Can I File a Medical Malpractice Claim Because of a Doctor’s Failure to Refer?

Posted on behalf of Peter T. Nicholl in Medical Malpractice Published on May 4, 2023 and updated on July 3, 2023.

female patient in doctor's officeDoctors have a legal obligation to provide care that meets accepted medical standards. This might include referring patients to another doctor who specializes in certain medicines.

Failing to refer a patient to another doctor could result in a serious injury, which is why it may be possible to file a medical malpractice lawsuit based on failure to refer a patient.

If you have questions about your medical malpractice claim, call The Law Offices of Peter T. Nicholl. Our experienced Maryland medical malpractice lawyers are here to answer your questions and explore legal options. Our services come with no upfront costs.

Learn more by calling us: 410-297-0271 We are ready to help you.

When Should a Doctor Make a Referral to Another Medical Professional?

This is a complicated question. The answer may depend on many factors, including the:

  • Medical issue you are dealing with
  • Training and experience of the doctor you saw
  • Symptoms you reported to the doctor

Essentially, doctors are required to provide treatment until you no longer need it or until you stop seeing the doctor in question. If your condition gets better or it can no longer be treated, the doctor may have met the standard of care.

It is possible the doctor may not have the qualifications to treat your illness. He or she may not specialize in treating the part of the body that is affected by your condition. For example, a general practitioner is not going to have the same knowledge and experience as a cardiologist.

If this happens, the doctor may have an obligation to refer you to another doctor who has the knowledge and experience to treat you.

Would another doctor in a similar situation have referred you to a specialist? If the answer is yes, the doctor you met with may have had a legal obligation to make a referral.

Making a Proper Referral

If your doctor determines it is best for you to see another medical professional, he or she needs to be cautious about where you are referred.

  • Referring you to a doctor or facility that can be trusted – Doctors should only refer you to a doctor or medical facility that is properly accredited and licensed. Referring you somewhere that is in trouble with regulatory authorities could be considered negligent.
  • Giving patients options – Physicians often give patients a few options when they make a referral. They may also tell you to contact your insurance company to find a specialist in your network.
  • Explaining the referral – When making a referral, the doctor should explain his or her decision. The doctor should explain why your medical issue is beyond the scope of his or her training, experience and medical knowledge. For example, the doctor could explain what kind of services the specialist may be able to provide.
  • Documenting the decision – The doctor’s decision should be documented in your medical records. Your records should explain why the referral was made and to whom it was made.

Why Failure to Refer a Patient Can Cause Serious Injury

Not referring a patient to another doctor can have serious, even life-threatening consequences:

  • Your illness could get worse – Not referring you somewhere else could allow your illness to get worse.
  • You could be misdiagnosed – The first doctor may provide treatment that causes dangerous side effects or injuries, while your actual illness goes untreated.
  • Your illness could threaten your life – If the patient has a serious illness, like cancer or a heart condition, and it goes untreated for too long, the result could be life-threatening. Treating cancer is often more successful if it is caught early. But if you are not referred to an oncologist soon enough, your cancer may go undiagnosed and untreated.

Can I File a Medical Malpractice Lawsuit Over a Failure to Refer?

Your lawyer may be able to hold a medical provider liable for medical malpractice for failing to refer you to another doctor for treatment. Your lawyer would need to prove:

  • The standard of care for the situation demanded a referral.
  • The doctor’s failure to refer you resulted in an injury and damages. For example, your lawyer may be able to show how your medical condition got worse and resulted in the need for costly or invasive treatment.

If you have cancer, your lawyer may be able to show how failing to refer you resulted in a worse prognosis. For example, if the doctor referred you when your cancer was in its early stages, it may have been possible to perform surgery to remove the entire tumor. Your lawyer may provide evidence about how patients in a similar situation who were referred to another doctor had more success with treatment.

Your case is going to require an expert witness to explain, in detail what the standard of care was for your situation. The witness will also need to explain how a delay in treatment or misdiagnosis resulted in an injury and damages (medical expenses, lost wages, pain and suffering, etc.).

Contact Us to Discuss Your Medical Malpractice Claim

Our law firm has obtained millions in compensation for victims of medical malpractice. Doctors, hospitals and medical malpractice insurers are going to fight hard to avoid accountability for malpractice. That is why you need a lawyer with significant experience to fight for your interests.

There are no upfront fees or legal obligations. Call us at 410-297-0271.