Obviously, no one wants to terminate a patient, but sometimes it is reasonable and in the best interest of both parties. There are circumstances when it may be within the rights of the provider and appropriate to terminate a patient. Some examples include a patient who:
-No-shows or cancels appointments frequently or repeatedly
-Does not adhere to office policies
-Is abusive or inappropriate to office staff
-Fails to arrange for a payment plan with a large outstanding balance
-Fails to follow a treatment plan
It is important to take steps to minimize liability when terminating a patient. No matter how frustrated you are, you must remain professional and use caution. Follow best practices and consult with your counsel as you take precautionary steps. A few things to consider:
1) Remember that you may need to continue care if a patient is in an acute phase of treatment and needs time to arrange for another provider to continue the care. It is necessary to reduce the risk of any patient being abandoned.
2) There are some payer guidelines that would require notification from the provider to transfer the patient before the termination.
3) Patients should never be terminated for any reason that is discriminatory such as race, gender or HIV status.
Consider developing a written policy for your practice. This will help to ensure that you take consistent steps even when you are caught off guard. Here’s a sample from the First Healthcare Compliance sample document library: Termination Policy
AMA provides guidance
Opinion 8.115 – Termination of the Physician-Patient Relationship
Physicians have an obligation to support continuity of care for their patients. While physicians have the option of withdrawing from a case, they cannot do so without giving notice to the patient, the relatives, or responsible friends sufficiently long in advance of withdrawal to permit another medical attendant to be secured. (I, VI)