Responsibilities of an unlicensed doctor

March 22, 2015 8:15 PM

In the United States what are the responsibilities of a doctor who's in the US but is registered in another country (i.e. not licensed in the US)?

Our daughter who recently qualified as a doctor in Britain is visiting us in California. Today we drove past a road accident where fortunately there were no injuries, but that brought up the question of what her responsibilities would be had someone been hurt. In Britain a doctor who encounters an injured person must provide care, and can be sued (I think) if they do not; it's not simply an ethical obligation. Is there something similar in the United States, and if there is how would it apply to someone who's not licensed here?

posted by anadem to Law & Government (10 answers total)

So according to this, which is admittedly 7 years out of date, California doesn't have a "duty to rescue" law. So even ignoring the fact that as far as California is concerned she's not a doctor, she likely wouldn't have an obligation to provide care. And even if so, she's not a licensed doctor so she would likely have the same obligation as you would. That would depend on how the (wholly fictional) "duty to rescue" law was drafted - I could easily see them drafted as "medical professionals" or "people trained in first aid" to catch non-doctors with useful experience. I guess you could look at other duty to rescue laws to see how they're worded, but that is getting rather complicated.

Of course, I'm not really sure how the licensing mechanism works - often the Anglosphere has reciprocal licensing-esque agreements for professionals, for short-term work. So it might be that she could qualify as a doctor without writing any exams (she'd affirm or swear that she's read a bunch of material, is what I've seen with lawyers), which could theoretically complicate the question of whether she'd have an obligation, again if there was even a law on the books about that.

Note: IANYL, IANA(U.S.)L, I'm basing this entirely off a 2008 practice management seminar and wikipedia. Caveat Lector.
posted by Lemurrhea at 8:47 PM on March 22, 2015

There is generally no duty to rescue people in the US (and I am a bit skeptical that this is the case in the UK, given the shared common law). This lack of a duty to rescue makes sense. Otherwise, what are we doing on the Internet when we could be on streets rescuing people?

That said, a small number of states have laws saying that citizens have a duty to report in certain situations. These laws are largely illusory in practice because how could the police ever know that I failed to report in such a situation? California has such a statute (Section 152.3), but it is limited to a few offenses against minor children.
posted by Tanizaki at 9:21 PM on March 22, 2015

Best answer: It's very different here because of the malpractice environment (at least to my understanding - I'm an American doctor but no expert on the law). A lot of medical professionals feel hesitant to provide care in situations like the one you described because of the concern for liability. I am not aware of any 'duty to rescue'. In this country I would say the relevant laws are the Good Samaritan laws - not designed to prosecute folks who could provide care but don't, rather to protect those who do from lawsuits unless they do something truly far outside their purview with a bad outcome.
posted by treehorn+bunny at 9:55 PM on March 22, 2015 [2 favorites]

Best answer: I took a Red Cross first aid course, and one of the things they emphasized was that if you did see an accident and tried to help a victim, the FIRST THING you do is ask them if they want you to help them.

Unless and until they say "yes", you don't do a thing. That's because if you do something without permission and it turns out badly, they can sue you. If they say "yes", then you are legally covered and can't be sued.

(This was Massachusetts; the law may vary in other states. But I think it's like this most places in the US.)
posted by Chocolate Pickle at 10:48 PM on March 22, 2015 [2 favorites]

UK doctor here. There's no law that she has to stop, and she wouldn't be sued. What you are thinking of is the GMC - Good Medical Practice states that she has to "make the care of patients her first concern", which has been interpreted to mean she has to stop. However it also says we have to "recognise and work within the limits of our competence", so if she is a new F1 she will not be expected to be cracking chests by the roadside.

Realistically most doctors interpret this as first aid if you witness something or if an announcement goes out for a doctor or if it's a major incident, but not pulling over to every minor accident or elbowing the ambulance crew out of the way if they are already dealing with it. The risk if she doesn't is fairly low though - somebody would have to report her to the GMC for her to get into any trouble. It is more that she will feel guilty.
posted by tinkletown at 1:33 AM on March 23, 2015 [4 favorites]

I should add, the kind of thing the GMC takes an interest in is stuff like "watching a fitting person choke on their own vomit rather than putting them in the recovery position" or "not doing CPR when somebody arrests in front of you" - we have no legal requirement to intervene in the UK so she couldn't be arrested, but the GMC (and public opinion) would think that was pretty poor behaviour in a doctor. They can still only take action if somebody actually complains to them though.
posted by tinkletown at 1:44 AM on March 23, 2015 [1 favorite]

Unlicensed practice of medicine can incur civil and possibly criminal penalties, depending on the state.
posted by kschang at 2:10 AM on March 23, 2015

To add slightly to what tinkletown said, the most relevant bit of Good Medical Practice is paragraph 26: "You must offer help if emergencies arise in clinical settings or in the community, taking account of your own safety, your competence and the availability of other options for care."
posted by James Scott-Brown at 3:56 AM on March 23, 2015 [1 favorite]

Best answer: California is one of the states that has a Good Samaritan law (here is the statute text). So if she renders medical assistance in good faith to people at the scene of an accident she should not be vulnerable to a lawsuit.
posted by yoink at 11:45 AM on March 23, 2015 [1 favorite]

Response by poster: Thanks for the answers which are all helpful.
posted by anadem at 4:53 PM on April 22, 2015