Avoid Patient Abandonment Claims When Ending the Patient Relationship

Ending a patient relationship can be a necessary part of medical practice, but it carries the risk of patient abandonment claims if not handled carefully. Patient abandonment occurs when a healthcare provider terminates care without giving the patient adequate notice or a reasonable opportunity to find alternative care. Understanding the proper steps to end a patient relationship helps protect providers from liability, protects the medical license, and ensures patients continue to receive the care they need. Here is how providers can end the patient relationship while sidestepping patient abandonment claims.

Reasons to End a Patient Relationship

Healthcare providers may have legitimate reasons for discontinuing care, and it is important to recognize these circumstances to ensure the termination is handled appropriately. Common situations include:

• Noncompliance with treatment, where the patient repeatedly refuses to follow recommended therapies, take prescribed medications, or attend necessary follow-up appointments. This can make it difficult or unsafe for the provider to continue care effectively.
• Disruptive behavior, such as aggressive, abusive, or threatening actions toward medical staff, other patients, or the provider. Such behavior can create an unsafe environment and interfere with the delivery of quality care.
• A conflict of interest, which arises in situations that could compromise the provider’s professional judgment or ethical responsibilities. This could include financial, personal, or other conflicts that make continuing the relationship inappropriate.
• Relocation or retirement, when the provider is moving to a different location, closing their practice, or retiring. In these cases, it may be impossible for the provider to continue offering care, and patients must be transitioned to another qualified professional.
• Scope of practice limitations, when the patient’s medical needs exceed the provider’s area of expertise or specialty. This may occur if a patient develops a condition that requires specialized treatment beyond the provider’s training or resources.

About Patient Abandonment

Just because the patient relationship ends does not mean that the patient has been abandoned. Patient abandonment occurs when a healthcare provider terminates the physician-patient relationship without reasonable notice or fails to provide the patient with an opportunity to secure alternate care. Patient abandonment can only occur once a physician-patient relationship has been formally established. This relationship begins when a physician takes an active role in the patient’s care, such as performing a diagnosis, prescribing treatment, or providing medical advice. It is also considered established if the physician agrees to evaluate, diagnose, or treat the patient, even if no treatment has yet been administered. 

Steps to Take Before Ending the Patient Relationship

Physicians should ensure that all reasonable efforts have been made to preserve and improve the physician-patient relationship. Here are the steps that physicians practices that are considering terminating the patient relationship should take:

Document all efforts thoroughly, including discussions, attempts to resolve issues, and any steps taken to accommodate the patient’s needs. Documenting all efforts thoroughly helps protect against claims of patient abandonment, as licensing boards, courts, or regulatory bodies can review records to determine whether proper notice and reasonable attempts were made to maintain the physician-patient relationship. It also provides evidence of attempts to resolve conflicts, with notes of discussions, interventions, or accommodations showing that the physician acted responsibly rather than terminating the relationship arbitrarily. Additionally, thorough documentation clarifies the sequence of events, helping to explain the context of repeated noncompliance or other problematic behaviors and ensuring that any review of the situation reflects an accurate and complete picture of the circumstances.

If a patient keeps missing appointments, does not follow their treatment plan, or shows other signs of not cooperating, it is important to talk with them directly. Take the time to ask about their expectations, concerns, and what they hope to achieve with their healthcare. By understanding the reasons behind their behavior, which could include stress, confusion, financial difficulties, or other personal challenges, underlying issues can be addressed more effectively. This approach allows you and the patient to work together to create a treatment plan that is realistic, manageable, and more likely to be followed, ultimately improving their health outcomes and reducing misunderstandings or conflicts.

Work together with the patient to establish care objectives that are realistic, achievable, and tailored to their individual needs and circumstances. Engage the patient in the planning process so they feel involved and empowered in decisions about their treatment. Clearly outline what the goals are, what steps need to be taken, and what the follow-up plan will look like. Setting clear expectations in this way helps both the clinician and the patient stay on the same page, ensures that treatment priorities are understood and agreed upon, and minimizes the risk of misunderstandings or frustration. It also fosters a sense of partnership and accountability, making it more likely that the patient will adhere to the plan and achieve the best possible health outcomes.

Best Practices In Ending A Patient Relationship 

Sometimes, ending the patient relationship is inevitable. Here is what to keep in mind before ending the relationship:

• Ensure compliance with state regulations and professional ethical standards regarding patient dismissal.
• Provide the patient with reasonable notice, ideally in writing, explaining that the physician will no longer provide services.
• Include the effective termination date and guidance for finding another healthcare provider.
• Allow sufficient time for the patient to secure alternative care, especially for those with ongoing treatments or chronic conditions.
• Document all communications, including letters, emails, and phone calls, to create a clear record of the termination process.
• Offer the patient copies of their medical records or facilitate the transfer of records to a new provider.
• Consider notifying staff and support personnel involved in patient care so they are aware of the transition.
• Maintain a professional and courteous tone throughout the process.

Contact An Experienced Physician Defense Attorney

If a physician faces allegations of patient abandonment, it is important to contact an experienced physician defense attorney immediately. This healthcare law attorney can provide guidance on legal risks and help build a strong defense to minimize liability.