The Board has received questions and expressions of concern about practicing medicine during the public health emergency brought about by COVID-19. Healthcare professionals have been forced to adapt to rapidly changing circumstances and this is only the beginning. The demand for services, constrained resources, the need to modify patient encounters to reduce risk of infection, and peers being unable to practice because of illness have impacted, or will impact, the way you treat patients.
What does all this mean for you in terms of your personal liability, either regarding discipline for unprofessional conduct, or with regard to malpractice liability?
With respect to the Board of Medical Practice and the potential for discipline based on a failure to meet the standard of care, you can be assured that your actions will always be judged based on the circumstances. That does not mean that anything goes in a crisis, but that due consideration will always be given to the circumstances in which you practice.
The law that defines the different forms of unprofessional conduct requires the Board to consider the circumstances whenever deciding if the standard of care was met, as seen in 26 V.S.A. § 1354(a):
22) in the course of practice, gross failure to use and exercise on a particular occasion or the failure to use and exercise on repeated occasions, that degree of care, skill, and proficiency that is commonly exercised by the ordinary skillful, careful, and prudent physician engaged in similar practice under the same or similar conditions, whether or not actual injury to a patient has occurred.
The Board does not play a role in malpractice lawsuits, and cannot give licensees legal advice, but we note that the statutory standard for malpractice liability includes comparable phrasing in the law that establishes what must be proved in a medical malpractice claim in Vermont, as seen in 12 V.S.A. § 1908:
In a malpractice action [ . . . ] the plaintiff shall have the burden of proving:
(1) the degree of knowledge or skill possessed or the degree of care ordinarily exercised by a reasonably skillful, careful, and prudent health care professional engaged in a similar practice under the same or similar circumstances whether or not within the State of Vermont;
(2) that the defendant either lacked this degree of knowledge or skill or failed to exercise this degree of care; and
(3) that as a proximate result of this lack of knowledge or skill or the failure to exercise this degree of care the plaintiff suffered injuries that would not otherwise have been incurred.
Healthcare professionals may also want to consult the State of Vermont guidance on medical services in times of crisis. The Vermont Department of Health has set forth a framework for operating in a public health emergency in a document known as the Crisis Standards of Care Plan. A summary of the plan and the plan itself are available on the Health Department website.