The dental attorneys at Nardone Limited in Columbus, Ohio are responsible for assisting dentists with a variety of matters, including labor and employment issues, human resource issues, and a wide scope of legal issues. Occasionally, we are asked to assist dentists as they terminate patient relationships. As a dentist, it is very important that you are aware of your legal obligations when you are considering the termination of a patient.

Reasons for Terminating a Patient Relationship

Doctors have the right to terminate a patient relationship for virtually any non-discriminatory reason. More specifically, doctors may terminate the relationship when the patient: (i) does not or will not follow the treatment plan; (ii) frequently cancels or does not show up for follow-up appointments; (iii) consistently fails to follow office policies; (iv) is rude, uses inappropriate language, exhibits violent behavior, or threatens violent actions; or (v) has accumulated debt but has made no effort to arrange a payment plan.

How to Terminate a Patient Relationship

Regardless of the reason for terminating the patient relationship, you must avoid patient abandonment. Patient abandonment refers to the termination of a patient relationship without providing enough time for the patient to find a qualified replacement and without providing a reasonable excuse for the termination.

To avoid patient abandonment, you may terminate the patient relationship by providing the patient a written notice that they must find another dentist. You should mail the written notice to the patient via regular and certified mail, with return receipt requested. It is important to keep a copy of the letter, a copy of the certified mail receipt, and the original certified mail return receipt in the patient’s medical record. Your written notice should include the following:

(i) Reason for Termination – The specific reason is not required. It is acceptable to use the phrase “inability to achieve or maintain rapport,” or something similar.

(ii) Effective Date – Provide the patient with enough time to establish a relationship with another dental practice. Thirty days from the date of the letter is considered adequate. But, you should follow your state’s regulations. You may terminate the relationship immediately if the patient has requested the termination or if the patient has exhibited violent behavior.

(iii) Interim Care Provisions – Offer interim care. In case of emergencies, you may refer the patient to an emergency department or offer emergency care for a limited period of time, such as two weeks.

(iv) Request for Dental Record Copies – Offer to send a copy of the patient’s dental records to the new dental practice. Enclose an authorization document for the patient to sign and return to your office.

(v) Patient Responsibility – Inform the patient that it is their responsibility to follow up and pursue continued dental care.

(vi) Medication Refills – Note in the letter that you will provide any necessary medications only up to the effective date of termination.

In sum, doctors may terminate patient relationships for any lawful reason, as long as they provide the patient with adequate time to find a qualified replacement.  It is in the dentist’s best interest to send the patient a written notice to avoid patient abandonment and to ensure that the transition process is as smooth as possible for all parties involved.