Q&A: Can I fire a patient who refuses to pay his account balance?

September 4, 2009

Most states do not outline or limit the reasons a physician can terminate that relationship, which gives the physician considerable discretion to determine the reasons he or she might do so.

Q: My practice is hurting financially, and I'd like to dismiss a patient who's refusing to pay off his account balance. Can I do that? What should I do if the patient shows up at the office during the time when we accept walk-in patients and demands a visit?

A: The specifics of ending the doctor-patient relationship typically differ by state, so be sure to check on your state's procedure with a local attorney or your state medical society. However, most states do not outline or limit the reasons a physician can terminate that relationship, which gives the physician considerable discretion to determine the reasons he or she might do so. (Common reasons include non-adherence with treatment recommendations, hostility toward the physician or staff, and non-payment of an account.)

Typically, to terminate the physician-patient relationship, you must send a notice to the patient, by regular and certified mail, return receipt requested, informing the patient that: the physician-patient relationship is terminated, the physician will continue to provide emergency treatment and access to services for up to 30 days from the date the letter was mailed to allow the patient to secure care from another physician, and the patient's records will be transferred to the new physician upon the patient's signed authorization to do so.

Send your practice management questions to mepractice@advanstar.com (please include your regular postal address). Answers to our readers' questions were provided by Robert C. Scroggins of Clayton L. Scroggins Associates in Cincinnati, Ohio, and Judy Bee of Practice Performance Group in La Jolla, California.

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To learn more about ending a relationship with a non-adherent patient, go to http://memag.com/nonadherence