How to Effectively Terminate Treatment with Your Doctor
- Honeymoon: This is the phase at the beginning where both doctor and patient are on their best behavior. The doctor...
- Testing Phase: This is usually the next phase, where the patient may miss an appointment, decide to skip some...
- Fear of Rejection: After missing some appointments, becoming irregular in...
How do I terminate a relationship with a patient?
Termination of the Treatment Relationship. Termination of the treatment relationship is appropriate for any number of reasons, including when there is a lack of agreement on a treatment plan, the patient no longer requires treatment, the psychiatrist is closing his or her practice, or the psychiatrist or the patient is moving away.
How do you terminate a patient in a managed care facility?
In appropriate cases, the attending physician may terminate treatment or preclude some or all future treatment with an appropriate written order when the patient is not dead. B. In making decisions about withholding or withdrawing treatment, the competent patient's wishes must be identified and documented by the medical staff.
How do you terminate a patient in a nursing home?
Jan 30, 2022 · A physician-patient relationship can be terminated either in an agreement providing the patient with notice, a reasonably practicable alternative way of receiving information that would enable them to obtain the patient’s records, or an agreement providing notice to patients.
What should be included in a termination letter for a physician?
Jan 04, 2009 · How to Effectively Terminate Treatment with Your Doctor 1. Honeymoon: This is the phase at the beginning where both doctor and patient are on their best behavior. The doctor... 2. Testing Phase: This is usually the next phase, where the patient may miss an appointment, decide to skip some... 3. Fear ...
Can a patient decline medical treatment?
Every competent adult has the right to refuse unwanted medical treatment. This is part of the right of every individual to choose what will be done to their own body, and it applies even when refusing treatment means that the person may die.
How do I break up with my doctor?
Doctors' notes, test results and other information will be useful to your new doctor. If you feel the need to discuss your reason for leaving, take a thoughtful and compassionate approach as you would any breakup. You can be honest with your feedback without being rude.Jan 16, 2019
How do you terminate patient care?
The typical termination procedure involves consulting with the patient's insurer about your plans, then sending a letter to the patient by certifed mail, with a return receipt requested.
When should a patient be terminated?
The patient came to you in need of care. They can only be terminated when they are not actively in need of care. The patient sought care with you. They can only be terminated by giving them reasonable time to find care elsewhere.Jun 7, 2016
How do you end a doctor patient relationship?
In general, the physician-patient relationship can be terminated in two ways without creating liability for abandonment: 1) the physician ends the relationship after giving the patient notice, a reasonable opportunity to find substitute care and the information necessary to obtain the patient's medical records, or 2) ...Jun 24, 2019
Can I stop seeing a doctor?
Can My Doctor End the Patient/Physician Relationship? Yes. The patient/physician relationship can be terminated by your doctor when he or she gives you notice and a reasonable opportunity to find substitute care.
What are the policies necessary for a patient to initiate or terminate medical treatment?
Proper termination requires the following points:Reasonable notice. The length of appropriate notice may depend on the patient's condition and available psychiatric resources in the community. ... Treatment recommendations and education. ... Resources for treatment. ... Records and information. ... Follow-up letter.
How do you fire a patient sample letter?
This letter is to advise you that I will no longer be available to provide medical services to you after (FUTURE DATE ALLOWING PATIENT REASONABLE TIME TO FIND ANOTHER PHYSICIAN). I will be available to treat you until (DATE FROM ABOVE), so that you will have access to care while you choose another physician.
How do I write a letter to dismiss a patient?
In the letter, I stated that it would be necessary to terminate our physician/patient relationship if we did not hear from you. Since we have not heard from you, please be advised that I will no longer be able to treat you as a patient.Mar 17, 2021
Why would a doctor terminate a patient?
The reasons physicians give for wanting to dismiss patients include patient noncompliance, failure to keep appointments, or rude behavior. When deciding whether to dismiss a patient the physician must consider the patient's medical status and needs.Mar 17, 2021
Why would a doctor drop a patient?
"From a malpractice and medical board standpoint, a physician can basically discharge a patient for any reason he wants, as long as it is nondiscriminatory and doesn't violate [the Emergency Medical Treatment and Labor Act] or other laws, or puts the patient's health, safety, and welfare at risk," says Kabler.May 29, 2012
How Do You Dismiss A Patient?
A formal written notice indicating that you will be withdrawing care and requiring the patient to find another professional is required when you find the situation appropriate for discharging a patient. You should write a notice in both first class and certified mail that needs a return receipt.
What Is Termination Of Care?
Having a termination agreement between a physician and patient is not an automatic process, although the physician needs to carefully document that this is necessary and in accordance with his or her patient’s medical history. This request should include reviewing the past treatment the patient has received and the current state of her health
How Do You Legally Discharge A Patient?
A formal discharge letter is the proper way to end a clinical relationship with the patient. You must let the patient know that you are ceasing to provide health care. If the letter was sent within 30 days after its date of issuance, the date should be deemed certain.
What Are The Policies Necessary For A Patient To Initiate Or Terminate Medical Treatment?
