Q: My practice is hurting financially, and I'd like to dismiss a patient who's refusing to pay off his account balance. Can
I do that? What should I do if the patient shows up at the office during the time when we accept walk-in patients and demands
a visit?
A: The specifics of ending the doctor-patient relationship typically differ by state, so be sure to check on your state's procedure
with a local attorney or your state medical society. However, most states do not outline or limit the reasons a physician
can terminate that relationship, which gives the physician considerable discretion to determine the reasons he or she might
do so. (Common reasons include non-adherence with treatment recommendations, hostility toward the physician or staff, and
non-payment of an account.)
Typically, to terminate the physician-patient relationship, you must send a notice to the patient, by regular and certified
mail, return receipt requested, informing the patient that: the physician-patient relationship is terminated, the physician
will continue to provide emergency treatment and access to services for up to 30 days from the date the letter was mailed
to allow the patient to secure care from another physician, and the patient's records will be transferred to the new physician
upon the patient's signed authorization to do so.
In your case, you should send a termination letter to the patient as soon as possible. If, during that 30-day period, the
patient requests an appointment or shows up during walk-in hours and the patient's condition is emergent, urgent, or a follow-up
of prior treatment, you should schedule the appointment or see the patient. It might cost you a little, since the patient
probably won't pay you, but that beats any negative publicity or other problems that could arise from refusing to treat the
patient.
Send your practice management questions to mepractice@advanstar.com
(please include your regular postal address). Answers to our readers' questions were provided by Robert C. Scroggins of Clayton
L. Scroggins Associates in Cincinnati, Ohio, and Judy Bee of Practice Performance Group in La Jolla, California.
Modern Medicine Network
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To learn more about ending a relationship with a non-adherent patient, go to http://memag.com/nonadherence
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