Dr. Wendy Malik operates an independent practice in a suburban area. She receives a referral from a physician, with whom she has a positive working relationship. Dr. Malik contacts the patient, completes a phone screening, and sets up an appointment with Mr. Larry David.
As is her practice, Dr. Malik sends a confirmation email, attaching her version of informed consent. She instructs Mr. David that he does not have to print it out, only review it and they would discuss any questions at the initial appointment.
Several days later, Dr. Malik checks her email. In it, Mr. David sent her an email with an attachment. Mr. David asks Dr. Malik to review his edits on the informed consent document.
While Dr. Malik notes some suggested corrections on the document, Mr. David modified the cancellation policy. Dr. Malik’s form (and standard policy) is appointments cancelled with less than 24-hour notice will be charged to the patient. Mr. David added a sentence that if Dr. Malik cancels an appointment with less than 24 hours, Mr. David expects Dr. Malik to pay him an amount equal to her hourly rate.
Flustered by this edit, Dr. Malik contacts you for a consultation.
What are the ethical issues involved in this case?
What are the pertinent clinical issues in this case?
How would you help Dr. Malik work through these issues?
Would you recommend Dr. Malik call to address the issue ahead of the appointment or wait for the initial session?
At this point, must Dr. Malik keep Mr. David as a patient?
If not, does Dr. Malik need to contact her referral source about the issue?