Identifying the individual who is the “most responsible physician” is not always straightforward, particularly in hospitals and other institutional settings. But knowing who that person is at any given time is important for ensuring the delivery of safe and effective care.
The term most responsible physician (MRP), or most responsible practitioner, generally refers to the physician, or other regulated healthcare professional, who has overall responsibility for directing and coordinating the care and management of a patient at a specific point in time. While typically the attending or admitting physician will be the MRP, this may not always be the case.
Generally, a healthcare professional is not responsible for the care provided by another healthcare professional. Often, more than one healthcare professional will owe a duty of care to a patient. When a referral is made to a specialist, the referring MRP is generally not responsible for the care provided by the consultant, even though that MRP continues to be responsible for coordinating the patient’s ongoing care — at least until a new treating physician can assume such care.
Misunderstandings about who is responsible for a patient’s care during handovers can be avoided when there is open communication among the healthcare team and when systems are in place, such as the use of structured communications tools. This includes documenting the handover and communicating to patients and families on who is most responsible for care at particular points in time. Hospital or institution policies and procedures that outline what is expected of the MRP may provide valuable guidance.