When appropriate notice is provided to a patient it will be time to check on him or her condition or to provide psychiatric support in the community…
Why Might A Physician Terminate Care Of A Patient?
It may be that a physician cannot meet with a patient when it is not complying with their treatment plan, ignoring their appointments, drug-seeking behavior, or refusing payment for services.
Can A Doctor Dismiss You As A Patient?
Regardless of whether it is legal or not, as long as it puts the patient’s welfare, safety, health, and benefit in the hands of the patient and doesn’t violate (the Emergency Medical Treatment and Labor Act).
When Should A Patient Be Dismissed?
There were several reasons cited for firing a lot of personnel. Drug-seeking behavior and verbal abuse ranked very high among them. The proportion of physicians who discharged patients citing verbal abuse was 40%, while the proportion who cited drug-seeking behavior was 40%.
How to terminate a physician-patient relationship?
The criteria for terminating a physician-patient relationship are numerous and varied and require careful documentation in the patient’s record. Although the following list is not exhaustive, it is generally appropriate to terminate a relationship under the following circumstances: 1 Treatment nonadherence—The patient does not or will not follow the treatment plan or the terms of a pain management contract, or discontinues medication or therapy regimens prior to completion. 2 Follow-up noncompliance—The patient repeatedly cancels follow-up visits, or is a frequent no-show for scheduled appointments with providers or consultants. 3 Office policy nonadherence—The patient fails to observe office policies, such as those implemented for payment, prescription refills, or appointment cancellations. Even more pressing are patient refusals to obey COVID-19 infection-control precautions that should mandate wearing masks, practicing social distancing, sanitizing hands frequently, and avoiding contact with anyone on the premises except as may be necessary for treatment purposes. 4 Verbal abuse—The patient, a family member, or a third-party caregiver is rude and uses improper language with office personnel or other patients, visitors, or vendors; exhibits violent or irrational behavior; makes threats of physical harm; or uses anger to jeopardize the safety and well-being of anyone present in the office. 5 Display of firearms or weapons—The patient, a family member, or a third-party caregiver wields a firearm or weapon on the premises. 6 Nonpayment—The patient owes a backlog of bills and has declined to work with the office to establish a payment plan or has discontinued making payments that had been agreed on previously.
What are some examples of circumstances that require additional steps or a delay or even prohibit patient dismissal?
Exceptions and Special Circumstances . A few situations, however, may require additional steps or a delay or even prohibit patient dismissal. Examples of these circumstances include the following situations: If the patient is in an acute phase of treatment, delay ending the relationship until the acute phase has passed.
What is the patient responsibility in a dental plan?
Patient responsibility—Include a reminder that the patient is personally responsible for all follow-up and for continued medical or dental care. Medication refills—Explain that medications will be provided only up to the effective date of termination.
How long has a patient been in your practice?
A patient has been in your practice for about 10 years, has faithfully made regular visits, but has not been compliant with your medical regime for taking hypertension medications . You have repeatedly explained the risks of nonadherence, and you have rescued the patient on many occasions with emergent medications, usually in the local emergency department over a weekend. You are convinced that the patient understands but stubbornly refuses to comply.
What documents should be kept in a patient's medical record?
Keep copies of all the materials in the patient’s medical record: the letter, the original certified mail receipt ( showing that the letter was sent), and the original certified mail return receipt (even if the patient refuses to sign for the certified letter).
Can a patient's disability be the reason for terminating the relationship?
The existence of a patient’s disability cannot be the reason for terminating the relationship unless the patient requires care or treatment for the particular disability that is outside the expertise of the practitioner. Transferring care to a specialist who provides the particular care is a better and safer approach.
Is it reasonable to screen incoming patients?
Just as it is an acceptable and reasonable practice to screen incoming patients, it is acceptable and reasonable to know when to end patient relationships that are no longer therapeutic or appropriate based on patient behaviors. It is critical, however, that the physician end the relationship in a manner that will not lead to claims of discrimination or abandonment.
What to do after termination of a patient?
Advise staff not to schedule the patient after the effective termination date. Consider alerting the patient's other healthcare providers, such as specialists and the patient's primary care provider, that you are no longer treating the patient.
What happens if a physician terminates a patient relationship?
A physician's improper termination of the physician-patient relationship may put the physician at risk for a claim of abandonment. Following the guidelines below may mitigate this risk.
How long does it take to terminate a physician relationship?
A deadline for end of coverage, from the date of the termination letter. Thirty days is a general guideline, but longer may be necessary based on patient ...
What are the reasons for termination?
Common causes of termination include non-payment, excessive missed or canceled follow-up appointments, failure to follow agreed upon treatment plan and the refusal of a patient to maintain acceptable behavior.
How to communicate patient noncompliance?
Don't act hastily in making a decision. For "patient noncompliance", facilitate a face-to-face conversation with the patient to clearly communicate expectations. Allow the patient to voice their understanding and expectations. Clarify any misunderstanding or misperceptions. Facilitate a mutual agreement to a plan.
