Medical Abandonment and a Physician's Responsibility

What responsibilities does a doctor have to continue treating a patient, and what happens when he or she fails to do so?

Once a patient-physician relationship has begun, a physician is said to "abandon" a patient who still needs medical attention when the physician refuses to continue treating the patient (i.e., severs the physician-patient relationship) without giving the patient proper notice and an adequate amount of time to find another physician who can take over the patient's care. Medical abandonment can form the basis of a medical malpractice case. Read on to learn more.

What Is a Physician-Patient Relationship?

A physician-patient relationship is the professional relationship that a doctor has with his/her patient. The relationship begins when the physician first diagnoses and treats the patient, or at least participates in the patient's diagnosis and treatment. The physician-patient relationship continues until either the physician or the patient terminate the relationship. The physician-patient relationship is both an ethical relationship governed by the state medical boards and a legal relationship defined by the courts or by state law.

Terminating This Relationship

A physician-patient relationship can be properly terminated in the following ways:

  • The physician and the patient mutually agree to terminate the relationship.
  • The patient unilaterally dismisses (fires) the physician.
  • The physician terminates the relationship after giving the patient notice and a reasonable amount of time to find another physician.

Additionally, the physician-patient relationship is generally considered to be ended when the patient no longer requires the physician's services. For example, if a patient sees an orthopedist for a broken finger, the physician-patient relationship would end when the physician discharges the patient and says that the patient does not need to see the physician any further for treatment of this injury.

However, if the physician never formally terminated the physician-patient relationship, then, depending on the circumstances, the patient may have a reasonable expectation that the physician will continue to treat the patient. For example, if a patient suffers from ear infections that recur every few years, the patient might assume that the physician-patient relationship still exists, even if five years pass between office visits.

How Can a Physician Properly Terminate the Physician-Patient Relationship?

For a patient who is actively treating for a condition, a physician must:

  • give the patient proper notice that the physician is terminating the physician-patient relationship, and
  • give the patient sufficient time to find another physician before finally refusing to treat the patient any further.

Giving proper notice to a patient usually includes telling the patient, either on the phone or face to face, that the physician is terminating the physician-patient relationship and writing the patient a letter confirming the termination. The letter should be sent by certified mail, return receipt requested. The physician should not just say to the patient, "You're fired. I don't want to see you anymore." The physician should tell the patient the reasons why he/she is terminating the relationship.

The definition of sufficient time for the patient to find another physician depends on the nature of the patient's condition and the patient's location. If, for example, the patient is treating for a broken finger, one or two weeks' notice might be sufficient time. For a more serious condition, one or two months might be deemed sufficient. But very serious conditions, such as chronic heart problems or treatment of HIV, might require even more time, especially if the patient lives in a rural area where there are very few doctors.

Proper notice might also include assistance in helping the patient find a new physician or even recommendations for new physicians, depending on the patient's circumstances.

Does a Patient's Failure to Pay a Physician's Bill Terminate the Physician-Patient Relationship?

A patient's failure or inability to pay the physician's medical bill does not in itself terminate the physician-patient relationship. The physician may choose to terminate the relationship because the patient has not paid the bill, but the doctor still must give proper notice as described above.

What Must a Patient Prove in a Malpractice Case?

The patient must show the following:

  • the patient needed continuing medical treatment
  • the physician stopped treating the patient
  • the physician did not give the patient enough time to find another doctor before the physician stopped his/her treatment of the patient
  • as a result of the physician's abandonment of the patient, the patient's condition was made worse

Like any medical malpractice lawsuit, the claim hinges on the theory of medical negligence. In this type of case, the doctor is negligent for abandoning her patient.

What Can the Patient Recover?

If a physician improperly terminates the physician-patient relationship, the physician is liable for all damages that the patient incurs as a result of losing access to medical care. Let's take an example. Let's say that a physician stops seeing a patient without giving proper notice, and, as a result, the patient goes without medical treatment for three months. As a result of this three month gap in treatment, the patient is left with a permanent disability. Remember that medical malpractice cases almost always require medical expert testimony. If the patient's lawyer can find another physician who will testify that the three month gap in treatment caused the patient's permanent disability, the patient would be entitled to make a claim for damages for that permanent disability.

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