Terminating the Physician-Patient Relationship

1. Clearly communicate your decision and reasons for terminating the relationship with the patient as compassionately and supportively as possible.
2. Provide the patient with a reasonable amount of time to find another otolaryngologist. What is “reasonable” will vary, depending on the patient’s individual circumstances and the level of care required.
3. Offer to provide the patient with assistance in finding a new otolaryngologist.
4. Offer to provide the patient or the patient’s new otolaryngologist with a copy of the patient’s medical record.
5. If the patient is in need of medical care during the transition period, it is advisable to provide that care so the patient is not abandoned while he/she finds a new otolaryngologist.
6. If the patient will require ongoing medical care, make sure that information is clearly conveyed to the patient.
7. If the patient has been habitually noncompliant with the treatment plan, ensure that the patient has an accurate understanding of the possible consequences.
8. Inform your office staff about the termination so that they may handle any contacts with the patient appropriately.
9. Notify the patient’s other health care providers of the transfer to the new otolaryngologist.
10. Document the termination process and maintain detailed records of any discussions with the patient.
11. Send the patient a letter drafted by a health care lawyer confirming the termination and the reasons for this decision. Be sure to send the letter with tracking and delivery confirmation in case a question arises as to whether the letter was sent and received.
12. Place a copy of the letter and the postal receipt in the patient’s medical record and write a final entry in the record.

You may consider including the following sample language in a termination letter sent to a patient:

“This letter is to inform you that I am terminating our physician-patient relationship. I do not believe it is in your best interest for me to continue as your physician for the following reasons … After [date], I will not be in a position to provide you with further medical care. Until that time, I will be available to render emergency services to you, but I urge you to obtain the services of another otolaryngologist as soon as possible. I will be happy to forward a copy of your medical records to you or to your new otolaryngologist upon receiving your signed, written request.”

Both the patient and physician have the right to terminate the physician-patient relationship. However, it is important for the physician to be fully cognizant of the patient’s situation.