A practice recently called us. They asked if they had to see a patient who just tried to schedule an appointment. The rub: the last time they saw this patient was five years ago. They wanted to know if enough time had lapsed to declare the doctor-patient relationship legally terminated.
But there’s more to this case than meets the eye.
The patient’s husband saw the same doctor. The husband failed to pay his outstanding bills and was sent to collections. The husband was no longer a patient of the practice.
The practice did not want to rekindle the doctor-patient relationship with the wife.
What to do? Did they have to see the patient?
The doctor-relationship is terminated if the patient sends notice they have moved their care to another doctor; if the doctor has formally terminated the relationship in writing; if the doctor has transferred care to another doctor and the patient accepted that transfer; or there is some constructive type of termination where it is obvious the patient has functionally terminated the relationship (such as the patient moving to the other side of the country). There are also other triggering events that terminate the doctor-patient relationship. But, did any apply to this case?
No – the doctor-patient relationship had not been terminated.
The patient is still a patient of the practice unless and until the doctor-patient relationship is formally terminated. If the practice does not want to schedule the appointment, they can terminate the doctor-patient relationship and state they will only see the patient for urgent or emergent conditions for 30 days or until the patient finds another doctor, whichever comes first.
Obviously, the longer the interval between a patient’s last visit and the date a patient schedules an appointment, the better the argument becomes that the patient constructively terminated the doctor-patient relationship on their own. After a number of years records are destroyed and a reasonable person will conclude the patient moved on. Still, if in doubt, err on the side of caution. The cost of getting it wrong is a charge of patient abandonment and an ugly letter from the Board of Medicine. Also, it becomes trickier if you are the only regional subspecialist with the skills to treat the patient’s condition.
Terminating a doctor-patient relationship can be a high-risk event.
Make sure you understand the rules before pulling the trigger. If you are in doubt, call Medical Justice (1-877-633-5878) and tell us you read this article online and are seeking guidance. We’ve walked the walk with hundreds of practices. And we’ve devised strategies that allow doctors to terminate the doctor-patient relationship completely and compliantly – your patient will not be abandoned. And you won’t have to worry about a rogue abandonment charge. Our Founder and CEO, Jeff Segal, MD, JD provides complimentary medico-legal consultations to doctors seeking guidance. Use the tools below to get in touch.
About the Author
Jeffrey Segal, MD, JD
Chief Executive Officer and Founder
Dr. Jeffrey Segal is a board-certified neurosurgeon. In the process of conceiving, funding, developing, and growing Medical Justice, Dr. Segal has established himself as one of the country’s leading authorities on medical malpractice issues, counterclaims, and internet-based assaults on reputation.
Dr. Segal is also a partner at Byrd Adatto, a national business and health care law firm. With over 50 combined years of experience in serving doctors, dentists, and other providers, Byrd Adatto has a national pedigree to address most legal issues that arise in the business and practice of medicine.
What is Medical Justice?
In 1998, founder and CEO Dr. Jeffrey Segal developed the concept of Medical Justice while practicing neurosurgery. His vision is a unique approach that forms part of our two-pronged strategy: to deter the filing of frivolous medical malpractice lawsuits and to enable viable responses and remedies from wrongful suits against physicians. We filed our first patents in 1999, and with the signing of our first distribution agreement in 2002, Medical Justice commercialized our proactive professional liability service.
Today, Medical Justice has assisted over 12,000 physicians in the US. We create a practice infrastructure to prevent, deter, and respond to frivolous medical malpractice suits. We offer prospective and retroactive service plans that enable “points forward” service as well as optional benefits as far back as residency. Medical Justice supports a broad group of medical specialties and is endorsed by many state, county, and specialty medical societies.