My doctor fired me - what can I do? - The Globe and Mail
Generally speaking, once a physician-patient relationship is established, the physician has an ongoing responsibility to the patient until the. Patient–doctor relationships may break down. treatment side effects, disease with poor prognosis, and the recent diagnosis of recurrence . in a way that conflicts with the other's expectations, and subsequent “termination”. Termination of the Physician-Patient Relationship for Non-Compliance or a bad outcome, include this information in the termination letter.
Instead of providing a specific referral, patients should be referred to a local medical association or online directory of physicians in the area. The letter should also include a clear direction to seek care from another physician promptly but, in the interim, until the effective date of the termination, care will continue to be provided in true emergency situations.
The letter should not contain legalese or difficult terms but should be written in a manner that would not provide grounds for embarrassment for your practice, or worse, if the letter is posted online by the patient. Even when circumstances become difficult—including if the patient stops paying for your services—there are some situations where a patient should not discharged.
Once a patient has been discharged from the practice, the scheduling system should be flagged and the staff informed accordingly so the patient is not permitted to schedule another appointment with the practice. This can be difficult in a multi-specialty, multi-office group but steps should be taken to avoid inadvertently re-establishing the relationship with a discharged patient.
Broken doctor–patient relationships: why won't they listen? | The Medical Journal of Australia
Other factors to keep in mind include non-retaliation, non-discrimination and payer considerations. A patient cannot be discharged for a discriminatory reason. Relatedly, a patient should never be discharged in retaliation for making a complaint under the Section regulations, other anti-discrimination laws, or HIPAA.
Doing so could result in regulatory violations.
While each situation is unique and the decision to discharge a patient must be made thoughtfully on a case-by-case basis, having a documented policy in place helps your practice handle these difficult situations more consistently.
Additionally, if your practice provides notice of the grounds in the policy potentially leading to termination, it should reduce a claim of surprise or disbelief by a patient when he or she is discharged from the practice. Hopefully, the vast majority of the relationships with patients are positive, if not harmonious. Circumstances may arise in your practice, however, when it becomes necessary to terminate a patient relationship.
Discharging a patient carries significant risk but properly terminating a patient-physician relationship can certainly reduce the risk. Members regularly contact Avant seeking advice about managing their relationships with patients. In general terms if a medical practitioner is unwilling to continue a treating relationship with a private patient, they are not compelled to do so. More specifically, when the relationship has become untenable. Emergency Situations It is not appropriate to end the doctor-patient relationship during an acute illness.
Dismiss a problem patient in 10 safe steps
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. 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. 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.
My doctor fired me - what can I do?
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.