Ending the Patient-Physician Relationship
Discontinuing patient-provider relationships should be undertaken only or familial relation) that makes termination of the relationship an ethical and The American Medical Association (AMA) has formally addressed this. The physician-patient relationship is established when the physician evaluates the The current American Medical Association (AMA) ethics document on the physician should provide a model patient termination letter to be given to the. Learn physician's ethical/professional responsibilities. • Understand legal and The AMA defines abandonment as “the termination of a professional relationship between a physician and patient at an unreasonable time and without giving the .
At a glance Providers may become concerned about being blamed for a poor outcome when a patient is continually noncompliant with prescribed interventions. Discontinuing patient-provider relationships should be undertaken only after a serious attempt has been made to clarify and understand the expectations and concerns of all involved parties.
Dismiss a problem patient in 10 safe steps
Having a guided pathway available to protect oneself and staff from unfortunate patient situations will result in better patient outcomes, better delivery of care, and better business overall. The phrase can be seen in print or heard uttered by exasperated providers in reference to individuals who have become "problem patients. Termination of the relationship may even be necessary for such benign reasons as the patient changing insurance carriers or the relocation or retirement of the clinician.
Protecting yourself Although there are no formal laws against a provider terminating a patient relationship for nondiscriminatory reasons,1,7 certainly ethical concerns exist, but these are beyond the scope of this article.
However, such valuable resources as time, money and manpower can be diverted away from one's profession when terminating a patient becomes a legal issue in defense against litigation arising from accusations of abandonment. The American Medical Association AMA has formally addressed this issue by outlining legitimate reasons for dismissing a patient and offering a protocol for dismissal that advocates safety in patient care as well as legal protection for the provider.
Discontinuation of the professional relationship should be undertaken only after a serious attempt has been made to clarify and understand the expectations and concerns of all involved parties. The Texas Administrative Code, which defines the scope of practice and rules of NPs, is silent on the issue of terminating the clinician-patient relationship.
These include terminations which are discriminatory or circumstances where no other licensee is currently able to provide the type of care that the licensee is providing to the patient. The AMA defines abandonment as "the termination of a professional relationship between physician and patient at an unreasonable time and without giving the patient the chance to find an equally qualified replacement. The AMA has given the following advice for the termination process: Giving the patient written notice, preferably by certified mail, return receipt requested; Providing the patient with a brief explanation for terminating the relationship this should be a valid reason, for instance non-compliance, failure to keep appointments.
Such behavior, if unmodified, may constitute sufficient justification for the physician to arrange for the transfer of care.
For example, some insurance carriers require 60 or 90 days notice before dismissal as compared to the 30 days notice required under New Jersey law and some require prior written notice to the carrier to enable the carrier to contact the patient. There also may be specific requirements concerning pregnant or mental health patients. Medicare, Medicaid, and other government payors have strict policies on terminating a patient that should be reviewed before terminating a governmental plan beneficiary.
Review Your Malpractice Carrier Requirements. Send Written Notification to Your Patient. The physician should send written notification advising the patient that he or she is terminating the patient relationship.
The patient notification should be prepared or reviewed by counsel for the physician. The notice period should be structured to comply with any payor or malpractice carrier requirements.
Dismiss a problem patient in 10 safe steps - The Clinical Advisor
A copy of the letter and the postal receipt should be maintained by the practice. Provide Continuity of Care. Physicians should ensure that they provide the proper continuity of care when dismissing a patient from their practice, including any requirements under state licensing rules, their payor contracts and their malpractice policy.