Ask ECRI: Alternatives to Terminating the Relationship with a Difficult, but Pregnant Patient

May 23, 2019 | Ambulatory Care Risk, Quality, & Safety Guidance

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A member recently asked for guidance about how to handle a difficult and pregnant patient who is considered part of a "protected class" of patients that should not be terminated. In our response, ECRI Institute notes that there are always risks involved with terminating a physician/patient relationship. Risks are even more complicated when the patient is pregnant.

Most literature on prenatal care strongly suggests that providers maintain treatment of pregnant patients to ensure continuity of care. In certain circumstances, such as prenatal complications or high risk pregnancies , the provider/patient relationship should be maintained as early as 20 weeks in the pregnancy, and must continue through the third trimester and postpartum period. This article from a healthcare lawyer says that patients in the third trimester should not be terminated even if they stop paying for services because of the potential risks involved with pregnant patients not receiving proper prenatal care. It would thus be advisable to make every effort to preserve the provider/patient relationship during a patient's pregnancy. ...

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