Many people go years without seeing their doctor for a general wellness check or for important preventive care. For most, this delay comes from the fear of bad news or because they forget. Doctors can become frustrated, especially if they request that a patient does something and that patient fails to follow through, even though medical issues can cause a great deal of stress and anxiety for the people experiencing them. In certain situations, a doctor may become frustrated with a patient and decide to stop treating them, either because they don’t believe the patient has their own best interests in mind or because they believe they have exhausted every option to treat the patient. Are doctors allowed to “ghost” their patients?
The Doctor-Patient Relationship
Every person who sees the same doctor on a regular basis enters a specific type of relationship with that doctor. That relationship, also known as the doctor-patient relationship, is instrumental in ensuring that the patient receives adequate and timely medical care. Formally, this relationship is established when a doctor agrees to treat a patient, the patient agrees to be treated by the doctor, and treatment has begun. The doctor-patient relationship has two essential components:
- Instrumental: The instrumental aspect of the doctor-patient relationship refers to the doctor’s ability to perform the aspects of medical care that are technical, including (but not limited to) physical exams, prescribing medications, performing tests to diagnose illnesses, etc.
- Expressive: The expressive aspect of the doctor-patient relationship refers to what many people call “bedside manner,” or the art of practicing medicine. This includes a doctor’s ability to be empathetic and warm when treating their patients.
In some situations, a doctor may choose to terminate their working relationship with a specific patient. The manner in which this termination takes place determines the legality of it.
What Is Patient Abandonment?
Patient abandonment is medical malpractice, and it can have detrimental effects on the patient being abandoned by their healthcare provider. Patient abandonment occurs when a doctor or healthcare provider abandons their relationship with a patient without providing notice or a legitimate reason for termination of the relationship. In certain situations, doctors can terminate their relationship with a patient, but there is a fine line between cutting a patient off for legitimate reasons and abandoning a patient.
In order for a case of patient abandonment to be proven, the following conditions must be met:
- The doctor-patient relationship existed and was well established: For the end of a doctor-patient relationship to be considered abandonment, the doctor in question must have already decided to treat the patient and treatment must have already started.
- Treatment must be ongoing: For a claim to be proven as patient abandonment, the abandonment must take place when the patient is still in need of medical care, be it the continuation of an ongoing treatment plan or continuing work to diagnose an ongoing issue.
- The abandonment was abrupt and without warning: For someone to effectively prove a case of patient abandonment against their former healthcare provider, they must have been abandoned by the doctor so abruptly that there wasn’t ample time to select a new provider and begin a new treatment plan.
- The abandonment resulted in injury to the patient: For a situation to be considered patient abandonment in a legal sense, the abandonment must result in injury to the patient. For example, the patient’s illness became worse because they were unable to continue the treatment plan initiated by the doctor who abandoned them.
What Can’t Be Considered Patient Abandonment?
Any time a doctor decides not to continue treating a patient is very concerning for both the patient and anyone else on their care team. However, there are certain situations that may be interpreted as abandonment by the patient but won’t meet the legal requirements for patient abandonment. Some examples include:
- A doctor who does not treat certain issues: If a patient is diagnosed with a specific issue that their doctor is not qualified to treat or has chosen not to treat, they can legally terminate their working relationship with that patient as long as they provide notice.
- Continuing the doctor-patient relationship would be unethical: If a healthcare provider is concerned about the ethical or legal consequences of continuing to treat or work with a patient, they can terminate the relationship without it being considered patient abandonment.
- Limited access to resources: If a doctor is not provided with the necessary tools and supplies needed for them to provide the best care possible to the patient, they are within their rights to terminate the working relationship with the patient and suggest other sources of care.
- Violation of provider policies by the patient: Healthcare establishments put policies in place that are meant to protect their employees, other patients, and the establishment itself. If a patient breaches these policies, knowingly or unknowingly, their relationship with a doctor at the practice can be terminated.
- Missed appointments: A doctor can decide they no longer want to treat a patient if that patient cancels or misses appointments in excess. Such behavior prevents other people from receiving care from that provider.
- Inappropriate behavior from the patient: If a patient behaves inappropriately with, or in the presence of, their healthcare provider, that provider is not obligated to continue providing the patient with treatment. Verbal or physical abuse and sexual advances are examples of patient behavior that could result in termination of the doctor-patient relationship.
- Refusal to follow doctor’s orders: If a patient does not follow through on specific orders from their healthcare provider, such as scheduling follow-up appointments, seeing a specialist, or getting a procedure done, the healthcare provider can opt to terminate their working relationship with the patient.
What Are Some Examples of Patient Abandonment?
Patient abandonment occurs in many types of medical treatment settings, such as hospitals, primary care centers, and even specialists. Since there are so many types of healthcare providers, patient abandonment can happen in a lot of ways, but here are some of the most common:
- Unintentionally: When a healthcare practice becomes overwhelmed with patients, such as what we have seen occur with the COVID-19 pandemic, some patients may be forgotten about unintentionally. While this may happen on accident, it does not absolve the doctor or practice from their responsibility to provide care to their patients, and failure to do so can be considered patient abandonment.
- Lack of payment: If a patient is unable to pay for their treatment or does not have adequate insurance to cover their treatment, a doctor cannot abandon them in the middle of a treatment plan. However, the treatment the patient is receiving must be critical treatment; a doctor can terminate the doctor-patient relationship if the patient is receiving care that isn’t critical.
- Lack of communication with a new doctor: When a doctor chooses to terminate a doctor-patient relationship, they must do so within the confines of the law. Part of terminating the relationship correctly includes providing the patient’s new healthcare provider with their medical records. These records are essential to the new provider’s ability to give the patient quality care. If the doctor terminating the relationship fails to provide these records in a timely manner, they may be liable for patient abandonment.
- Being unreachable: If a doctor does not follow up regarding a concern their patient has or critical care they have provided the patient within a reasonable timeframe, an argument for patient abandonment could be made.
- Lack of staff: If a healthcare practice is unable to keep enough staff to provide appropriate care for all their patients, they may be liable for patient abandonment if one of their patients becomes ill or injured due to lack of care.
- Failure to contact patient after missing important appointment: It is the responsibility of medical staff (doctors and/or clerical staff) to make sure their patients know about follow-up appointments that are essential to their well-being. If medical staff does not reach out to a patient after the patient misses an appointment, an argument for patient abandonment could be made.
- Scheduling appointments too far apart: If a patient needs to be seen for an issue that is time-sensitive and their healthcare provider schedules the appointments with too much time between them, that patient may be able to make a successful claim of abandonment against the physician.
Is Patient Abandonment Different Than Medical Negligence?
Medical negligence and patient abandonment are similar because both involve a patient enduring pain and suffering because their doctor failed to provide proper care. However, patient abandonment and medical negligence are not interchangeable terms. For a situation to classify as patient abandonment, the doctor must refuse treatment to a patient without providing them with notice or ample time to find the appropriate care from another provider. On the other hand, medical negligence occurs when a doctor gives a patient treatment that is incorrect or unnecessary.