Discontinuing a Patient from Your Practice

Linda Mangels

Guest post by Linda Sue Mangels, BSED, MSED, CPHRM, senior risk management/patient safety specialist, the Cooperative of American Physicians.

Doctors often get into the field of medicine because they love helping people (their patients). However, from time-to-time, a patient’s behaviors and actions may require the physician to sever ties. Non-compliance with the treatment plan, rude, abusive behavior, repeatedly not showing up for appointments, drug-seeking behavior and non-payment of services rendered are all reasons physicians terminate their patient relationships. A good relationship/partnership between the physician and patient is essential for optimal treatment outcomes.

If, for whatever reason, it is not possible to establish this partnership, it is best for the patient to seek treatment elsewhere.

However, a physician can’t simply stop providing care to a patient. In fact, once the physician-patient relationship is established, the physician must continue to provide care to the patient to avoid allegations of abandonment until one of the follow occurs:

1)    The patient terminates the physician-patient relationship.

2)    The patient’s condition no longer requires the care of this particular physician.

3)    The physician agreed to treat only a specific condition or agreed to treat only at a specific time or place.

4)    The physician terminates the physician-patient relationship by notifying the patient in writing of withdrawal from care after a specific time which is stated in the letter. The patient is also given information necessary to obtain their medical records or transfer to another provider.

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The Necessity for a Patient Satisfaction Survey

Stephanie McMullin

Stephanie McMullin, Senior Risk Management and Patient Safety Specialist for the Cooperative of American Physicians, Inc. (CAP). 

Despite the enormous amount of knowledge that was imparted upon you during your education, perhaps one of the most important elements of maintaining a successful practice was, most likely, barely touched upon. The concept of quality health care is not complete without a rigorous discussion of patient satisfaction. A good physician/patient relationship is a crucial element of a successful practice. The fact that patients do not complain does not necessarily mean they are satisfied with the care they are receiving.

The Necessity for a Patient Satisfaction Survey

Let’s face it: In the big picture, seemingly no matter which profession, a majority of complaints to licensing boards does not revolve around specific ‘practice-based’ issues. Instead, those complaints tend to be based on “client-expectation” issues. From this, we can make the claim that happy clients do not tend to complain. If your practice can meet your patients’ expectations then your patients will more than likely react favorably by continuing their relationship with your practice, and perhaps even recommend your practice to a friend. The best method to gauge your patients’ opinion of their experience is to ask them, and by far the most cost effective method of achieving that is by a properly constructed and thoroughly analyzed patient satisfaction survey.

The Objections to a Patient Satisfaction Survey

Certainly, there are what some see as “legitimate” objections to the patient satisfaction survey. Certainly high on that list would be the issue of cost. If your practice is a member of a medical malpractice insurance organization, it’s possible that the administration and analysis of a patient satisfaction survey is a member service, available to the practice for no additional cost. If not, there are independent consulting firms that can work with your practice to design and analyze a survey. Additional costs that would be incurred would include staff time necessary to distribute and collect the survey.

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Every Physician and Medical Practice Should Be Aware of These Common Risks and Safeguards for EHRs – Are You? (Part 1)

Guest post by Allan Ridings and Joseph Wager, senior risk management and patient safety specialists, Cooperative of American Physicians.

Part 1 of a two-part series.

Introducing an electronic medical records system into the practice helps the physicians and staff provide more efficient healthcare by making medical records more accessible to all health care team members. It also brings some risks. In this two-part article, CAP Risk Management and Patient Safety identifies 10 areas of risk exposure and provides some brief recommendations in each area.


Know your system.  Electronic Medical Record is the term most often used for the electronic system now holding the medical records of the physician’s patients. If patients’ medical data is shared electronically with other facilities, locations, caregivers, and/or billers, the term Electronic Health Record is more accurate. The terms are often used interchangeably. Most articles are using the words “Electronic Health Record.”

Provide updated/additional training periodically, especially after software updates and enhancements.

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