As a primary care physician, if a patient was involved in a motor vehicle accident and a lawyer is now involved, can I refuse to see the patient for follow‑up after the emergency department visit?

Can a Primary Care Physician Refuse Follow-Up Care After a Motor Vehicle Accident When a Lawyer Is Involved?

No, you cannot ethically or legally refuse to see this patient solely because a lawyer is involved. Your duty to provide medically necessary follow-up care is not conditional on the patient's litigation status, and refusing care based on legal involvement violates core ethical principles of beneficence and nonmaleficence while exposing you to significant malpractice liability. 1, 2

Your Fundamental Ethical Obligations

The physician-patient relationship is the moral center of medicine, and your primary responsibility is the patient's medical welfare—not the avoidance of potential legal entanglement. 3

• Your duty to serve the patient's best interests by treating or preventing disease and injury is fundamental and does not disappear when litigation is involved. 3
• The principle of nonmaleficence requires you to maximize benefits and minimize risks, which includes delivering appropriate follow-up care after a motor vehicle accident. 1
• Competent adult patients have the right to accept recommended healthcare interventions, and you must respect that choice and provide the care. 1

Why Refusal Creates Legal Liability

Physicians who deviate from the prevailing standard of care expose themselves to malpractice liability, and refusing medically indicated follow-up constitutes such a deviation. 1

• A reasonable physician adheres to "the care a prudent and reasonable physician would exercise under the circumstances," and this standard does not include refusing care based on litigation concerns. 2
• Motor vehicle accident patients require specific follow-up within one week to assess injury healing, ensure appropriate counseling, and screen for delayed complications. 1
• Liability can extend to third parties who suffer injury as a consequence of inadequate patient management—if your patient's untreated condition leads to harm, you may be held responsible. 1

The Critical Medical Reasons You Cannot Refuse

Post-MVA patients face substantial risks of delayed complications that require physician monitoring:

• 18.7% of motor vehicle accident patients report three or more persistent symptoms requiring ongoing medical management. 1
• Patients may develop repeated vomiting, worsening headaches, increasing abdominal pain, confusion, seizures, or focal neurologic deficits—all requiring immediate emergency department return. 1
• Follow-up at one week is recommended to assess injury healing and ensure appropriate counseling, with additional reassessment at two weeks for symptoms and emotional status. 1
• Patients with persistent symptoms beyond three weeks require specialist referral, and delaying this referral worsens outcomes. 1

Your Only Acceptable Option: Proper Transfer of Care

If you genuinely cannot maintain therapeutic objectivity, you may transfer care—but only under strict conditions that protect the patient. 1

• Transfer is permissible only if the patient is assured access to equivalent or superior care. 1
• You must provide adequate notice and interim care to bridge the transition period. 1
• The patient must not be abandoned during any acute phase of treatment while the transfer is arranged. 1
• You remain responsible for ensuring continuity of care until another qualified physician accepts the patient.

Documentation Is Your Protection, Not Refusal

Thorough documentation of objective clinical findings constitutes your strongest legal protection—not refusing to see the patient. 1

• Document all objective clinical findings and avoid speculation about litigation motives. 1
• Record all warnings given about return precautions and activity restrictions. 1
• Note the patient's adherence—or lack thereof—to the recommended follow-up plan. 1
• Your medical record should demonstrate that you provided appropriate care regardless of legal involvement.

Common Pitfalls to Avoid

• Do not assume that lawyer involvement means the patient is seeking to sue you—many MVA patients need legal representation for insurance claims against the other driver. 1
• Do not dismiss seemingly minor symptoms, as delayed complications are common and 18.7% of patients develop persistent symptoms. 1
• Do not delay specialist referral beyond three weeks of persistent symptoms, as early intervention improves outcomes. 1
• Do not fail to screen for chronic headaches, anxiety, memory problems, difficulty concentrating, and sleep difficulties, as these predict poor outcomes. 1

The Bottom Line

Patient well-being must be your primary motivating factor in patient care, ahead of your own interests and needs. 2 Refusing to see this patient because a lawyer is involved prioritizes your convenience over the patient's medical welfare, violates established ethical principles, and exposes you to malpractice liability for abandonment and deviation from the standard of care. 1, 2, 4 If you cannot provide objective care, arrange a proper transfer—but you cannot simply refuse. 1