Approved by the Board: October 16-17, 2000 Board Meeting
Service Area: Medical
Subject: Ophthalmic Surgery, Co-management of
In accordance with S.C. Code Ann. Section 1-23-40, notice is hereby given that the South Carolina Board of Medical Examiners has adopted the following statement regarding ophthalmic pre-operative assessment and post-operative care for patients as guidance for licensed physicians in the practice of medicine under the South Carolina Medical Practice Act and the Principles of Medical Ethics, as adopted by the Board. For disciplinary purposes in matters before the Board, compliance with this statement will not be considered a violation of the physician's professional duty to provide competent medical service under S. C. Code Ann. Sections 40-47-200(F)(7), (8), (12) or Regulation 81-60(A), (B), (C), and (E) of the Principles of Medical Ethics, adopted by the Board.
OPHTHALMIC PRE-OPERATIVE ASSESSMENT AND POST-OPERATIVE CARE
The ophthalmic surgeon has the primary responsibility for the pre-operative assessment and the post-operative care of his/her patients regardless of the type of surgery performed. For most ophthalmic surgery, this includes an examination on the first post-operative day by the operating surgeon or another medical doctor of equal skills and training.
The surgeon should follow the patient until post-operatively stable and there is no fixed time when the patient is sent back to the referring provider.
If a situation arises in which the surgeon concludes that the delegation of post-operative care is in the patient's best interest, then the surgeon should pre-operatively inform the patient of the pre-arranged plans and the patient must voluntarily consent to this in writing. This consent process should include the reason for the transfer of the case, the qualifications of the healthcare provider who will render the post-operative care, and any special risks that may result from this arrangement.
The transfer of care must not occur unless it is clinically appropriate and in the patient's best interest.
The co-management must not be done as a matter of routine policy on all patients.
Although a physician who conducts himself in accordance with this policy will avoid disciplinary action by the Board of Medical Examiners, a physician may still face civil liability under some circumstances, and should therefore consult private counsel where doubt exists as to what actions are appropriate.