Terminating Dentist-Patient Relationships
Dentist-patient relationships can end for various reasons. Patients may terminate the relationship due to relocation, dissatisfaction with the provided care, or financial concerns.
Dentists can end the relationship for nearly any reason if they give the patient proper notice. However, some exceptions apply to this seemingly unrestricted right to terminate the relationship. For instance, a dentist cannot terminate a patient for discriminatory reasons or in violation of state or federal laws prohibiting discrimination, such as the Americans with Disabilities Act. Additionally, dentists cannot withdraw from providing care when a patient’s oral health is unstable or at risk.
Dentists often end the relationship with a patient for reasons such as the patient:
• Is uncooperative or non-compliant – does not follow advice.
• Has a lack of trust.
• Does not keep appointments.
• Does not pay their bill(s).
• Has unreasonable expectations regarding treatment outcomes.
• Is unruly or hostile to staff.
When you decide to terminate a patient, you should follow safeguards to ensure the relationship is appropriately ended and does not endanger the patient’s oral health. If not handled appropriately, it could lead to a malpractice claim or board complaint.
Always handle discharging a patient warmly and professionally. Consult local, state, and federal laws to determine the specific requirements for terminating a patient in your practice location. Review provider agreements to ensure compliance with termination processes and procedures you are contractually obligated to follow. Provide written or in-person notice to the patient to reduce the risk of an allegation of abandonment. Upon proper authorization, please provide them with a copy of their chart. It is never recommended to withhold records or dental information because the patient has an outstanding balance on their account, doing so may create liability exposure, and may violate state board rules.
The dentist should end the relationship – not an office staff member. Send the patient a termination letter. The letter should be marked “personal/confidential” and mailed to the last known address via certified mail and regular mail. Email is acceptable if the patient has authorized email communications and you have a HIPAA-certified email server unless your state board rules state differently.
The letter should inform the patient of the dentist’s intent to terminate the relationship and suggest continuing care (in an emergency) for a reasonable time (usually 30 days). It should also offer resources for finding a subsequent dentist—your local dental society can be a good resource. The letter should also provide details of specific at-risk conditions for which the patient should seek timely care. And don't forget to maintain a copy of the termination letter in the patient’s chart. You can find a sample patient termination letter template here.
Inform your staff of the termination. Once the patient has been notified of the relationship’s ending, staff should not schedule an appointment without consulting with you during the 30 days of emergency care or any time after that. Doing so may reestablish the relationship.
The information contained on the DentistCare Blog does not establish a standard of care, nor does it constitute legal advice. The information is for general informational purposes only. We encourage all blog visitors to consult with their personal attorneys for legal advice, as specific legal requirements may vary from state to state. Links or references to organizations, websites, or other information is for reference use only and do not constitute the rendering of legal, financial, or other professional advice or recommendations. All information contained on the blog is subject to change.
