Medical Abandonment and a Physician's Responsibility

When a doctor or other health care professional fails to take the right steps before ending a patient's course of treatment, it might amount to "patient abandonment" or "medical abandonment." In situations where the patient's condition is made worse, or they suffer some new harm, medical abandonment can form the basis of a medical malpractice case.

What Is Patient Abandonment?

A doctor or other health care provider is usually said to “abandon” a patient when the caregiver refuses to continue treating the patient (i.e., ends the doctor-patient relationship):

• without giving proper notice, and
• without providing an adequate amount of time for the patient to find another doctor who can take over the patient’s care.

Let's look at a few examples of patient abandonment.

"Inadvertent" Medical Abandonment

A doctor might simply forget about a patient, or the patient might become "lost in the system" due to a computer glitch. In some cases, doctors have argued that they shouldn't be held liable for patient abandonment when there was no intent to abandon. But doctors have a duty to continue treatment until a patient is properly released. The only difference between an intentional and an inadvertent abandonment case is that punitive damages might be available in a case where there's evidence of an intent to cause harm.

Patient Transfer Without Proper Instruction

A doctor might transfer a patient to the care of a second health care professional who isn't familiar with crucial details of the patient's situation. So, the first doctor has an ongoing obligation to give the new provider proper instructions and all relevant records (treatment notes, test results, etc.). Failure to do so could rise to the level of medical negligence.

"Patient Dumping" in Emergency Rooms

If a patient arrives at a hospital with an emergency health issue, federal law requires the hospital to treat the patient, regardless of the patient’s ability to pay and other factors like the patient's citizenship or immigration status. This law is called the Emergency Medical Treatment and Active Labor Act, or "patient dumping" statute.

According to the act, when the patient arrives at the ER or urgent care center, the hospital must determine whether the patient’s condition constitutes an emergency. If it does, the hospital must make all reasonable efforts to stabilize the patient. If a hospital fails to comply with the act, the patient may sue the hospital for both the monetary equivalent of the harm caused by the failure, and for an additional penalty.

What Is a Physician-Patient Relationship?

A physician-patient relationship is the professional relationship that a doctor has with a patient. In the eyes of the law, the relationship usually begins when:

• the physician first diagnoses and treats the patient, or
• the physician 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. Learn more about a doctor's duty of care.

Terminating the Doctor-Patient Relationship

A physician-patient relationship can be properly terminated when:

• the physician and the patient mutually agree to terminate the relationship
• the patient unilaterally dismisses (fires) the physician, or
• 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 orthopedist advises that no further treatment is needed, and discharges the patient.

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 treatment. For example, if a patient suffers from recurring ear infections, the patient might assume that the physician-patient relationship still exists, even if a few months 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 over email, by phone, or face to face—that the physician is terminating the physician-patient relationship, and the reasons why. If it's a conversation, the doctor should send the patient a letter confirming the termination, and what was said.

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 more appropriate. But very serious conditions (such as chronic heart problems or treatment of cancer) might require even more lead time, especially if the doctor is a specialist, and/or the patient lives in a rural area where there are very few treatment options.

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

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

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

What Must a Patient Prove in a Malpractice Case?

In a medical malpractice case based on patient abandonment, the patient must show that:

• they needed continuing medical treatment
• the physician stopped treating them
• the physician didn't give the patient enough time to find another doctor before the physician stopped treatment, and
• as a result of the physician’s abandonment, the patient’s condition was made worse.

Did the Abandonment Cause the Patient Actual Harm?

The critical issue in these cases is often whether the abandonment actually worsened the patient's condition or otherwise caused them harm. This harm can take many forms, including:

• mental and physical pain and suffering
• cost of additional treatment
• loss of earning capacity, and
• loss of the ability to enjoy life.

If abandonment occurs and a patient dies, but it turns out they had an acute health condition that was both untreatable and incurable, it may be difficult to show how the patient was harmed through the abandonment. But an expert's opinion can be used in this situation, to show that the patient would have at least been made more comfortable and as stable as possible had the abandonment not occurred. And if treatment would have had a significant chance of sustaining the patient's life, the family would probably have a more clear-cut case of medical malpractice case against the doctor.

Learn more about proving a medical malpractice case.

What Can the Patient Recover In a Medical Abandonment Case?

If a physician improperly terminates the physician-patient relationship, the physician is liable for all losses ("damages") that the patient incurs as a result of losing access to medical care. Get details on compensation in a medical malpractice case.

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.

If you think you might have a medical malpractice lawsuit based on patient abandonment or similar conduct on the part of a health care professional, it might make sense to discuss your situation with an experienced legal professional. Learn how to find the right medical malpractice lawyer for you and your case.