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

As the song says, breaking up is hard to do, and that can be the case in discharging a problem patient from your practice.

There's a right way, however, to terminate a patient, according to one practice administrator and an attorney writing in Physicians Practice. Whether you are discharging a patient for being verbally abusive to staff or not paying for care, you will need to send a letter, says Lucien W. Roberts, III, administrator of Gastrointestinal Specialists, Inc., in central Virginia, and Rodney K. Adams, J.D., a healthcare attorney with LeClairRyan in Richmond, Virginia. Here's what they recommend:

Start your letter by telling the patient upfront 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.

Patients have a right to a copy of their medical records and the letter should offer to make that available to the patient or his or her new physician. Document the patient's termination in your system so staff will know not to make future appointments for the patient.

With health plans increasingly holding physicians accountable for quality measures, it may be tempting for practices to dismiss patients who don't keep appointments, take their medications or otherwise follow advice about their health, but it is most often possible to make it work, as FiercePracticeManagement previously reported. For instance, look for the root causes behind the problems and try to resolve them.

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