Doctors: Say 'goodbye' to problem patients

Sometimes the only answer is for doctors to dismiss a problem patient.

While some doctors may be reluctant to do so, there are times when it’s necessary to dismiss a patient from a practice.

A patient may be abusive to physicians or staff, fail to comply with recommended treatment plans or vaccination schedules, or repeatedly fail to keep appointments, according to a report in Physicians Practice.

Try to resolve issues—but if that doesn’t happen, physicians can ask patients to leave, says Rebecca Fox, M.D., a pediatrician at FoxCare Integrative Pediatrics in Virginia, in a related Physicians Practice article. "If it's one bad day, we all have bad days. If it becomes a pattern of bad behavior, at that point, you need to say goodbye," Fox told the publication.  


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Have a process in place for dismissing problem patients and follow it, healthcare attorney Rodney Adams of LeClairRyan in Richmond, Virginia, tells the publication. He advises sending a certified letter giving patients 30 days to find a new physician. During the transition, you must provide emergency and urgent care.

RELATED: There's a right way to terminate your relationship with a patient

It can be possible to make the physician-patient relationship work by looking for and trying to resolve the root cause of the problems, FiercePracticeManagement has reported. Jennifer Frank, M.D., a family physician in Wisconsin, says she will sometimes ask a neutral colleague for advice before dismissing a patient to see if there is a way to resolve the problem.

But if you do decide to break ties with a patient, be sure to document. Tell the patient in writing that he or she is being discharged from your practice and include an effective date. Usually, you give patients a 30-day notice, but it can be longer if you practice in a specialty or an area where it may take the patient longer to find another doctor.

You don't have to—and probably should not—recommend another provider.