Terminating the Dentist/ Patient Relationship

Many dentists struggle to terminate the dentist/ patient relationship. Relationship termination can be crucial to practice risk management, but improper relationship termination can lead to legal trouble. The list below contains legal justifications for terminating the dentist/ patient relationship:
– The patient is cured, or treatment is completed.
– The patient decides to terminate the relationship (usually occurs over fiscal, administrative, management, or personality issues).
– The dentist decides to terminate the relationship.
– Both parties agree to terminate the relationship (the patient has a new dental benefits plan, the patient moves out of the area).
To terminate the patient from a practice without risking patient abandonment, the dentist should:
1. Give the patient sufficient notice of the dentist’s intent to withdraw in writing. The letter should be delivered through Certified Mail with a return receipt requested to document that the patient was notified or a valid attempt was made.
2. Write a letter that include reasons for professional relationship termination:
– Patient not cooperating in care or following directions
– All the times appointments were canceled or missed
– Patient failure to meet compensation obligations for professional services
– All cases of abusive or disruptive treatment of staff or others in the office
– Instances in which the patient was less than forthcoming about current medical status, medical history, or administrative inquiries
3. Strongly urge the patient to seek continued care if necessary. The letter should give a specific and adequate time frame for the patient to seek a new dentist as well as state availability for emergency care, consultations, and referrals, if necessary.
4. Inform the patient that a copy of his or her records may be forwarded to the new treating practitioner. 
Dentists may be considered for abandonment of the patient charges if any of the  following occur:
– Termination of care without the patient’s knowledge
– Premature patient discharge
– Failure to provide proper instructions before discharging a patient
– Refusal to accept calls or further attend to the patient
– Failure to follow up on postsurgical care
– Harm to the patient, as a result of the termination, that should have been foreseen by the dentist (proximate cause)