Firing a Patient
While never desirable, it is equally inevitable that you will eventually find yourself needing to "fire" a patient -- meaning ask the patient to go elsewhere and not return to your office. Most commonly this arises when a patient is beligerent and disrespectful to the staff. But, whatever the reason, sometimes it is far better to let go of a patient than put up with abuse.
To that end, here are the steps:
EXPERT ADVICE: Do not terminate a patient relationship during active treatment (i.e., while treating a corneal ulcer, or in the midst of myopia management) unless there's simply no other option. Complete the treatment and terminate the relationship once it is completed. Be prepared and willing to refund money if necessary. If it is simply not possible to complete the treatment, arrange a specific referral to a doctor that will see the patient and document this fully in your records. It is essential that claims of patient abandonment be prevented.
1. First, send the patient a copy of their most recent eyeglass prescription and a properly crafted termination letter. Here is text you can use (put this on your business letterhead) for the termination letter:
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Dear [patient name], A healthy doctor-patient relationship built on mutual trust and respect, both between patient and doctor and between patient and the office staff, is an essential part of care. Because of a breakdown in that relationship I believe it is in your best interest and therefore necessary for you to obtain your future eye care elsewhere. If you need or want referral to a new optometrist for your care going forward you should contact either your insurer for a list of participating providers, or the state optometric association. If you would like a complete copy of your records for all care provided to date please return the attached records release form either via fax or mail and we will promptly send your records as directed in the form, or have your new eye doctor contact my office directly and we will ensure they promptly receive a copy of your records. Also included is a copy of your most recent eyeglass prescription for your records. Yours truly, |
2. Second, provide the patient with the blank form for a records release referred to in the termination letter. This will allow the patient to obtain their records from you, or have the records sent to another provider.
- Sample RECORD RELEASE form.
That's it. Just make sure the patient receives it: send an email and a snail mail backup, and notate everything in your records -- remembering that the patient will likely obtain a copy of the records, so do not say anything inflammatory or derogatory. Stick to the facts.