written by Leah Gehrke

We’ve all been there. The dreaded patient at 10:00 am who has continuously been disrespectful, refused recommended treatment, or has even berated you and your colleagues in multiple visits. What if there was a way we could “fire” these patients?

There is. And even in a calm, cool, and collected (legal) manner.

Allowing this patient to return is giving them the green light to continuously treat us as clinicians poorly. If there is an instance that is unresolvable, a provider has the right to dismiss if discriminatory behavior has not been introduced, while following the proper protocol of course.

Developing a template for dismissal and allowing the patient to “find a better fit elsewhere” is a common and legal practice. Allowing patients access to their records is needed for them to move on to a better fit that will work best for the provider and the patient.

Your next question may pertain to abandonment. Abandonment is introduced when a patient is released without a sufficient amount of time to relocate, or when a provider refuses to see a patient without reasonable termination. When properly dismissed, abandonment is not questioned. Documenting all interactions with the patient is legally pertinent to avoid this. Notify the patient by formal letter, explaining the reasoning, and placing a copy of this letter in the patient’s chart. Consulting with your attorney is always recommended for specific rules and regulations regarding patient termination. No matter the severity of the situation. 

Be sure to check your state’s requirements for dismissing patients. For example, in Wisconsin, it is required to provide your patients with emergency care for 30 days. You can also address certified mail needs vs just sending via mail. This assists in providing proof that the letter was delivered and obtains a signature from the dismissed parties. 

“Firing” these patients can be a huge weight off you and your staff’s shoulders. Make your practice and your patient base what you want it to be, one fire at a time. Now we can go to sleep at night, knowing that the 10:00 am appointment is no longer.