How do I terminate a terrible patient properly? This patient does not follow direction, is disruptive in my office waiting room and has had an outstanding balance for a long time. Please help!
Yes, its time for our annual termination reminder - You are not required to continue to treat terrible patients once you have properly terminated the doctor-patient relationship. To do so, you must adhere to your obligation to not "abandon" your patient. In New York, abandonment constitutes misconduct (under New York State Education law, section 6530(30)) and if you are reported to patient dumping may result in a disciplinary inquiry. So, you want to make sure you are properly terminating.
To effectively terminate a patient appropriately: (1) you must provide proper and adequate notice to the patient (make sure to document this!); and (2) the patient must be able to secure another doctor to replace you (the latter requirement may be difficult to fulfill if your practice is located in a rural area or your specialty is unique to an area, in which case you may be forced to continue treatment).
See AMA Opinion 8.118 - 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)
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