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how to fire a patient

Medical Justice provides free consultations to doctors facing medico-legal obstacles. We have solutions for doctor-patient conflicts, unwarranted demands for refunds, online defamation (patient review mischief), meritless litigation, and a gazillion other issues. We also provide counsel specific to COVID-19. If you are navigating a medico-legal obstacle, visit our booking page to schedule a free consultation – or use the tool shared below.

Can a doctor fire a patient? Absolutely. And sometimes ending the doctor-patient relationship is the best path for both the doctor and the patient. Is firing a patient an easy, risk-free solution to a distracting patient conflict? Absolutely not. But there are ways a doctor can fire a patient while minimizing the risk of a bad outcome – such as an abandonment charge or a frivolous medical malpractice lawsuit.

This article will describe broadly best practices – how to fire a patient, how to know when to fire a patient, the consequences of firing a patient improperly, and how to qualify the necessary legal counsel – because you should never do this solo. In our expert opinion, no doctor should terminate a patient relationship until after conversing with qualified legal counsel – and by qualified, we mean someone who understands both the practice of medicine and healthcare law. You don’t want to antagonize an already angry patient by acting on bad advice.

Medical Justice is more than qualified to educate you on the challenges. If you are preparing to fire a patient, schedule a free consultation with our executive team. We’ve been protecting doctors from medico-legal threats for 20+ years. We’ve helped thousands of doctors dismiss difficult/conflict-propelling patients. With proper counsel, doctors CAN get this right.

Let’s begin.

When should a doctor fire a patient?

If you are reading this article, you likely already made up your mind – your hands are full, and you need to fire a difficult patient. You have a problem and are seeking a remedy. But it’s helpful to identify the red flags that signal the doctor-patient relationship is on the rocks.

Doctors want to treat as many patients as reasonably possible – but when the doctor-patient relationship decays, having the wisdom to part ways is invaluable. If your patient exhibits any of the behaviors listed below (either in front of you or in front of your staff), re-evaluate your relationship with the patient.

If the patient threatens to sue you, fire that patient…

If the patient regularly harasses your staff, fire that patient…

If the patient refuses to commit to any payment plan (even a symbolic one), fire that patient…

If the patient’s expectations are unreasonable, fire that patient…

If the patient threatens to extort you (give me a refund or I’ll sue/slam you online), fire that patient…

(Of course, there are exceptions to every rule…but these principles apply more often than not.)

A brief aside that addresses a related problem: Many doctors ask us whether they should fire a patient after said patient posts a defamatory online review. If dismissing the patient will de-escalate the conflict at hand, this is an option – but you need to tread carefully. You don’t want your decision to dismiss the patient to become ammunition for another damaging post: “This doctor fired me because I called him/her out! Stay away!” In such cases, doctors should consult with experts who understand the practice of medicine, the law, and online review sites. Medical Justice is equipped to solve this kind of problem for you. Click here to schedule a free consultation with our executive team.

Every “red flag” mentioned in this article represents a node of conflict among doctors and patients. These are common problems. Retaining a patient after they’ve raised just one of these red flags will create problems for your practice down the road. They’ll become a drain on resources – a sink that swallows your time, your money, and your staff. Plug the drain by terminating the doctor-patient relationship.

We cannot emphasize enough how critical it is for doctors to consider the feelings of their staff when evaluating a patient’s bad behavior. Your staff likely sees a side of your patients that you do not. And we’ve seen cases where a doctor has lost valuable, well-liked members of their team because a difficult patient was not fired in a timely manner. One doctor was even sued after failing to fire a patient who was sexually harassing a member of his staff. The doctor eventually acted, but not fast enough to avoid litigation.

What can happen if a doctor fires a patient, but does so improperly?

Doctors frequently go astray when they fire a patient and fail to account for two critical details…

Continuity of care; a patient is fired from a practice, and the doctor does not transfer the patient’s care to a different doctor (or provide options for follow-up care).

Improper documentation; a patient is “verbally” fired from the practice, but there’s no corresponding paper trail. Or the necessary documentation appears too slowly and is lost to time.

A patient with a bone to pick will contact an attorney. An attorney will investigate. And if the attorney believes the patient has an abandonment case in play, the attorney will propel that case. Defending such a case damages a doctor’s reputation; and losing such a case creates compounding professional challenges.

I need to fire a patient. What should I do next?

You need a document that resolves the conflict. This frequently takes the form of a patient dismissal letter/patient release form. This document achieves three key goals…

It formally terminates your relationship with the patient…

It provides for the transfer of the patient’s care to a different doctor/practice (or options for follow-up care)…

If there’s a signed release, it neutralizes the conflict. For example, a patient may receive a modest amount of money (perhaps a refund). In exchange, the patient signs an agreement stating the two sides have resolved any and all issues.

Get on the phone with qualified legal counsel – someone who knows healthcare and healthcare law. Ask them to supply a patient dismissal letter. They will walk with you through this process. If you retain qualified counsel, that counsel will help you transfer the patient’s care from your practice to a different practice. They’ll also make sure your practice documents all the critical elements so that you are insulated against charges of abandonment.

Medical Justice can provide such templates – we can solve many of these problems for you. If you are firing a patient, schedule a free consultation with our executive team. You can also schedule a consultation via the calendar below.

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Jeffrey Segal, MD, JD

Chief Executive Officer and Founder

Dr. Jeffrey Segal, Chief Executive Officer and Founder of Medical Justice, is a board-certified neurosurgeon. Dr. Segal is a Fellow of the American College of Surgeons; the American College of Legal Medicine; and the American Association of Neurological Surgeons. He is also a member of the North American Spine Society. 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 was a practicing neurosurgeon for approximately ten years, during which time he also played an active role as a participant on various state-sanctioned medical review panels designed to decrease the incidence of meritless medical malpractice cases.

Dr. Segal holds a M.D. from Baylor College of Medicine, where he also completed a neurosurgical residency. Dr. Segal served as a Spinal Surgery Fellow at The University of South Florida Medical School. He is a member of Phi Beta Kappa as well as the AOA Medical Honor Society. Dr. Segal received his B.A. from the University of Texas and graduated with a J.D. from Concord Law School with highest honors.

In 2000, he co-founded and served as CEO of DarPharma, Inc, a biotechnology company in Chapel Hill, NC, focused on the discovery and development of first-of-class pharmaceuticals for neuropsychiatric disorders.

Dr. Segal is also a partner at Byrd Adatto, a national business and health care law firm. Byrd Adatto was selected as a Best Law Firm in the 2021 edition of the “Best Law Firms” list by U.S. News – Best Lawyers. 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.