Termination of the physician –patient relationship is a two step process. First, identify the behaviors or patterns of behavior that trigger termination. Then provide. Ending the doctor–patient relationship. Withdrawing your source of care to a patient should be done for the correct reasons, and in the correct fashion. Abstract. Background. The doctor–patient relationship in general practice is often viewed by practitioner and patient alike as a long-term.
Dear [name], As discussed with you on [date] I regret that I am unable to continue as your treating doctor. I feel it would be in your best interest to transfer your care to an alternative practitioner.
I will of course continue to provide ongoing care until you identify your new practitioner. However, you should do this within a reasonable time. I am happy to forward a copy of your medical records and I have enclosed a form authorising the transfer of your records to your new practitioner. Yours faithfully Alternative paragraphs depending on circumstances The overly demanding patient I have considered your health care needs and I believe that it is no longer possible to continue to provide the level of service you might expect.
Accordingly, I have decided that it is in your best interest to make alternative arrangements for future consultations at another medical practice.
I am aware that you have failed to follow the advice and recommended treatment that I believe are important for your wellbeing.
While I acknowledge your right to refuse advice and treatment, I believe that it is not in your best interest to do so.
Bad behaviour or complaints The events of [date] lead me to believe that you have lost faith in my care.
Terminating the Physician-Patient Relationship - Crozer-Keystone Health System - PA
As trust is the cornerstone of an effective doctor—patient relationship I feel it would be in your best interest to transfer your care to a new medical practitioner. Inappropriate advances Medical practitioners have an ethical duty to maintain only a professional relationship with their patients.
Your personal feelings expressed on [date] suggest that it would be in your best interest to find a new medical practitioner. As such, I will be unable to see you again except in the case of a genuine emergency. Finding a new practitioner Give the patient a reasonable deadline for finding a new doctor. You may wish to provide a list of practitioners in your community or refer the patient to the relevant medical college to find one who is acceptable.
Doctors in rural settings, where the availability of alternative medical practitioners is limited, face particular difficulties and may wish to seek advice from Avant.
How to end the doctor-patient relationship
Reassure the patient that you will within an appropriate time frame provide care for any necessary medical problems which arise before they find a new practitioner. In cases where the patient has not complied with treatment, in your letter explain the consequences should they continue to go without appropriate treatment.
Continuity of care Advise your practice staff that your relationship with the patient has ended and they should not make further appointments for the patient after a specified date. Make sure all staff at the practice including the other doctors are clear on what the termination means for the practice.
It may be that there are other doctors in the practice who are happy to treat the patient, or it may mean that no doctors in the practice will see the patient. You may wish to place an alert on the patient file to ensure that all staff including new staff who may be unfamiliar with the patient are aware of the situation. However, your staff should also understand the extent of your ethical and legal obligations to render assistance in the event of an emergency, so as to prevent them inadvertently refusing the patient access to you in the event of an emergency.
The physician cannot walk away. The physician must follow specific procedural steps to ensure that the relationship is ended in the appropriate legal and ethical way. Termination of the physician —patient relationship is a two step process.
First, identify the behaviors or patterns of behavior that trigger termination. Then provide the appropriate notice of termination to the patient. The first step is to determine what behavior or pattern of behaviors, actions or omissions by the patient can trigger termination.
It may be a pattern of negative behavior such as missed appointments without excuse, non-compliance with treatment, failing to honor their financial commitments, drug seeking behaviors or an irreconcilable difference in treatment philosophy that triggers the termination.
The underlying element in each of these triggers is a breach of trust in the relationship.
The steps taken by the physician to address the negative behavior, such as telephone calls, letters and or conversations with the patient should also be well documented.
Notice of Termination Proper termination of the physician—patient relationship requires proper notice to the patient. The following steps need to be done: Notify the patient in writing that the care will be terminated.
It should be a certified letter, return receipt requested. A copy of the letter should also be sent via regular mail. In some cases, you may want to contact the patient directly to notify them of the termination. In those cases, you must document the conversation and written notice must still be sent to the patient as follow up.