How to Appropriately Discharge a Patient

In the letter, don’t give too many details about why this relationship is ending. For example, the letter should not cite examples of when the patient was disruptive or state the patient has unrealistic expectations or demands. Instead, the letter should simply state that you will no longer be able to treat the individual and that the termination of the relationship will be effective 30 days from the date of the letter.

To reduce abandonment claims, if the patient requires further medical attention, you will want to stress the importance of selecting another physician as soon as possible. You may suggest the patient contact their insurance carrier or local medical society for recommendations. To ensure the patient does select another physician, we recommend including a release form in the certified letter for the patient to complete and return to your office so you know to whom the patient’s medical records should be forwarded. This will alleviate any doubt the patient has a new physician who can continue treatment.

Additional Considerations

It is important to act quickly and prudently after you decide to terminate a physician–patient relationship to reduce the disruption to the patient’s care and to protect yourself. Keep a file on the patient. Keep track of the dates you contacted them, including the dates the certified notification letter was mailed and when you receive the patient release. Make copies of all correspondence with the patient, and save them in the patient file.

Once directed to send medical records to the patient or another physician, send these records promptly. State statutes differ as to the specific amount of days a physician has to release requested medical records, so consult with an attorney or review the state statute as soon as you receive the request. If you are releasing the medical records to another physician, call the physician before you send the records and ask to whom the medical records should be addressed to avoid privacy concerns. Send records via certified mail so you can track that they are being sent properly and to whom they are delivered.

Train your receptionists, assistants and others who work in your office how to handle a call from a terminated patient. They should be polite and helpful, but not offer specific details about why the patient was terminated. Instead, they should simply refer the patient to the letter.

Although following these guidelines won’t eliminate the risk inherent in terminating a patient relationship, doing so will reduce the risk to you and your practice.