It is not easy for doctors to maintain a good relationship with all patients. Every patient is a new experience for the doctor from the moment he or she steps into the consultation room. Some patients are nice and a welcome experience for doctors, but others can be so distressing that their visits are dreaded. So it is important for doctors to note that if necessary, they are able to end their professional relationship with a patient.

There are many reasons why the relationship between a doctor and a patient has to end. It is a doctor’s duty to see all patients, but after some time, if a patient persistently gives causes trouble for unacceptable reasons, then the doctor has the right to terminate the relationship. Some such disruptive behaviours include inappropriate emotional attachment, unreasonable demands, discriminatory abuse, harassment and acts of violence. Criminal acts like lying to the doctor to get something in return, obtaining drugs illegally, stealing and blackmailing can also be reasons for the termination. However, complaints from patients are not considered a valid reason for ending the relationship.

The decision to end a doctor-patient relationship is no small matter. Patients who have their doctors terminate the relationship may feel helpless, especially those that require access to healthcare services on a regular basis. It is not a decision that should be made lightly. However, if doctors find themselves left with no choice but to terminate the relationship, here is a guide on how they can get through that.

From thoughts to action

It is not easy for the actual termination process to be completed, so the best way to get started is to make preparations, both mentally and emotionally. Decide on the reason termination is the best option, and acknowledge that ending the relationship with the patient is the right thing to do for the sake of well-being, as doctors are not obligated to put themselves in a position to treat anyone that makes them anxious or upset. This would also be unfair to patients as doctors may not be able to deliver the best care when they are distressed throughout the consultations.

Inform the patient

Depending on the severity of the situation, doctors should first try to communicate with the patient. If things really cannot be salvaged, then it is best to directly inform the patient of the decision. It is also important to let the patient know why the termination of relationship is taking place, both so that the patient is aware of why the doctor has taken such an action, and cannot plead ignorance otherwise, and to understand the consequences of such actions.. Doctors should also encourage patients to go ahead and seek ongoing care from other doctors in the practice or elsewhere.

Document the incidents

Write down, in detail, the steps that ultimately lead you to make this decision and your justification for terminating the relationship. This is to ensure that there is proof of the patient’s behaviour, especially if the patient ever became violent during a consultation and the police were involved. 

Seek legal advice

If doctors are unable to terminate the relationship due to non-cooperation on the patient's part, there is the option of taking a legal route - Lawyers can be brought in if the situation requires it. This is to ensure that both the rights of the patients and the doctors are protected, in the case where the patients feel they were blindsided by the termination. The presence of an attorney will prevent doctors will not feel vulnerable, and patients from feeling taken advantage of, too. MIMS

Read more:
Demoralised doctors and the impact on patients’ welfare
Delivering bad news to a patient
7 ways to build a productive doctor-patient relationship

Sources:
http://careers.bmj.com/careers/advice/view-article.html?id=20000869
http://www.medicalprotection.org/uk/practice-matters-issue-2/removing-patients
http://www.physicianspractice.com/blog/ethics-ending-patient-physician-relationship