A myriad of situations might bring about a doctor’s discharge of a patient and termination of the physician-patient relationship. The physician might move, leave the insurance network, or determine that the patient needs the care of a different specialist. The physician also might want to end the relationship due to inappropriate patient conduct such as disruptive or violent behavior; repeatedly missing appointments and/or nonadherence to treatment plans; or refusal to pay for medical services.
Physicians must avoid discriminatory practices that are prohibited by law, including refusing to treat or discharge of a patient based upon the patient’s race, nationality, religion, age, sex or sexual orientation.
What defines patient abandonment?
Patient abandonment generally is defined as the unilateral severance by the physician of the physician-patient relationship, without giving the patient sufficient advance notice to obtain the services of another practitioner, and at a time when the patient still requires medical attention.
While individual states have their own definitions of patient abandonment, the concept of reasonable notice is common to most jurisdictions. In New York, for example, the following is considered professional misconduct: “Abandoning or neglecting a patient under and in need of immediate professional care, without making reasonable arrangements for the continuation of such care, or abandoning a professional employment by a group practice, hospital clinic or other healthcare facility, without reasonable notice and under circumstances which seriously impair the delivery of professional care to patients or clients.”
Significant liability, fines and/or restrictions or loss of the physician’s professional license can result. In states such as California, Texas and Washington, D.C., patient abandonment is addressed in the medical malpractice laws, and significant liability may result if the physician abandons a patient without sufficient notice in advance of termination and injury results.
While some jurisdictions require a specific amount of time for providing notice to the patient, others simply allude to “reasonable” notice. In the absence of a specific legal notice period, 30 days generally is considered a reasonable amount of time to provide adequate notice to the patient in advance of termination.
The physician also should check his or her managed care contracts, which may include specific requirements concerning the termination of covered patients.
Most importantly, during the “notice” period, the physician must continue treating the patient and remain available for office visits.