When a physician is on call to the ED, must the physician respond to the ED's request to
When a physician is on-call to the ED, the physician must respond to the ED's request to treat a patient even if the patient has been terminated from the on-call physician's practice.
Can the same type of medical care be found within a reasonable geographic area?
The same type of medical care cannot be found within a reasonable geographic area. The patient has an urgent or emergent condition or is being treated for an acute condition requiring continuous care. The patient must be treated until the acute phase has stabilized.
What factors affect the amount of time needed for a patient to receive care?
The amount of time necessary may depend upon such factors as the acuteness of the patient’s medical condition, the availability and accessibility of alternative care, and the patient’s ability to afford such care.
Can a physician terminate a patient relationship?
There are numerous reasons why a physician may terminate the physician-patient relationship. Physicians, however, should be aware of potential liability, including for patient abandonment, if the relationship is not properly terminated. In general, the physician-patient relationship can be terminated in two ways without creating liability ...
Do physicians have discretion?
While physicians do have discretion as to whether to provide services to any particular person, they should be aware that there are legal and ethical constraints on the scope of that discretion such as contractual obliga tions and non-discrimination laws.
What is the legal dilemma in terminating a physician-patient relationship?
The Ethical and Legal Dilemma in Terminating the Physician-Patient Relationship. A physician-patient relationship is essential for the well-being of the patient, for without a strong and trusting relationship between both individuals, the patient may not receive the best care that they deserve. There are many legal policies ...
What is the duty of a physician?
It is both the legal and moral duty of the physician to act in the best interests of their patients, while making sure to respect them regardless of background and personal behaviours.
Why is a physician-patient relationship important?
A physician-patient relationship is essential for the well-being of the patient, for without a strong and trusting relationship between both individuals, the patient may not receive the best care that they deserve. There are many legal policies and ethical principles a physician must follow when caring for a patient.
Can a physician terminate a relationship?
Termination of a relationship creates a difficult situation for the patient, and therefore there are only specific situations where a physician may have permission to follow through and terminate their relationship.
How to withdraw from a case?
When considering withdrawing from a case, physicians must: 1 Notify the patient (or authorized decision maker) long enough in advance to permit the patient to secure another physician. 2 Facilitate transfer of care when appropriate.
What is the fiduciary responsibility of a physician?
Physicians’ fiduciary responsibility to patients en tails an obligation to support continuity of care for their patients. At the beginning of patient-physician relationship, the physician should alert the patient to any foreseeable impediments to continuity of care.
Exceptions and Special Circumstances
- A few situations, however, may require additional steps or a delay or even prohibit patient dismissal. Examples of these circumstances include the following situations: 1. If the patient is in an acute phase of treatment, delay ending the relationship until the acute phase has passed. For example, if the patient is in the immediate postoperative stage or is in the process of a medica…
Steps For Withdrawing Care
- When the situation with the patient is such that terminating the relationship is appropriate and none of the restrictions mentioned above are present, complete a formal termination of the patient relationship. Put the patient on written notice that you are withdrawing care as the treating physician and require that the patient find another healthcare practitioner. The written notice sh…
Elements of The Written Notice
- The written notice terminating the relationship should include the following information: 1. Reason for termination—Although a specific reason for termination is not required, it is acceptable to use the catchall phrase “inability to achieve or maintain rapport,” to state that “the therapeutic practitioner-patient relationship no longer exists,” or to assert that “the trust necessary to suppor…
Case Examples
- The following scenarios illustrate some of the issues involved in terminating a patient relationship.
Case One
- A patient has been in your practice for about 10 years, has faithfully made regular visits, but has not been compliant with your medical regime for taking hypertension medications. You have repeatedly explained the risks of nonadherence, and you have rescued the patient on many occasions with emergent medications, usually in the local emergency department over a weeke…
Should This Patient Relationship Be terminated?
- With any nonadherent patient, it is essential to document your recommendations, the patient’s continued noncompliance, your attempts to address the patient’s reasons for noncompliance, your efforts to help the patient understand the risks of nonadherence, and the patient’s persistent failure to follow the treatment plan and advice. Terminate the relationship if the patient and phys…
Case Two
- A new patient has made an appointment with your office for a full and complete physical examination. Before the appointment, the patient experienced an unusually long wait in your office as a result of your need to address an urgent situation with an infant. Your office personnel explained the delay to those in the waiting room, and this new patient reacted by becoming loud …
Options For The Practitioner
- In the privacy of an office or an examination area, address your concerns about his behavior by indicating that the practice maintains a zero-tolerance policy for loud, threatening, or abusive behavior, and state that this type of reaction will not be condoned in the future. After you have completed his physical examination, suggest that he seek medical care elsewhere if he is reluct…
Assistance Is Available
- The final decision about terminating a patient relationship is the practitioner’s. The Doctors Company’s Department of Patient Safety and Risk Management is ready to assist you. We can discuss patient dismissal issues, send you sample correspondence, or help you develop special letters if needed for the situation. Contact your patient safety risk manager at (800) 421-2368 or …