Why a Doctor Ends a Patient-Doctor Relationship

The relationship between most physicians and their patients is among the most confidential and sensitive there is. Doctors know more about their patients than almost anyone else does, including members of the patient’s own family. The relationship should be one of mutual respect and trust. The physician has an obligation to care for his patient, but at times, the doctor will terminate the relationship for a variety of reasons.

Economic Issues

• While a physician’s first concern should be the welfare of his patient, money sometimes gets in the way. The doctor may believe that payments from private insurance companies or the government through the Medicare and Medicaid programs are insufficient to cover the cost of their services. In those cases, doctors are either refusing to take any new patients or they are ending the relationship with existing patients whose status changes.
  Some doctors have established concierge practices in which they charge annual retainers to their patients. If the patients are unwilling or unable to pay the retainer, the physician may refuse further treatment.

Medication Issues

• Some doctors refuse to prescribe pain medication because of their fear that the patient may become addicted or overdose and the physician may be held responsible. Because it is sometimes difficult to distinguish between legitimate pain care and the so-called pill mills proliferating around the country, this is a legitimate concern.
  Doctors also drop patients who refuse to vaccinate their children because of autism concerns. The doctors appear concerned that they may not be able to properly treat the children if they contract the illness the vaccines prevent. They are also concerned about liability issues.

Skill Concerns

• Doctors may also drop patients if they believe they lack the skills to properly care for the patient. Some OB-GYN doctors have dropped patients that are over a certain weight. They are concerned that their equipment is not strong enough to support the obese patients. They are also concerned that obese patients can develop complications the physician is ill-equipped to deal with.
  Some doctors also drop patients because they are overwhelmed with the amount of work they have. As payment rates decrease, doctors must increase their patient loads, sometimes to excess.

Ethical Concerns

• Under the physician’s code of ethics, a doctor cannot just abandon a patient without a clear explanation, so that the patient understands the reason for the termination. The doctor must ascertain that the patient has another source for health care. In some states, the doctor must give the patient adequate time to find another physician.