On July 21, 2014, the Indiana Court of Appeals issued an opinion in Giles v. Anonymous Physician I, refusing to extend the physician patient relationship to a hospitalist asked to consult on a patient – the hospitalist refused the consult because the patient’s primary care provider had not approved hospitalist care for his patients.  Plaintiff argued that even in the absence of a physician-patient relationship, the courts should create/recognize a legal duty akin to nonfeasance owed by physicians to would-be patients.  Plaintiff argued that such a duty should be based on public policy grounds.  The Indiana Court of Appeals rejected this argument and stated:

As an alternative to showing that there was a genuine issue of material fact regarding the existence of a physician-patient relationship, Giles invokes public policy and out-of-state cases and seeks to have this Court impose or create a duty for Hospitalist—even without the existence of a physician-patient relationship—to have treated Ruth by virtue of the hospital rules and regulations. Giles asserts that ‘[t]here are considerable public policy reasons for the Indiana Court of Appeals to recognize the significant relationship between [Hospitalist] and [Ruth] as a matter of public policy.’ (Giles’s Br. 18). We, however, decline Giles’s invitation to create a duty for a physician based on public policy and absent a physician-patient relationship.

Giles v. Anonymous Physician I,  WL 3572831, at 7 (Ind. Ct. App. 2014).  In the alternative, Plaintiff also argued the hospital’s rules and regulations created a duty to consult with patients and further argued the patient was a third-party beneficiary under such agreement.  The court rejected this argument and determined Indiana law is clear that a “physician who does not treat a patient or perform some affirmative act regarding the patient has no physician-patient relationship and thus owes no duty to that patient.”  Because the hospitalist did not treat the patient and took no affirmative action with regard to the patient, there was no physician-patient relationship.

This case supports the historical understanding by physicians that they must take some action on behalf of a patient in order to establish a physician-patient relationship.