Ending a relationship with a patient isn’t something providers take lightly. But when certain patterns continue – missed appointments, refusal to follow a treatment plan, or inappropriate behavior – it may be time to move on.
A clear, professional patient dismissal letter helps document the decision and set expectations going forward. It also gives the patient what they need to transition their care to another practice.
If you’re not sure how to write a patient dismissal letter, using a template can take some of the pressure off. In the sections below, you’ll find guidance on when dismissal makes sense, how to write the letter, and what to keep in mind as you deliver it.
There’s no single reason why a provider might decide to end the patient relationship. But a few patterns come up often.
Nonpayment: Some patients fall behind on balances with no attempt to communicate or make arrangements. When repeated efforts to resolve the issue go unanswered, dismissal may be appropriate.
Noncompliance: This can include missing appointments, refusing treatment, or ignoring office policies. If the behavior continues after clear communication, it may lead to a patient non-compliance letter and, if necessary, a formal dismissal.
Inappropriate behavior: This can include verbal abuse, threats toward staff, harassment, or boundary violations. When behavior creates a hostile or unsafe environment, separation may be the best option.
Before terminating a patient from a medical practice, make sure you’ve taken reasonable steps to address the issue. Dismissal should never be the first response.
Is the patient aware there’s a problem? Sometimes, noncompliance stems from confusion, lack of transportation, or financial stress – not defiance. A phone call may be enough to reset expectations.
Could anything in your scheduling process, billing system, or communication habits be contributing? If so, resolve what you can first.
If the issue continues, give the patient a written notice that outlines the concern, what needs to change, and what happens if it doesn’t. This documentation is valuable – especially if dismissal becomes necessary.
Once you’ve made the decision to dismiss a patient, the letter should be clear, professional, and complete. If you're using a template to guide the process, make sure it includes the necessary details to support a smooth transition and limit confusion.
At a minimum, your letter should include:
The date you write it
The patient’s full name and contact information
The date the provider-patient relationship will officially end
A recommendation to seek care from another provider
A referral resource, such as a local physician directory, if available
Instructions for requesting or transferring medical records
The provider’s printed name and signature
You may also choose to include:
A brief, factual explanation for the dismissal
How long the patient has been with your practice
A statement confirming you're available to speak with their next provider
If the patient hasn’t formally ended the relationship, this letter must act as your official notice. Without it, you may still be legally obligated to continue care.
Once you’ve decided to move forward with dismissal, your discharge letter to the patient should follow a clear structure. These five steps will help you communicate the decision professionally and avoid confusion.
1. Be direct and specific.
Start the letter by clearly stating its purpose. Use plain language like: “This letter is to inform you that you are being discharged from our medical practice.”
You can include a general explanation – such as ongoing missed appointments or noncompliance with treatment – but keep it factual and objective. Avoid language that could be seen as emotional or judgmental.
Include the exact date the physician-patient relationship will end. Allow enough time for the patient to find a new provider. Depending on your location or specialty, what’s considered “reasonable” may vary.
Clarify that your practice will remain available for urgent care needs until the end date or until the patient establishes care elsewhere.
Let the patient know how to request their medical records or have them sent to a new provider. Including a release form can streamline this process.
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[Date] To [Patient Name] Please be advised that I will no longer be able to provide treatment for you, effective [specific date or timeframe following letter]. You will need to seek a new healthcare provider to oversee your ongoing care. Upon receiving authorization, my office will send a copy of your records to your new provider. Sincerely, [Physician’s Name] |
Once the letter is written, it’s important to send it in a way that creates a clear record of delivery. Some providers choose certified mail, thinking it offers more protection – but that method has limitations.
Certified mail requires a signature and may go unclaimed if the recipient doesn’t visit the post office. In those cases, the patient technically may never receive it.
Regular first-class mail, on the other hand, doesn’t require action from the patient and is more likely to be opened. If you go this route, keep a dated copy of the letter in the patient’s file, along with a note confirming when it was mailed.
The most important checkbox is that your method creates documentation that the letter was sent. Whether the patient reads it or not, your practice should be able to show that it provided notice.
Some patients may leave a negative review after receiving a dismissal letter. It’s a frustrating situation – but how you respond matters, especially when you’re limited by HIPAA guidelines.
Acknowledge the feedback: You don’t have to agree with the review, but a polite reply can show that you’re listening. A simple, “Thank you for your feedback – we take patient concerns seriously,” is usually enough.
Keep it general and professional: Instead of getting defensive, keep your reply short and stick to general practice policies. Something simple like, “Our office follows standard procedures for all patient relationships,” works well.
Look for patterns: One review may not mean much, but if you’re seeing similar feedback more than once, it’s worth taking a closer look. Sometimes it points to a bigger communication issue or something in your process that needs attention.
FAQs About Patient Dismissal LettersWriting and sending a dismissal letter can raise questions that go beyond the template. Here are a few that providers often ask. Q: What legal risks should providers consider when dismissing a patient?A: One major legal risk is patient abandonment. If a provider ends care without proper notice or during a time when the patient still needs treatment, they could face liability. This is especially true if the patient suffers harm as a result of not receiving timely care. Another risk involves failing to follow local laws or board guidelines. Some states have specific rules about patient dismissal, and ignoring them can lead to disciplinary action, such as board warnings, fines, or even license review. Providers should also be careful to protect patient privacy under HIPAA and avoid using language in the letter that sounds emotional or accusatory. Q: How much notice is considered "reasonable" before ending the provider-patient relationship?A: In most cases, a 30-day notice is considered reasonable. This gives the patient enough time to find a new provider without interrupting care. Some practices choose to give more time, especially in complex cases. The provider should stay available for urgent needs during this notice period. The letter should clearly list the last day of care and explain how to transfer records. If you need more clarification, check with legal counsel or a malpractice insurer. Q: What SHOULD providers do if the patient becomes confrontational or refuses the dismissal?A: If a patient reacts badly, the provider should stay calm and follow the plan. Keep records of all communication and continue to act professionally. Don’t argue or respond emotionally. If the patient continues to call, threaten, or make appointments, the provider may need to get legal help. In serious cases, law enforcement may need to be involved. As long as the provider gives proper notice and documents the steps taken, they’ve done their part. |
A dismissal letter is one part of the patient termination process, and it should do one thing well: communicate clearly. Before you send it, check that everything is complete and documented. That includes the letter itself, your warning to the patient, and any steps you took beforehand.
Keep the tone professional. Avoid unnecessary detail. Stick to what’s relevant, and state it plainly.
If you’re using a template, take a moment to review the information you’ve added. Even small details – like dates or referral instructions – matter.
Once the letter is ready, send it using a method that leaves a paper trail. If questions come up later, you’ll want that record in place.
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(Editor’s Note: This blog was originally published in February 2019 and was updated in July of 2025 to reflect current information.)