Terminating the Physician – Patient Relationship

The relationship between a physician and patient, or between other health care providers and the patient, continues until it is terminated. The relationship can be terminated by the patient at any time. A patient has the freedom to choose his or her health care providers. However, a physician has both an ethical and legal obligation to provide services to his or her patients.

A physician or other health provider who wants to terminate the physician-patient relationship must do so properly or he or she may be liable for a claim of “patient abandonment.” The American Medical Association (AMA), defines abandonment as “the termination of a professional relationship between physician and patient at an unreasonable time and without giving the patient the chance to find an equally qualified replacement.”

Dentists are held to the same standard as a physician on the issue of patient abandonment. In Massachusetts a patient can file a legal action for damages resulting from abandonment.

Reasons for termination of the physician-patient relationship may include relocation, retirement, or changes in insurance coverage. Other reasons might more directly involve the specific relationship such as noncompliance with medical treatments, personality conflict or repeated failure to keep appointments. Regardless of the reason, the physician has an ongoing responsibility to the patient until the relationship is terminated with reasonable notice and the opportunity to find a new provider.

There is no specific law in Massachusetts as to what constitutes reasonable notice and opportunity to find a replacement provider. What is reasonable may depend on the unique circumstances of a specific case. However, generally the standard will be met if the physician provides written notice to a patient of the intent to terminate the relationship effective no less than thirty (30) days from the date of the notice. The notice usually includes the reason for termination, a statement concerning the importance of a patient finding continuing medical care, a referral source the patient may use to find another physician in the community, an offer to send the medical records to the new provider at the patient’s request and notification that care should be sought at a local emergency department if medical attention is required after the 30-day period and before a new provider has been selected.  In addition, if the patient under the physician’s care is taking prescribed medication, the notice should make provisional arrangement to continue the medication during the transition period.

If you receive a termination letter from your physician, you may want to follow-up directly with the physician or office for any specific questions. Openness and honesty should be a part of the termination process as the physician continues to fulfill his or her obligations to patients during the transition and until the termination takes effect.