How to Appropriately Discharge a Patient

© Elnur / shutterstock.com

Are you a physician with a patient who no longer requires medical treatment? Do you have a patient you believe would be better served by another physician, specialist, or practice due to a developing condition? Do you want to terminate a patient relationship because it is costing more than it is worth to your practice?

Dealing with a burdensome or difficult physician–patient relationship can be frustrating and time consuming. But before you terminate the relationship and refuse to see a patient, you should review the essential guidelines below to ensure you are complying with law and to reduce exposure to medical malpractice or abandonment claims.

The Difficult Relationship

A difficult patient relationship can develop for a number of reasons. A patient may be unruly, uncooperative, disruptive or threatening. A patient may not be paying their bills in a timely manner. A patient may be taking up valuable time or resources from your team with unrealistic expectations or demands. A patient’s course of treatment may be complete. The first step in navigating how to end these types of relationships is to understand whether a physician–patient relationship exists.

If a physician–patient relationship exists, you cannot simply ignore the patient or tell them you will no longer treat them. You have a duty of care to the patient and must treat them or ensure the patient is being treated by another qualified physician. Therefore, it is important to determine whether a clear and direct relationship has been established with the patient.

Determining whether this type of relationship exists is often a question of fact. Courts look at many different factors, including the history of the interactions between the patient and physician, whether the patient has sought the physician’s medical advice in the past and whether the physician has offered treatment or care to the patient. If it appears that a patient has asked a physician for medical advice or treatment and the physician has offered that advice or treatment, a court will likely find that a relationship has been formed.

Act quickly and prudently after you decide to terminate a relationship with a patient to reduce the disruption to her and to protect yourself.

Appropriate and Ethical

If a relationship has been formed that you want to end, you must take the proper steps to eliminate any possible malpractice or abandonment claims. The first step is to notify the patient that you will no longer be treating him. Although laws vary by state, most statutes mandate a reasonable notification time period. To be safe, you should give the patient at least 30 days’ notice. This notice should be in writing and sent via certified mail so you can track whether the patient received the notification.