QUESTION:
We have a patient who is extremely disruptive and abusive to staff. We have spoken to the patient and given them several opportunities to curb this behavior. However, it appears to be getting worse. Can we terminate our relationship with this patient?
OUR ANSWER FROM HORTYSPRINGER ATTORNEY MARY PATERNI:
Dealing with disgruntled patients can be a common occurrence, but patients who exhibit abusive behavior to practitioners and staff can be extremely disruptive to daily operations and patient care. While it is unfortunate that it has to come to this, you have the option of ending your relationship with that patient. How you go about doing so is key.
Providers who wish to terminate a patient must avoid doing so in a manner that would constitute “patient abandonment.” This can occur when the physician withdraws services after establishing a physician-patient relationship and fails to provide the patient with notice of the physician’s exit. State medical boards often hold physicians accountable and impose disciplinary action when this occurs.
Therefore, when considering terminating a patient relationship, it’s imperative that you provide the patient with written notice that explains, in brief, the reasons why the relationship is being terminated and the importance of continuing treatment.
In order to maintain continuity of care, you should give the patient a sufficient opportunity to make other arrangements and offer assistance/recommendations to help the patient identify alternative services. In the interim, it is important that you continue to provide treatment and access to services for a reasonable time prior to the termination of the relationship. We generally recommend 30 days; however, this may be longer or shorter considering the access to and availability of alternative services.
Keep in mind, however, that when a physician’s relationship with the patient terminates, the hospital’s obligations under EMTALA do not. Should the patient present to the hospital’s emergency department with an emergency medical condition, the hospital will still be required to provide a medical screening exam and stabilizing treatment for the patient regardless of whether you terminated your relationship with them.
We recommend checking your state medical boards for template letters that you can use when terminating a patient relationship. And, as always, if this unfortunate circumstance arises, consider consulting with an attorney to discuss how to approach ending your relationship with the patient to avoid running into “patient abandonment” issues.
If you have a question regarding terminating a patient relationship or questions you’d like to see featured in a future Health Law Express, email Mary Paterni at mpaterni@hortyspringer.com.