Wiki Discharging patient from care

[knedley]

I am currently with an ENT practice where the Dr would like to discharge a patient from care with in the practice permanently. The pt is very oboxious and the Dr does not want to continue care for this pt.
Does anyone know proper steps to dismiss this patient from the practice so that the Dr is not accused of abandoment?

 

[mdoyle53]

The steps could be different for each state so check with the state Medical Society. The termination needs to be in writing and I would recommend Certified mail/Fedex/UPS, etc.

The letter needs to:

1. Inform the patient why the termination - there should have been prior discussion in the practice with the patient's disruptive behavior,.
2. Provide suggestions for the patient to obtain treatment - you may not want to provide specific doctor names but you could provide information for the medical society, insurance carrier, hospital hotlines, etc.
3. Inform the patient of the timeline (suggestion of 30 days minimum) where you will see the patient for any acute situation. The timeline could change based on the need and situation of the patient and the ability to obtain a new physician
4. Inform the patient of treatment that needs immediate type care and inform him or her of any potential consequences of failing to do so
5. Inform the patient you will provide medical records, etc. to the new provider and enclose your release of information form

Last of all, depending on the situation, you may need the advice of your healthcare attorney to make sure you do not terminate inappropriately.

 

[ajs]

I am currently with an ENT practice where the Dr would like to discharge a patient from care with in the practice permanently. The pt is very oboxious and the Dr does not want to continue care for this pt.
Does anyone know proper steps to dismiss this patient from the practice so that the Dr is not accused of abandoment?

Check with your malpractice insurance company as many of them have standard letters to use in these situations. The letters my former practice sent out simply stated the physician was no longer in a position to provide the care this patient needed. They are informed the physician will provide emergency care only for the next 30 days and suggest the patient contact their insurance company and/or the local medical society for recommendations for a new physician. There was also a statement that records would be provided to the new physician as soon as we were notified. These letters are sent via certified mail with signature required.

 

[penguins11]

We send a certified letter offering to provide emergency treatment only for 30 days and reccomend they contact their pcp and/or insurance company for another participating provider. We also put in the letter why they are being discharged from the practice, for obnoxious patient we might say something like "Dr. Smith feels that behavior exhibited to the physician and staff is not conducive to the ideal patient/physician relationship and we feel that it would be of the best interest of the patient to seek care elsewhere....." etc, etc etc.