The podiatrist-patient relationship

Podiatrist Patient Relations

Adopted: Thu, 2010-01-14

Back to Position Statements

Reviewed 2014-11-13 - no changes

The duty of the podiatrist is to provide competent, compassionate, and economically prudent care to all of his or her patients. Having assumed care of a patient, the podiatrist may not neglect that patient nor fail for any reason to prescribe the full care that patient requires in accord with the standards of acceptable podiatric medical practice. Further, it is the Board's position that it is unethical for a podiatrist to allow financial incentives or contractual ties of any kind to adversely affect his or her medical judgment or patient care.

Therefore, it is the position of the North Carolina Board of Podiatry Examiners that any act by a podiatrist that violates or may violate the trust a patient places in the podiatrist places the relationship between podiatrist and patient at risk. This is true whether such an act is entirely self-determined or the result of the podiatrist's contractual relationship with a health care entity. The Board believes the interests and health of the people of North Carolina are best served when the podiatrist-patient relationship remains inviolate. The podiatrist who puts the podiatrist-patient relationship at risk also puts his or her relationship with the Board in jeopardy.

Elements of the podiatrist-patient relationship

The North Carolina Board of Podiatry Examiners licenses podiatrists as a part of regulating the practice of podiatric medicine in this state. Receiving a license to practice podiatry grants the podiatrist privileges and imposes great responsibilities. The people of North Carolina expect a licensed podiatrist to be competent and worthy of their trust. As patients, they come to the podiatrist in a vulnerable condition, believing the podiatrist has knowledge and skill that will be used for their benefit.

Patient trust is fundamental to the relationship thus established. It requires that:

  • there be adequate communication between the podiatrist and the patient;
  • the podiatrist report all significant findings to the patient or the patient's legally designated surrogate/guardian/personal representative;
  • there be no conflict of interest between the patient and the podiatrist or third parties;
  • personal details of the patient's life shared with the podiatrist be held in confidence;
  • the podiatrist maintain professional knowledge and skills;
  • there be respect for the patient's autonomy;
  • the podiatrist be compassionate;
  • the podiatrist respect the patient's right to request further restrictions on medical information disclosure and to request alternative communications;
  • the podiatrist be an advocate for needed podiatric care, even at the expense of the podiatrist's personal interests; and
  • the podiatrist provide neither more nor less than the medical problem requires.

The Board believes the interests and health of the people of North Carolina are best served when the podiatrist-patient relationship, founded on patient trust, is considered sacred, and when the elements crucial to that relationship and to that trust -communication, patient privacy, confidentiality, competence, patient autonomy, compassion, selflessness, appropriate care-are foremost in the hearts, minds, and actions of the podiatrists licensed by the Board.

This same fundamental podiatrist-patient relationship also applies to mid-level health care providers such as podiatrist assistants, and nurses in all practice settings.

Termination of the podiatrist-patient relationship

The Board recognizes the podiatrist's right to choose patients and to terminate the professional relationship with them when he or she believes it is best to do so. That being understood, the Board maintains that termination of the podiatrist-patient relationship must be done in compliance with the podiatrist's obligation to support continuity of care for the patient.

The decision to terminate the relationship must be made by the podiatrist personally. Further, termination must be accompanied by appropriate written notice given by the podiatrist to the patient or the patient's representative sufficiently far in advance (at least 30 days) to allow other care to be secured. A copy of such notification is to be included in the medical record. Should the podiatrist be a member of a group, the notice of termination must state clearly whether the termination involves only the individual podiatrist or includes other members of the group. In the latter case, those members of the group joining in the termination must be designated. It is advisable that the notice of termination also include instructions for transfer of or access to the patient's medical records.