Termination of the physician –patient relationship is a two step process. First, identify the behaviors or patterns of behavior that trigger termination. Then provide. formed or a physician-patient relationship is no longer proceeding in a mutually productive manner, it is the policy of this practice to terminate the physician-. Remember that the responsibility for ending the doctor–patient relationship rests with you, the doctor – do not delegate it to another staff.
Emergency Situations It is not appropriate to end the doctor-patient relationship during an acute illness. Depending on the circumstances, it may be necessary to wait until any health crisis is over before broaching the subject with the patient. In an emergency, you have an ethical and legal duty to provide assistance to your patients. This duty exists even where the person was not previously a patient or if you have recently ended the therapeutic relationship.
Terminating the Physician-Patient Relationship - Crozer-Keystone Health System - PA
Sometimes, a conflict of interest is at the heart of the relationship breakdown. Remember that the responsibility for ending the doctor—patient relationship rests with you, the doctor — do not delegate it to another staff member.
If there has been a serious breakdown in the doctor—patient relationship, consider whether an incident report should be forwarded to Avant in case future complaints or claims are made. Avoid allegations of discrimination — take care that ending the relationship cannot be interpreted as based on reasons such as: Communicate openly When ending the relationship, you should initially aim to communicate in person with the patient if possible.
Avant - How to end the doctor-patient relationship
While it is not strictly required that you state your reasons, ideally you should. Try to ensure that the patient does not interpret the ending of the relationship as a personal rejection or affront.
You should carefully explain that the doctor-patient relationship relies on mutual trust and when there is a breakdown in that relationship of trust it can impact on the effectiveness of patient care.
In these circumstances, you believe it is in their best interests for you to transfer their care to another practitioner. Of course, if it is because the patient was aggressive and they refused to modify their conduct, this should be the reason given. Remember to remain calm and polite during any verbal exchanges. Follow up Follow up your discussions with a letter to the patient ensuring that you have clearly communicated your decision, highlighting the importance of any ongoing care they may require.
You may wish to send a draft of your letter to Avant for review before you send it to the patient. Sample letter Consider using the following letter template. 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.
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.
How to end the doctor-patient relationship
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. The termination letter should set out a reasonable time period in which you will continue to provide urgent or emergent care until a new provider can be obtained. This thirty day window is not a legal standard.
If the reason for termination is threatening, physically or verbally abusive behavior by the patient, then your safety and that of your staff comes first.