[Example] How to Write a Patient Dismissal Letter

Although it’s never easy, there are times when ending the relationship with a patient from a medical practice is absolutely necessary.

 There are three notable reasons to write a patient dismissal letter, and those include:

• Non-payment

• Non-compliance or failure to comply with treatment plans

• Inappropriate behavior

If this sounds like one of your patients, it may be time to part ways. Here are some tips for writing a patient dismissal letter for non-compliance.

Before Writing a Patient Termination Letter

Before proceeding with dismissal, we ALWAYS recommend exploring alternative options and communicating with the patient, for the benefit of your practice AND your patients. In today's world, unhappy patients - and customers in general - are more than willing to share that experience via an online review. Once that review is posted, there's no getting it back. Therefore, if possible, it is wise to reach out to a patient with a phone call to provide a personal connection and attempt to address the issues. 

Dismissing a patient is a serious decision that comes with ethical and legal risks. Even physicians who thoroughly cover their bases may see professional, legal, and reputational consequences. So, start by running through this list:

1. Attempt to understand WHY the patient is non-compliant.

• Does the patient understand their behavior is creating an issue?

2. Review internal processes before terminating the patient.

• If the issue is procedural, are there any internal practice operations that could be interfering with patients making/keeping appointments?

• If the issue is financial, can you provide any assistance or education to make payments easier for the patient?

3. Give a clear, documented warning with consequences explicitly outlined.

Make sure to document alternative steps you’ve taken to avoid dismissal of the patient. Dismissal is the next step once you’ve exhausted your options and checked all these boxes.

ALSO NOTE: If the patient has not requested termination of care, you MUST provide an official notice of dismissal. Otherwise, you may still have an obligation to provide care.

How to Write a Patient dismissal Letter Due to Non-Compliance

Certain informational points should be included in most patient dismissal letters. Items to consider for inclusion in every letter:

• Date the letter is written

• Recipient’s name

• Date the patient's relationship with the office will end (this can be a specific date or a time frame)

• Recommendation to seek a new care provider

• Reference to local physician referral service, if available

• Reason the relationship is being terminated (optional)

• Length of relationship with office (optional)

• Clarity of availability to discuss patient’s care with new provider (optional)

• Doctor's printed name

The steps to writing the letter are fairly straightforward as well: 

1. Get straight to the point

2. Provide the reason(s) for discharge

3. Give the patient a clear, dated deadline to find a new provider

4. Mention emergency care

5. Offer to transfer medical records

1.  Get straight to the point.

Don’t beat around the bush. Your letter should explicitly mention “This is to notify you that you are being discharged from our medical practice.” The patient should immediately be aware of your letter’s purpose.

2.  Provide the reason(s) for the discharge.

Explain the discharge is due to the patient’s failure to comply - with your treatment plan, office regulations, operations, or other grievances. These reasons should be presented factually and objectively.

3.  Give the patient a clear, dated deadline to find a new provider.

This is similar to giving an eviction notice. You CAN NOT fire a patient effective immediately. Check your state’s laws for more specific requirements - the state of Texas only requires “reasonable” notice.

Note: Depending on your geographical area and the number of physicians available, or whether you are in a specialty practice that may make it difficult for the patient to find another doctor, you might want to give the patient more time.

4.  Mention emergency care.

Let the patient know that, up until the deadline you provide or until they find a new provider (whichever comes first), you WILL provide emergency care. You may also offer to refill prescriptions during this period if you feel so inclined.

5.  Offer to transfer medical records.

Patients have a right to either get a copy of their medical records directly from you or to have you transfer them to their new provider. You may want to include an authorization to release medical records form with the dismissal letter.

Example Letter: 

What’s the best way to send a letter of patient DISMISSAL?

Some doctors prefer to send the letter by certified mail, but there is no legal requirement for doing that. Keep in mind that a certified letter must be signed for and, in some cases, the person receiving a certified one must go to the post office to get it. Many people do ignore certified mail, and technically never “receive” it.

So, in practice, sending the letter by regular mail and keeping a copy in your files is often the best approach.

PATIENT RESPONSE: HOW TO ADDRESS NEGATIVE REVIEWS

Patients are likely to respond negatively to a letter terminating their relationship with your medical practice. Therefore, it is a good idea to gather your thoughts and prepare to effectively respond to a negative review. 

Here are three main points to keep in mind when writing a review: 

• Express gratitude where appropriate. Even when addressing a negative review, thanking the review for their feedback relays the value you place on patient satisfaction. 

• Cite policies and procedures, keep the response general to stay within HIPAA guidelines, but remember to also respond with relevance to the complaint. 

• Look at criticism objectively and try to learn from it.

Final Thoughts: Use a Patient dismissal Letter Example to Organize Your Thoughts

If you’ve done everything by the book, terminating your physician-patient relationship should go relatively smoothly (though it’s never easy).  In short,

• Document any and all alternative steps taken prior to termination

• Keep your letter of dismissal concise & factual

• Make a copy of the letter for your records

The experienced staff at 99 MGMT can help you fine-tune your patient dismissal letter. Contact us today. 

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