Patient Discharge
A difficult patient keeps threatening to sue. Can I discharge him?
Unless a patient’s condition is urgent, no provider is forced to continue to care for them. In short, you can discharge a difficult or non-compliant patient, even one with a chronic condition. However, the real question is, should you?
In a recent survey of patients who sued their physicians, 83% cited the “doctor’s indifference” as their top reason for suing. This suggests a real disconnect in communications between doctors and their patients. In these circumstances, discharging an already frustrated patient may simply provoke them to talk to a lawyer. They may interpret their physician’s action as confirmation of their greatest suspicion, a genuine lack of interest in their health and wellbeing.
Of course, in spite of the doctor’s best intentions, there are times when no choice exists but to discharge a non-compliant or combative patient from the practice. Just contemplating the option usually means that the cornerstone of the doctor-patient relationship, trust, has already eroded.
In those cases, a proper discharge letter should be sent, including: 1) a diagnosis; 2)an offer to render “emergency care only” for the next 30 days; 3)a specific ‘final treatment’ date, beyond which no care will be rendered; 4)a clear recommendation to immediately find another physician, if appropriate; 5)a description of possible outcomes if no further treatment is obtained; and 6)an offer to send the records to the patient’s new physician. Lastly, be sure to send the letter by both regular and certified mail.
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