Should I discharge patients who are difficult?
Outpatient practices are faced with making hard decisions regarding continuing care for patients that are “difficult” in some manner. Repeated no-show appointments, threatening staff members, aggressive behaviors, and not following treatment care plans are all reasons cited by practices that terminating the patient-provider relationship may be needed. How do you know if there is a legal basis or not?
Discharging patients from a practice, also described as terminating the physician-patient relationship, is an issue with many legal and ethical implications. Issues that may seem like a legitimate reason for discharge at first glance may have significant legal risks. A recent article in Medscape, You Can Dismiss a Difficult Patient, but Should You?, highlighted that issues and events related to potential discrimination and patient abandonment could result in a future lawsuit.
Care should be taken when assessing whether to terminate the physician-patient relationship or not, as well as ensuring appropriate interventions and documentation has occurred along the way. When the decision has been made to terminate the physician/patient relationship, the practice should make every effort to help transition the patient to another provider and ensure prescribed medications are covered for at least 30 days. See Medical Mutual’s practice tip Termination of Physician-Patient Relationship