Northwest Physicians Insurance Company

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Risk Management

Sample Forms

Termination of Patient Care

Physicians have a duty to provide care to a patient until the proper termination of that relationship. A patient-physician relationship can be terminated by:

  • Mutual consent

  • Patient dismissal of the physician

  • The lack of need for further medical treatment, or

  • Withdrawal of the physician

When a physician withdraws from a patient who is in need of continuing care at that time, the physician must take the following steps:

  • Give reasonable notice of the intent to withdraw

  • Provide the patient with a reasonable time to find alternative care, and

  • Continue to be available during this time to treat the patient until the date indicated in the notice

The same rules apply to termination of care for non-payment of fees.

In most cases thirty days notice would be considered reasonable. It is not necessary to indicate to the patient why the relationship is being terminated.

Sample Termination of Care Letter

Use the physicians's letterhead.  Send it certified mail with return receipt requested.  Place the reciept and a copy of the letter in the patient's medical record.

Date

Patient's Name
Address
City, State XXXXX

Dear {Patient's Name}:

This letter is to inform you that I/we, {name of physician or name of medical group} am/are withdrawing from your further professional care.  Because you may have a medical condition that requires continued follow-up, I encourage you to contact a new physician as soon as possible.  Your County Medical Society will be able to assist you in finding a new physician.

I will be available to treat you for urgent or emergency care for a reasonable time but, in no event, for more than 30 (thirty) days following receipt of this letter.  Upon your written authorization, I will make available to your new physician your case history and information regarding the treatment you have received under my care.

Very truly yours,

{Physician's name here}

Certified Mail
Return Receipt Requested

 

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2965 Ryan Drive S.E., Salem, Oregon 97301