Generally speaking, once a physician-patient relationship is established, the physician has an ongoing responsibility to the patient until the relationship is properly terminated. Improper termination can result in a patient abandonment claim.
The appropriateness of a relationship termination depends primarily on two issues:
- The reason for termination
- The reasonableness of the time period given for the patient to find a new physician
Although a patient should never be dismissed for discriminatory reasons such as age, religion, gender, or ethnicity, there are many legally and ethically justifiable grounds for ending a patient relationship, including the following patient behaviors:
- Nonpayment of bills
- Continual cancellation or failure to keep appointments
- Rude, disruptive, sexually suggestive, uncooperative, profane, violent or threatening behavior
- Disagreement with recommended therapy
- Noncompliance with treatment recommendations
- Dishonesty
- Initiation of legal proceedings against the physician
Few patient abandonment lawsuits are filed because a physician terminated a patient relationship for improper reasons. In the great majority of cases, liability is premised on insufficient notice prior to termination. What constitutes an appropriate time period for termination can depend on specialty, practice location, patient condition, third-party payer agreement, state statutes, medical ethics and various other factors. To highlight the various scenarios that can lead to abandonment claims, we present these brief case studies and best practices from a variety of sources, including NORCAL companies closed claims files and risk management specialists’ reports, appellate court opinions and medical journal case reports. In them you'll find medical liability risk management recommendations to help reduce risk in your practice when terminating a patient relationship.
More Information About Reducing Risks when Terminating the Physician-Patient Relationship
- Closed Claim Case Study: Termination of the Physician-Patient Relationship for Non-Compliance
- Closed Claim Case Study: Dismissing a Patient in Labor Leads to Physician Removal from Hospital Call Panel
- Closed Claim Case Study: Dismissing a Patient with Post-Operative Complications Leads to Patient Abandonment Lawsuit
- Closed Claim Case Study: Lack of Continuity of Care for Psychiatric Patient Leads to Allegation of Abandonment
- Closed Claim Case Study: Dismissing a Patient with Chronic Pain and Addiction Leads to Allegation of Abandonment
- Closed Claim Case Study: Immediate Dismissal of a Patient Could Lead to Abandonment Allegation
- Closed Claim Case Study: Problems with Dismissing a Patient When Securing Alternative Care Is Difficult
- Closed Claim Case Study: Inadequate Coverage Arrangements Leads to Abandonment Claim
- Best Practices: Ensuring Continuity of Care When Retiring or Closing a Practice
