A physician is not required to accept as patients all who apply to him or her for treatment. The physician may arbitrarily refuse to accept any person as a patient, even though no other physician is available. The physician-patient relationship begins when the physician, in response to an express or implied request by the patient or patient's guardian for treatment, undertakes to render services. The mere rendering of first aid services in an emergency does not give rise to the relation, but the physician nevertheless is required to use due skill and care in administering emergency treatment. The physician may, by special agreement with the patient, limit the engagement to treat the patient to one particular treatment or procedure or to administering treatment at a particular time or place.

After the physician-patient relationship has been entered into, the physician is under an obligation, in the absence of a special agreement, to attend the case as long as it requires attention, unless he or she gives reasonable notice of the intention to withdraw from the case, or is dismissed by the patient or patient's guardian. Once the physician-patient relation is terminated, a physician has no duty to follow the progress of the patient. A physician cannot withdraw from a case and be relieved from liability by simply staying away without notifying the patient of his or her withdrawal. If the physician wishes to withdraw from the case, he must give the patient reasonable notice of his withdrawal in order that the patient may secure other medical attention if he so desires. What is reasonable notice to the patient depends upon the circumstances of each case. Factors to be taken into consideration are the condition of the patient, the size of the community, and the availability of other physicians. One court has held that a physician's malpractice insurance company may be held liable for inducing the physician to withdraw from a case merely because it believes the patient may file a malpractice claim. The company has a right to induce such a physician to withdraw only if there is an immedicate threat to its economic interest because the patient has expressed an intention to make such a claim. Whether other courts would follow this ruling is uncertain.

If the physician wishes to withdraw from a case, he or she should make it clear to the patient. To provide the greatest degree of protection, the physician should send a letter to the patient explaining the situation. This letter should preferably be sent by certified mail and a copy should be retained in the physician's files.

Adapted from the AMA's Medicolegal Forms.