Once a doctor-patient relationship is established, healthcare providers across all disciplines have a legal and ethical obligation to provide patients with the best care possible. However, there may be circumstances when it is no longer appropriate to continue the doctor-patient relationship. A doctor may choose to discharge a patient for a variety of reasons, such as noncompliance with treatment, failing to keep appointments, or inappropriate behavior. Properly discharging a patient from care can be a complex issue. In order to avoid allegations of abandonment, healthcare providers should consider establishing a formal process for discharging a patient.
The discharge of each patient must be determined on an individual basis, and the patients medical record should document any noncompliance or disruption on the part of the patient. A formal patient discharge should be made in writing, and most cases urgent or emergency or continuous care must be given to the patient for at least 30 days from the date of the letter, in order to avoid allegations of abandonment.
The three (3) most common reasons why doctors discharge patients are:
• nonpayment;
• non compliance with doctor recommendations; and
• disruptions in the doctor-patient relationship
The discharge of a patient should be effective as of the date of the letter. A patient discharge may not be an option in all situations, such as if the patient is in need of urgent or continuous care without a gap. All healthcare providers should become knowledgeable about the requirements regarding any restrictions on discharging a patient that may be imposed by third party payors with whom a doctor participates. A copy of the patient’s records should be sent to the patient’s new provider immediately upon written receipt of a proper authorization. In addition, the patients chart should document the problems that led to the discharge of the patient.
Author(s)
Stuart J. Oberman, Esq.
Stuart J. Oberman is the founder and President of Oberman Law Firm. Mr. Oberman graduated from Urbana University and received his law degree from John Marshall Law School. Mr. Oberman has been practicing law for over 30 years, and before going into private practice, Mr. Oberman was in-house counsel for a Fortune 500 Company.
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