Ask ECRI: Terminating the Physician-Patient Relationship

​A m​​ember recently asked for guidance on developing policies and procedures for terminating the physician-patient relationship. In our response, ECRI Institute notes that, generally, once a physician-patient relationship is established, physicians have a legal and ethical duty to provide medical care for as long as care is medically indicated and the patient wishes to continue the relationship. A physician may not discontinue treatment of a patient as long as further treatment is medically indicated without giving the patient reasonable assistance and sufficient opportunity to make alternative arrangements for care (see American Medical Association code of medical ethics opinion 1.1.5).

However, at times, discharging a patient may be necessary or prudent—for example, in certain circumstances if a patient remains noncompliant despite the physician's reasonable efforts or if a patient makes verifiable threats against the practice or an employee of the practice. A physician who improperly terminates a physician-patient relationship risks exposure to liability for breach of contract or for the civil wrong of abandonment, as well as disciplinary action by the state medical board. When terminating the physician-patient relationship, practices should abide by all requirements...