A fiduciary duty is a legal relationship between at least two parties. The "fiduciary" is the party the duty is imposed on. The "principal" is the party that is owed the duty.
What Are the Different Fiduciary Duties?
- Duty of Care: The fiduciary owes a duty of care toward the principal. This means they are legally required to be educated and informed about the laws and issues regarding the procedures, conditions, and surgeries they are administering. If they are not adequately informed, they may not be legally liable if they did not have enough time to obtain the relevant information. However, doctors must also have a critical eye when processing medical information and have a sound method of evaluating the credibility of the information.
- Duty of Competence: A doctor must be accredited, receive the state and federally mandated education for his or her role, must stay up to date on licensing, and stay current on new forms of treatment and new medications. The doctor has a duty to stay at a baseline of competency in order to best serve patients. Competency is assessed by measuring what other professionals might do in a similar situation or under similar circumstances. The “locality rule” may apply in assessing competence: a doctor is judged by what other doctors in the same area are doing in regards to specific treatments and procedures.
- Duty of Good Faith and Fair Dealing: The doctor cannot be trying to cheat the patient in any way. This would include charging fair market prices for procedures and not ordering unnecessary procedures in order to increase insurance billing.
- Duty of Loyalty: The fiduciary must remain loyal to the principal’s interests over his or her own. In the medical field, this could mean the doctor must not prescribe any procedures or medications that are not in the best interest of the patient. This sounds simple enough, but perhaps a doctor wants to try a procedure new to him or her, has a bias toward a certain medication, or is tempted to wrangle an insurance company with a specific kind of billing for an unnecessary procedure. The doctor cannot receive any financial or professional incentives for prescribing particular medications or ordering certain surgeries.
- Avoid Conflicts of Interest: Conflicts of interest for doctors and patients vary widely and must be assessed with caution and care. A doctor may have developed a technique that is now marketed and sold. Is it a conflict of interest for that doctor to prescribe that technique to a patient and receive a royalty? Yes, if this is systematically done and not done in the best interest of a patient.
Is Confidentiality a Fiduciary Duty?
Yes. Doctor-patient confidentiality is a very important fiduciary duty. This is to encourage disclosure to the doctor of facts which may help in diagnosis or treatment but which may be embarrassing or harmful to the patient if released to others.
This fiduciary duty includes a duty not to disclose any medical information received in connection with treatment. If medical information is disclosed without the client's prior approval (usually in the form of a waiver), the client may bring a lawsuit against the doctor for breaching their duty of loyalty.
Do I Need to Consult an Attorney about Fiduciary Duties?
Whether a doctor improperly disclosed confidential information about a client, thereby breaching their fiduciary duty, is not always clear. An personal injury lawyer can help determine if you are entitled to recover for wrongful disclosure of your confidential medical information.