Risk Management

Before You Say Goodbye

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Digest, Spring, 1992

Although the decision to terminate a doctor-patient relationship should never be taken lightly, unresolvable noncompliance, patient conduct or financial reasons may make a continued relationship impossible. Should you decide that it is in your and the patient’s best interest to end the relationship, OMIC suggests you take the following steps recommended in a publication by the American Medical Association’s Specialty Society Medical
Liability Project. 1

• Notify the patient in writing, preferably by return receipt mail;

• Provide the patient with a reason for the termination;

• Agree to continue as the patient’s treating physician for a reasonable period of time, such as 30 days, while the patient makes arrangements for the services of another physician;

• State clearly the date on which the termination will become effective;

• Provide information about resources, such as the medical society or local medical center, that can aid the patient in identifying other physicians of like specialty; normally, the terminating physician should also offer to recommend other physicians from whom the patient may choose;

• Offer to transfer records to the new physician upon receipt of a signed authorization to do so;

• Offer to see the patient in cases of emergency within a stated period of time after termination;

• Include the above-referenced items in the letter notifying the patient of termination;

• Finally, check with your personal legal counsel regarding specific requirements in your state or jurisdiction for terminating a doctor-patient relationship.


1. Risk Management Principles & Commentaries for the Medical Office. American Medical Association/Specialty Society Medical Liability Project, Chicago. 1990: 14-15.

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