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HEALTH & LAW
■ Termination occurred when the patient was in need of continuing medical care;
■ secure an alternate physician; and
■ The patient was harmed as a result.1
The American Medical Association summarizes your responsibility this way: Once a physician-patient relationship exists, physicians are ethically obligated to place the patient’s welfare above all other considerations, including the physician’s own self-interest.2
Once you’ve determined it’s prudent to terminate a patient from your practice, lower the risk of a patient’s claim of abandonment or malpractice by:
■ Evaluating the patient’s condition and rendering stabilizing care, if needed. Avoid discharging a patient during treatment
in the letter, be sure you are objective and tactful in your choice of words. We suggest you include the following:
➤ to provide care. The AMA suggests at least 30 days’ notice; however, there is at least one state that requires at least 60 days’ notice. Review your state’s laws before you terminate a physician-patient relationship.
➤ physician as quickly as possible.
➤ physician. These services may include the local medical society or the state board of medicine.
➤ condition is resolved.
■ When possible, discuss the termination and your reason(s) for termination with the patient. You may conduct the conversation via telephone or in person. We encourage the physician to have this conversation with the patient. Be sure to document this discussion in the patient’s medical record.
■ termination from the practice. We suggest sending the letter
requested. If you choose to include the reason for termination
AUTHOR
■ JEREMY A. WALE, JD is a Risk Resource Advisor for ProAssurance Coporation
REFERENCES
We also encourage you to contact any third-party payer or managed care provider that may be involved in the patient’s care. Some third-party payers and managed care providers terminating one of their covered patients.
This article is not intended to provide legal advice and no attempt is made to suggest more or less appropriate medical conduct.
➤
Information on how the patient can get a copy of his or her medical record. You may want to consider including a release-of-records form to make this process easier.
A signature. We encourage the terminating physician to personally sign the letter and retain a copy of the letter in the patient’s medical record.
1. American Medical Association. Ending the patient-physician relationship. 2013. Available at: http://blog.letterstream.com/files/2013/10/Ending-the- Patient-Physician-Relationship-07.13.pdf. Accessed Aug. 25, 2014.
2. American Medical Association, Code of Medical Ethics Opinion 10.015. Available at http://www.ama-assn.org/ama/pub/physician-resources/ medical-ethics/code-medical-ethics/opinion10015.page
188 Del Med J | June 2015 | Vol. 87 | No. 6
