Question

Explain the policies necessary for a patient to initiate or terminate medical treatment. Include what the physicians policies may be regarding the termination of the treatment with the patient.

Answer 1

once the physician-patient relationship is established, the physician must continue to provide care to the patient to avoid allegations of abandonment until one of the follow occurs:

.The patient terminates the physician-patient relationship.

.The patient’s condition no longer requires the care of this particular physician.

.The physician agreed to treat only a specific condition or agreed to treat only at a specific time or place.

.The physician terminates the physician-patient relationship by notifying the patient in writing of withdrawal from care after a specific time which is stated in the letter. The patient is also given information necessary to obtain their medical records or transfer to another provider.

The physician can terminate the care through a letter, the letter should be certified with return receipt requested and regular mail.

If the certified letter is returned, it should be placed in the patient’s file unopened.

Scheduling staff should be told that the patient has been terminated and instructed not to schedule them should they attempt to make further appointments.

It is not necessary to give the patient a reason for the termination but providing one often prevents the patient from reaching back out to ask why.

In the termination letter, if the patient’s condition requires continued medical care, it is recommended that this be clearly stated with the risks of not continuing treatment/care identified.

A copy of this letter should be kept in the patient’s medical record.

Depending on the availability of physicians in the specialty required and the patient’s ability to access care from another provider, the termination window is generally 15 days to 30 days.

During this time, the terminating physician continues to provide emergency care and prescription refills.

When a physician in a specific specialty is the only one available within a reasonable distance, the relationship may need to continue until the patient finds another doctor. This needs to be taken into consideration.

The physician should not provide the patient with a specific name of another physician, but provide them with a physician referral source, such as the patient’s health plan for a list of physicians, the local medical society, or a physician referral service.

According to the AMA’s Council on Ethical & Judicial Affairs, a physician may not terminate the relationship as long as further treatment is indicated without sufficient time to make other arrangements for necessary care.

Additionally, in the rare situation of an acute episode of illness, the transfer of care may be physician to physician to avoid any lapse in continuity of care.