"Firing" Patients: Avoiding Patient Abandonment 

By Kim C. Stanger

Holland and Hart

Once a physician-patient relationship is established, the physician generally may not refuse to provide necessary care unless and until the physician: 1) notifies the patient that they are ending the patient relationship; 2) gives the patient a reasonable period of time to transfer care to another provider; and 3) provides any necessary care during the transition. Failure to do so may violate Idaho's Medical Practices Act, which generally prohibits physicians and physician assistants from abandoning the patient. In addition, the patient may sue for damages resulting from patient abandonment.

A physician wishing to terminate the relationship should notify the patient in writing and perhaps orally. Most providers assume that thirty (30) days' advance notice is sufficient, but the required notice period depends on the circumstances. For example, a general practitioner who only treats the patient periodically for common ailments may not need to give much advance notice. An oncologist who is in the middle of a treatment regimen may need to complete the regimen or provide a longer period of transition time to ensure that the patient can effectively transfer care without adverse consequences. In either case, the physician should let the patient know that the physician will provide necessary care in the meantime.

There are situations in which immediate termination may be justified, e.g., if continuing care would pose a serious and imminent threat of harm to the patient, the provider, staff or others. In such cases, the provider should carefully consider and document the exceptional facts that warrant such a determination. Ultimately, the physician should ask herself, "If a jury were to consider this situation, would it conclude that I acted reasonably to ensure that the patient did not suffer damage during the transition to a new provider?"

Click here for more detailed guidance and a sample letter.

Risk Management Issues in Clinical Documentation

Join us on February 12th for this session from the 2025 IMA Education Series  

The accuracy and timing of clinical documentation continues to be a leading issue in medical professional liability. Failures in documentation can lead to poor communication, misdiagnosis, and other adverse events that lead to claims. In medical malpractice claims, inadequate documentation can significantly hinder the efforts of the defense and, in extreme cases, transform a defensible claim into one that is virtually indefensible.

This presentation by MIEC Patient Safety & Risk Management will address the role of documentation in the defense of medical malpractice claims, common documentation errors, and recommendations for improving documentation in the age of EHRs.

About the speaker:

Michael Anderson, CPHRM is the Manager of Patient Safety & Risk Management for MIEC. He has over 25 years experience working in medical professional liability, both in Claims and Patient Safety, and has worked with MIEC since 2004.