Terminating a Doctor/ Patient Relationship -Part 1

Medical and Healthcare professionals truly face distinctive risks for a multitude of reasons. Doctors depend on their Medical Indemnity Insurance, to protect them and keep their practice safe. Medical Indemnity Insurers regularly assist practitioners on issues that arise as a result of patient selection.

Many issues come up for doctors that are difficult and time consuming, one of them being when their relationship with the patient is no longer conducive to his or her best interests and it may be necessary to terminate that relationship.

To protect yourself against Medical Malpractice claims here are some helpful FAQS on patient termination.

Terminating a doctor-patient relationship is more complicated than just refusing to see him or her again. It must be carried out according to a number of ethical and legal principles.

Medical Indemnit

To arrive at a decision to terminate the relationship it is necessary to consider the patient’s autonomy, informed refusal and compliance with the established treatment plan. The patient maintains the right to refuse treatment, but it is imperative that the consequence of doing so has been fully explained and documented by the doctor (informed refusal) and understood by the patient. Prior to withdrawing from a patient’s care because that patient fails to follow advice or fails to attend appointments:

  • Document your recommendation(s) and the patient’s non compliance in their medical record
  • Advise the patient of the potential consequences
  • Confirm the patient’s non compliance, your subsequent discussion and the potential consequences in a letter to the patient. Consider sending the letter by certified mail if you think the situation warrants this action.
  • Additional discussions at subsequent visits including the patient’s response should also be documented.
  • Consider asking the patient to sign an informed refusal form. If all this has been done and you still believe that ending the relationship is necessary, it must be diligently carried out.

Adopting these strategies may help avoid an allegation by a patient that they did not fully understand the importance of the treatment or test being recommended. Medical Practice Insurance in Australia is a complex area of insurance requiring the skill and expertise of an experienced Medical Indemnity Insurer.

This publication is general in nature and is not comprehensive or constitute legal or medical advice. You should seek legal, medical or other professional advice before relying on any content, and practice proper clinical decision making with regard to individual circumstances. Persons implementing any recommendations contained in this publication must exercise their own independent skill or judgment or seek appropriate professional advice relevant to their own particular practice. Compliance with any recommendations will not in any way guarantee discharge of the duty of care owed to patients and others coming into contact with the health professional or practice. Tego Insurance Pty Ltd is not responsible to you or anyone else for any loss su­ffered in connection with the use of this information.