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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)
Removing a patient from your practice: A physician's legal and ethical responsibilities. While a doctor may discharge a patient for any nondiscriminatory reason, termination is not without pitfalls. Physicians should follow a careful process so as to avoid claims of patient abandonment.
According to CMA's California Physician Legal Handbook, physicians can terminate a patient-physician relationship without cause.
The discharge letter should be marked "personal/confidential" and mailed by certified mail, return receipt requested, to the patient's last known address. File a copy of the letter and the receipt in the patient's medical record. If the letter is returned unclaimed, mail it again.
Guidelines. 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.
A patient can end the relationship by giving the physician oral or written notification. Physicians should document this notification in the patient's chart. It may be prudent to send the patient an acknowledgment that he or she has terminated the doctor-patient relationship, and then retain a copy of the letter.
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.
Giving proper notice to a patient usually includes telling the patient, either on the phone or face to face, that the physician is terminating the physician-patient relationship and writing the patient a letter confirming the termination. The letter should be sent by certified mail, return receipt requested.
Even though physicians retain the legal right to dismiss patients in many situations, there are some circumstances when it's not only unadvisable but unethical and, depending on the state where it occurs, illegal and punishable both by law and by censure.
When the situation for dismissing the patient is appropriate, provide a formal written notice stating that you are withdrawing care and requiring the patient to find another practitioner. Mail the written notice to the patient by both first-class and certified mail with a return receipt requested.