[Legal liability in consultation of physicians of different specialties from the legal viewpoint].
Modern medicine is unthinkable without medical teamwork with differentiated cooperation. The horizontal division of the work, meaning the cooperation of physicians from different specialties on the basis of an equal order and the equal right in giving instructions, has to be differentiated from the relationship of subordinate and senior physicians in the vertical division of work which may be found in the relationship between the coordinator, subordinate physicians and the medical assistant staff. However, the danger of mistakes increases with the number of involved specialists. On one side, the jurisdiction has to protect the patient from the typical dangers of the division of work but has to protect the physician from an excessive liability for the malpractice of others on the other side. The necessary medico-legal rules in the area of the horizontal cooperation, after modification in the vertical cooperation as well, are the principle of a strict separation of work and the principle of trust. According to the principle of a strict separation of work, every specialist independently carries out the tasks entrusted to him without the right to instruct or supervise other specialists. The principle of trust means that every specialist may rely on the fact that the other partners will carry out their tasks with the necessary care. The limitations of trust are reached in a certain situation when a partner is not able to accomplish his tasks, i.e. due to incompetence, fatigue, or illness. Then, the physician, which is actually not in charge, has to act. Overlapping areas between the specialties should be discussed on-site or should be regulated by interdisciplinary agreements.
Biermann
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E
Berufsverband Deutscher Anästhesisten, Nürnberg.
D002983:Clinical Competence / Q000331:legislation & jurisprudence; D005858:Germany; D006801:Humans; D007351:Insurance, Liability / Q000331:legislation & jurisprudence; D007883:Legislation, Medical; D016365:Liability, Legal; D008318:Malpractice / Q000331:legislation & jurisprudence*; D010348:Patient Care Team / Q000331:legislation & jurisprudence*; D012017:Referral and Consultation / Q000331:legislation & jurisprudence; D013038:Specialization