Photo Credit: Andrii Iemelyanenko

There are many reasons to terminate a doctor-patient relationship, but it’s important to consider multiple issues before moving on.

We all have those patients. You know, the ones that we cringe when we see their name on the schedule. Some may be difficult because we don’t know how to help them. Others may be simply annoying. And then some are toxic, making everyone in the practice suddenly feel like they are having the worst day of their life and need a long vacation.

We are all human and trained to help all personalities of people. We don’t need to agree with them or even get along. However, there is a point when the relationship is no longer beneficial for the patient, and it is better to send the patient to someone else. Or perhaps the patient causes such a disruption or threatens the doctor so they no longer feel like they want to help the patient. There is a whole plethora of reasons the relationship just doesn’t work any longer.

There is nothing wrong when this happens. We are all unique and have our own personalities, which can sometimes clash. It is wrong to continue in a toxic patient-doctor relationship because it can impair the quality of care a patient receives.

It is perfectly legal to terminate the doctor-patient relationship for any reason we choose, as can patients. In fact, the law does not require us to give a reason to discharge a patient; however, it is good to do it in an intelligent way.

How to Terminate the Doctor-Patient Relationship?

Give the patient enough notice so they can find a new physician. Thirty days is a standard. Not providing notice can lead to abandonment issues. Make sure the patient receives the notification, whether sent via certified mail or given to them directly. If not, they can easily say they never received it.

Make it clear that you are terminating the relationship. The notice should be short and to the point. It should be clear that you will no longer be their doctor and that they need to find a new one.

Help them find a new doctor. It can be scary for patients to be suddenly told to find a new doctor. No matter what led us to our decision, we are still dealing with a human life. We can tell them to contact their insurance company for a list of names or provide it ourselves.

Don’t terminate the relationship unless you are sure you must. Discharging patients and then allowing them back in the practice sends the wrong message, and their behavior is unlikely to change. If you terminate the relationship, there should be no going back. You can help with refills or other tasks for the notice period. If the patient is sick, see them and treat them. However, the termination should remain unchanged, which should be clear to the patient.

Don’t get into lengthy discussions about the fact you are discharging them. This is unlikely to go well and may give the patient something to use against you. Instead, focus on the patient finding a new physician and continuing any treatment they may be on.

Don’t discharge a patient with an active, urgent problem. For example, maybe a CT scan was ordered for abdominal pain. Follow up on those results and complete your evaluation; otherwise, you set yourself up for liability.

While terminating the relationship is never easy, sometimes it is the best thing we can do for the patient. We shouldn’t be forced to treat patients who may be toxic to us, and patients shouldn’t feel compelled to be treated by a physician they don’t like. Conversely, if a patient discharges us, we shouldn’t take it personally. The doctor and patient both benefit when they are in a trusting relationship.