is a violation. You
cannot do that! We dont do that. But asking for a deposit per se is not prohibited by the law.

Right to withdraw

The physician has a definite right to withdraw from the case provided he gives the patient reasonable notice so as to
enable him to secure other medical attendance. Such a withdrawal does not constitute abandonment.
Dr. Capule explains that a physician must continue to attend to a patient until the conditions for his rightful withdrawal
are complied with. He cannot just abandon a patient. Some doctors withdraw because patient and family members
become hostile, disagree with the treatment plan, or if they become disruptive or difficult to deal with. A physician
may also find himself/herself unable to work with a medical colleague attending to the same patient.

Ive encountered cases where the doctor was being subjected to verbal abuse by the patient or family members.
The question is, are you still comfortable being the attending physician?

Dr. Capule shares one case he has handled wherein the doctor was recorded on video while doing his regular
rounds. The video recording was surreptitiously done and used as basis for a complaint.

The problem is he [complainant] didnt know that he was violating the Anti-Wire Tapping Act. It cannot be used as
evidence against the respondent. Luckily I was able to have it dismissed.

Dr. Capule advises the doctors if they feel that the environment, society, hospital is already hostile, they should not
subject themselves to that every day. He has the right to withdraw, but he has to follow certain procedures, so as not
to be liable for professional abandonment. He must formally sign out.

Doctors cannot be onion-skinned or hypersensitive. You dont have that right, says Dr. Capule. You cannot justify
abandoning your patient just because nagtatampo kayo (you were touchy).

Doctors as expert witnesses

Dr. Capule notes that some doctors refuse in the administration of justice especially when their colleagues are
involved. This issue continues to haunt the doctors as professionals on why they are not comfortable in helping the
court decide on a particular case.

That has been a nagging question ever since, especially if our colleague has committed malpractice. It is a
challenge for us. When lawyers talk to us, everything is off the record.

While doctors have the right to refuse to be an expert witness, they are challenged by the Duties of Physicians to the
Community [Article III Section (2) Code of Ethics of PMA], where a physician shall assist the government in the
administration of justice in accordance with law. He/she maybe accorded a fair and just remuneration when called
upon as an expert witness.

As a witness, doctors cannot refuse a subpoena. However, this law does not apply to a witness who resides more
than 100 kilometers from his residence to the place where he is to testify. [Rule 21 Section 100 of the Rule of Civil
Procedure]

Doctors must advocate for themselves in ensuring that their rights are not violated, in the same manner that they try
to respect and uphold their patients rights. A conscious effort to understand these rights is the key to preempt
conflicts that might arise in the course of a doctor-patient relationship, says Dr. Capule in conclusion.

Medico-Legal Issues: What are the Doctors Rights? by Dr. Rodel V. Capule, FPCP was one of the topics discussed
during the Philippine College of Physicians Annual Convention at the Marriott Hotel, Pasay City.
May 2016 Health and Lifestyle