What does the Medical Practice Act and case law require regarding “patient abandonment”?
Am I permitted to drop a patient?
How do I avoid abandonment problems when closing my practice?
The Medical Practice Act simply states that “abandonment of a patient” is grounds for discipline of a license, with no further definition. Therefore, a physician must conform to how a “reasonably prudent” physician would handle a particular case, based on the unique facts of each case. Some circumstances that might warrant discharge include: repeated failure to follow advice, chronic missed appointments, inappropriate behavior, including physical advances or significant disruption of the office and non-payment of fees. Discharge may be permitted if it is done with sufficient notice to the patient and does not interrupt care in a way that would cause immediate harm to the patient. It may be necessary to delay discharging a patient who is under acute care.
Any discharge should be put in writing and sent by certified mail to the patient’s last known address. Under normal circumstances where the patient does not require immediate medical attention, the physician should allow at least 30 days for the termination to become effective and should include the reasons for discharge, as well as a statement that it is in the best interests of the patient to seek care from another provider. If the patient seeks the terminating physician’s care within the 30-day period, the physician needs to evaluate the urgency of the patient’s condition and other facts to determine whether to treat the patient or proactively arrange for alternative care. In all cases, it is good practice to provide the name of another practitioner or a referral service, as well as a recommendation that the patient follows up on his or her care. The physician should also include an explanation of how the patient may request and obtain copies of records or have them transferred to a new physician.
In the event of closure of a practice, the physician is required by law to provide the public with at least 30 days’ prior notice of the closure of the facility or the health care practitioner’s practice. The notice must include an explanation of how copies of the facility’s records may be accessed by patients. The notice may be given by publication in a newspaper of general circulation in the area in which the health care facility or health care practitioner is located.