Câu hỏi có thể phát sinh cho dù bệnh nhân nghiên cứu giấc ngủ và đọc các bác sĩ ở xa đã thiết lập một mối quan hệ thầy thuốc-bệnh nhân cho mục đích của một hành động sơ suất. Xu hướng trong trường hợp pháp luật gần đây cho | Legal Implications of Obstructive Sleep Apnea 409 clearly reproduced on a video monitor or a compact printer the sleep specialist s interpretation of the test can occur anytime and at any place. Often the physician s diagnosis of OSA occurs without the physician examining or even speaking with the patient. Questions may arise whether the sleep study patient and the distant reading physician have established a physician-patient relationship for purposes of a malpractice action. The trend in recent case law is for courts to imply the existence of a physicianpatient relationship among physicians unknown to the patient if the physician affirmatively undertakes to diagnose and or treat the patient 32 . A Texas case Dougherty v. Gifford 33 is instructive. There the patient s specialist sent a biopsy to his contracted pathologist who practiced in the regional medical center in Paris Texas. The pathologist diagnosed cancer and aggressive treatments ensued only to be discontinued when the pathologist admitted to having misread the biopsy 34 . Like most distant readers of sleep tests the pathologist in Paris never intended to create a professional relationship with the patient. The pathologist never met the patient did not review the patient s records and only reviewed the specimen provided. The pathologist communicated the results to the patient s treating physician who retained primary responsibility for the patient s care 35 . Nonetheless the court found on these facts that a physician-patient relationship was created by the acceptance of the pathology work the conduction of the tests the preparation of a lab report and the acceptance of a fee for the services rendered. The court stated that there could be no doubt that the diagnostic services furnished on behalf of the patient constituted the practice of medicine 36 . As stated by the Tennessee Supreme Court in a similar case In light of the increasing complexity of the health care system in which patients routinely are
