ProAd - Risk Management: Terminating the Physician-Patient Relationship

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Terminating the Physician-Patient Relationship

Risk Factors:

Failure to document the termination properly.

Failure to give the patient alternative resources of care.

Failure to give the patient proper notification.

While terminating a patient relationship is fortunately not done frequently, it may at some point become necessary for a multitude of reasons, not the least of which is patient non-compliance. When considering terminating a patient relationship, be aware that the focus is to protect patient care and minimize any potential areas of concern regarding abandonment. Terminating a patient relationship requires documentation of patient non-compliance, disruptive behavior or evidence of poor rapport. In addition, the following approach is necessary:

Suggested Approach:

Notify the patient in writing preferably by Certified Mail and include the following terms in the letter:

Provide the patient if you so choose with a specific professional reason for termination.
Agree to continue as the treating physician for at least 30 days while the patient makes other arrangements.
State clearly the date termination becomes effective.
Recommend or refer the patient to the county medical society, a physician referral service or similar bureau.
Offer to transfer records to the new physician upon receipt of a signed authorization to do so.
Offer to see the patient in cases of emergency within a stated period of time after termination.

Different rules may apply to terminating a patient relationship in a managed care setting. In those circumstances, enrolled members of an HMO often cannot be "dropped" by an individual physician. Therefore, "difficult patients" may be transferred to another site. Be aware of the restrictions applicable to your specific plans.