Ending the Physcian Relationship: Thing to Know Before Letting Patients Go

Cutting Ties with Patients

You are not alone if you wonder how best to terminate the physician-patient relationship. Patient termination is a frequent issue for our physician practices. As an insurance agent, we cannot provide legal advice, but we can relay helpful hints we've compiled from our insurance carriers and the AMA.

Remember, every state has different laws and regulations, and the best advice we can give is to call your carrier if you are terminating a physician-patient relationship.

Potential Reasons for Termination: Although not exhaustive, the following are situations in which termination is appropriate and acceptable

• Treatment non-compliance

• Follow-up non-compliance

• Office policy non-compliance

• Verbal abuse

• Non-payment - The patient owes a backlog of bills and has made no effort to arrange a payment plan (not just one non-payment)

General Tips:

1. First, determine if the patient can be terminated. You won't want to do this until after their treatment is finished or their condition resolved.

2. Consult your third-party payor and managed care contracts before terminating a patient to determine if there are additional requirements for discharging covered patients.

3. Take extreme care when terminating a patient with a disability. Your reason for terminating a disabled patient should be "disability neutral," (i.e., the reason for ending the relationship cannot be due to the patient's disability.)

4. When possible, discuss the termination and reasons for termination with the patient then document this in the chart.

5. The written notice should be mailed to the patient by regular and certified mail, return receipt requested.

6. Keep copies of the letter, the original certified mail receipt, and the original certified mail return receipt (even if the patient refuses to sign for the certified letter) in the patient's medical record.

What to include in the notification:

1. Reason for termination - Provide the patient with a brief explanation for terminating the relationship. This should be a valid reason, for instance with non-compliance, failure to keep appointments, etc.

2. A reminder the patient's medical condition requires care and the patient should find another physician immediately.

3. Effective date - Agreeing to continue to provide treatment and access to services for a reasonable period of time, such as 30 days, to allow a patient to secure care from another person. A physician may want to extend the period for emergency services.

4. Suggest continued care - Provide resources and/or recommendations to help a patient locate another physician of like specialty.

5. Offer to transfer records to the new physician upon signed patient authorization to do so.

For more information contact your medical professional liability insurance carrier, visit the American Medical Association's website, or contact us today!