Q&A: Liability issues after dismissing a patient

Q: I have a patient who has been noncompliant for several years, and I have sent him a letter of dismissal. I still have not heard back regarding where he wants his medical records sent, and he is on several medications that must be refilled soon. I'm sure he's going to try to request refills again after 30 days. One of his medications needs to be monitored closely and cannot be discontinued for any length of time if it is to remain effective. Can I be held liable in any way if I deny his request for refills after the 30-day period?

A: Assuming that your letter of dismissal was sent by certified mail, you have a receipt indicating it was received, and that your letter instructed him on his need to have his medications refilled and monitored closely, you should not have liability beyond a 30-day period unless, for some reason, the patient, despite best efforts, has been unable to obtain alternative medical care. If the patient returns and indicates that he has been unsuccessful in obtaining other care-and care is not for some reason available in an emergency room or other facility-it may be prudent to provide one additional visit.