Discontinuation of the physician-patient relationship must be done according to protocol. The physician who terminates a patient relationship must do so carefully since the patient may be viewed as vulnerable.
Prerequisites:
(1) There should be a legitimate and defensible reason for the action.
(2) The patient should not be acutely ill or unstable at the time, in order to avoid a charge of abandonment.
Requirements for a physician terminating the relationship with a patient:
(1) The physician provides written notification to the patient that the relationship is being terminated.
(2) The physician notifies the patient that medical care will be provided to the patient for up to 30 days after the date that the notification was mailed.
(3) The physician notifies the patient that medical records will be transferred to a new provider upon receipt of a signed authorization from the patient. A copy of the patient's medical records should be available to the new physician, although the patient may be charged a customary copying fee.
(4) The physician maintains all documentation (copy of letter, documentation of mail receipts, etc) in the patient's medical record.
The written notification usually entails sending a letter by certified mail with return receipt requested.
Exceptions:
(1) The physician provided emergency medical care.
(2) The physician provided episodic care under the understanding that the physician would not provide care to the patient in the future.
(3) The physician has formally transferred the patient's care to another health care provider who is independent of the physician.
(4) The physician is retiring or relocating to a distant location.
(5) The patient terminates the relationship.
Whether or not to allow the patient to respond to the notice depends on the circumstances. Ideally a termination in the relationship would only be done after several unsuccessful attempts to resolve the issues, in which case further discussion may be futile. However, there are times when a further discussion may be warranted. If a discussion does occur then this should be fully documented in writing.
