Best Ways to Deal With Noncompliant Patients

Mark Crane, BA

Disclosures

June 05, 2009

In This Article

How to Dismiss a Noncompliant Patient

Discharging a patient should be a last resort only after repeated attempts to find out why the patient is disruptive or won't comply with your advice.

Physicians should personally speak with the patient to ask about any specific complaints, say malpractice risk managers. You may learn that the patient is unhappy with your treatment or office staff. These situations could potentially be corrected.

It's important to end the doctor-patient relationship carefully to avoid getting sued for abandonment or discrimination. Most liability insurers have protocols and sample letters that doctors can use to reduce their risk for a lawsuit when they discharge a patient.

It's wise to warn patients first that they'll be discharged unless their behavior changes. Document any noncompliance in the patient's chart. You should also document that you informed the patient of the specific potential consequences of failing to follow medical advice, says Dr. Palmisano, who also heads Intrepid Resources, a risk management firm in Metairie.

Send a termination letter by certified mail, return receipt requested, and keep the receipt in the patient's file. Give the patient sufficient notice that you will stop treating him or her. A month is usually adequate, but check with your insurer or state medical society for guidance.

Inform the patient that you'll continue to treat him or her until the termination date and for any emergencies that occur up to then. Refer the patient to the local medical society or hospital to obtain a list of physicians. Offer to transfer the patient's records promptly once you receive a written authorization.

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