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Legal diff in the meaning of Advice & Referral by a doctor

(Querist) 15 October 2009 This query is : Resolved 
Whether the meaning of Advice & Referral is same in the eyes of Law? and whether a doctor can be prevented by any Rule for not to give 'Advice' to a patient?

Please give your legal comments as in one of the Judgments of MP High court, the Honble Court has said that the meaning of 'Advice' & 'Referral' is same.

Dr. MI Khan
Chief Orth Surgeon
PJANARDHANA REDDY (Expert) 15 October 2009
TWO PROFESSIONS ARE NOBLE PROFESSIONS ,BUT THE NATURE OF IMPLICATIONS IN LAW PRACTICE IS DEPENDS ON PRINCIPLE OF JUSTICE.DOCTOR IS DEPENDS ON SO MANY FACTORS OF HEALTH SCIENCE,THE SCOPE IS LARGE.

HENCE WE CANNOT COMPARE THE TWO PROFESSIONS.
Raj Kumar Makkad (Expert) 15 October 2009
A referral is someone that passes on the name of someone that might be able to help someone else. "Hey, I’ve heard of Cher Wada and she does consulting- maybe you should check out her services."

An advice is someone that says this is a great person- you should do business with them. "Hey, I had Cher Wada re-do my resume and it was excellent- you should have her do yours."

So far verdict of MP High court is concerned, it should be gone through minutely. A doctor cannot be prevented to give advice but referrel is entirely different matter wherein the person does more than advice and refers something to do.
Dr. M I Khan (Querist) 16 October 2009
Thanks for the comments,

The two words: 'Advised' & 'Referred' are very commonly used in the medical practice, e.g. Dr. Khan says to some of his patient as: Mr.Jain is advised CT Scan of Head' or say 'Advised suger-free diet'

In contrast when a doctor says: 'Referred to Charak Diagnostic Centre for CT Scan' then this is altogether a different one.

The controversy had arised when in one of the organisation there has been a condition that 'Before getting the CT Scan, permission of the CMO is required'. Doctor 'X' of that organisation had advised for CT Scan to one of his patient BUT that doctor was penalised by the CMO saying that he has 'Referred the patient for CT Scan without his permission'. The doctor 'X' explained that he had only advised for the test and had not referred for the CT Scan. 'X' challanged the penalty in the Honble High Court saying that he had only 'Advised' for the test and had not 'Referred' to any centre for that test, hence the permission of the CMO is not required for giving a mere advice.

The doctor 'X' enclosed one letter of a Dean of Medical College where the Dean had differentiated the meaning of the 'Advice for a Test' & the 'Referred for a test'saying that both are entirely different. The doctor also referred the Oxford Dictionary.

BUT the Honble Court has opined that saying 'Advised for CT Scan' has the same meaning as of 'Referred for CT Scan'.

If such is the case, then every doctor now onward will not advise any patient for any test. In such condition if a patient comes with Head Injury where the test is urgently required, then the doctor of that organisation will never advise for such a test unless the doctor takes approval for that 'Advice' for that test from his CMO who might not be available in the city, till then God knows......

In light of this, should a doctor not give advise for the test before the approval of his CMO because if he does so, he will be penalised BUT if he does not do so, the morals of the doctor will not forgive him throughout his life?.

In my opinion, giving advise to a patient by a doctor is for the benefit and life saving measures of the patient and is an inherent professional right which can not be questioned and can not be bounded by any rule.

Please comment.

Dr MI Khan
Mob: +91-9425356874
Mail ID: abrar8899@yahoo.co.in
Arul Kumar (Expert) 22 October 2009
It depends up on the circumstances where the CT scan was reffered or advised. Here we have to construe referral to the contset of referring the CT scan test and not referring any particular diagnostic centere. The Hobl-Court is right in the above said judgement, as whenever a doctor advises a patient for CT scan, he is referring the patient for such test. So in the said circumstance both have the same meaning.
Dr. M I Khan (Querist) 22 October 2009
Dear Mr. Kumar,


Thanks for the comments.

We, the doctors, give our various advise to every patient for their benefit and coming to a conclusion for reaching a final diagnosis on which our treatment or the surgeries will be based.

So if any person of Head injury comes, we give him our advise as what best treatment options are available. Similarly the doctor had advised for CT Scan without asking him to go to a perticular centre. It is on the wish of the patient whether he gets the CT Scan done or not and if he wiches to get it done then it depends on his will as from which Centre he gets his CT Scan done.

In contrast to this, if the doctor writes in his prescription as "Referred to X Diagnostic Centre for CT Scan" then it is a specific advise which comes under the category of 'Referral'.

If all the advice for a Test given by the doctor are considered as the 'Referral' for the Test then what is the stand of that doctor because if he does not give proper advise then he is penalised under Consumer Protection Act for not giving proper advice, But if he gives his advice then also he is penalised for violating those rules of any organisation where the Organisation have Rules of taking permission before Referral of a case for CT Scan?


What a doctor should do in such case? Whether he should ask his organisation first, that he wants to give advise for CT Scan to patient 'X'and after his organisation says 'Yes' please give your advise for CT Scan to patient X??? then only the doctor should write or give his advise???

Please opine.

Dr MI Khan,
Chief Orth Surgeon


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