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Molly Maloof, MD

Director of Clinical Content

Dismissing A Patient

Why would a Doctor want to dismiss a patient from the clinic and would he/she do it in a conference room with other people around, why not in the exam room?
  • Female | 49 years old

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There are many reasons why a doctor may need to dismiss a patient...some of these include:

~ Violation of a Controlled Substance Agreement

~ Recurrently missing appointments without calling in advance

~ Aggressive or abusive behavior towards the physician, clinic staff or other patients

~ If the patient forges a prescription or fraudulently misrepresents themselves as a clinic employee to call in a prescription

~ If the patient is caught stealing medications, prescription pads or equipment from the clinic

~And various other reasons...

That being said, I do not feel that it is appropriate for a doctor to terminate the physician-patient relationship in the presence of other patients. Generally, that should be done in the privacy of the exam room or a private meeting room (although at times, depending on the circumstances, a member of the clinic staff is present as a witness). Our practice (& I believe most) generally reiterate the cause of dismissal with a certified letter.
Jorge A. Sabin
All med info are personal to the patient

Doctors should ALWAYS respect patient 'a privacy.
Don Ha
I agree with the other Docs. But, I would definitely ask for a letter explanation on why you were dismissed, in case there is confusion on the situation.
As others have said, it depends on the reason the patient is being dismissed. Often a dismissal is by letter but it might be done in a group if multiple physicians or multiple members of the office staff were involved.
I think it would depend on the reason the patient was being dismissed. If a patient is addicted to opioids and is using multiple pharmacies and physicians then it would be important that the entire staff be notified about the problem. THe same reasoning would apply if the patient was disruptive to the staff and non-compliant with medications.

Otherwise, most patients are dismissed with a form letter, approved by the medical board or their malpractice carrier, as a way to discharge a patient from a medical practice if their personality or non compliance created a problem with the doctor/patient relationship.
Many possible reasons but in general this occurs when the physician-patient relationship is not resulting in better health for the patient. In many circumstances this is a situation where the patient-physician relationship is such that the patient's health would be better off received from a different provider.

This happens in very rare instances but In my practice this most commonly occurs with:

1) Failed urine drug screen for patients on a controlled substance agreement

2) Frequent no-show appointments

3) Abusive behavior which makes staff or other patients uncomfortable

The methods to communicate this dismissal vary. We send a letter detailing the transition and dismissal process. Others choose to do it in a room with others to make sure questions are answered and that you rights as a patient are fully communicated. In general it's done to ensure the dismissal is done smoothly and respectfully as the end goal remains the best health for the patient.
Sumeet K. Goel
Because patient needs to understand the rights.