The relationship between the doctor and the patient is believed to be one of the critical elements in the ethical codes of medicine. There are many situations where the physician ends the patient’s relationship, leading to legal claims such as patient abandonment.
Table of Contents
- What is Patient Abandonment?
- What Constitutes Abandonment of a Patient?
- Common Legal Claims Due To Patient Abandonment
What is Patient Abandonment?
Patient abandonment is the termination of a physician-patient or healthcare professional-patient relationship unilaterally, without giving proper notice to the patient, especially when continued medical care is necessary. Patient abandonment is an often overlooked yet serious form of medical malpractice. It is a legal claim that occurs due to the doctor’s sudden termination of the patient relationship.
A doctor is not obligated to provide treatment to every patient they come across. While it is their right, once they decide to provide care to a patient, they cannot stop treatment abruptly. There is a need to follow a code of ethics that states that a doctor and other healthcare providers need to provide sufficient time for the patient to find a new physician before the care ends.
When a physician fails to provide a timely, alternate, qualified replacement for their patient, it can lead to serious malpractice. That being said, a doctor doesn’t need to wait for months to find a replacement for the patient. They are only required to provide ample time before terminating their relationship with the patient.
However, one should also bear in mind that there is no clear law around how much time is considered “reasonable,” hence should take caution.
Contrary to the more common medical malpractice claims, which usually involves a physician or medical practitioner failing to fulfill certain actions, patient abandonment occurs due to a lapse of proper conduct, but this also doesn’t mean that every patient abandonment claim can be accepted. When there is a clear understanding of patient abandonment’s legal implications and definitions, one can file a patient abandonment lawsuit. Whenever necessary, a doctor can prepare for their defense if an incorrect claim has been filed against them.
What Constitutes Abandonment of a Patient?
An ideal situation is when the relationship between the doctor and the patient is terminated with the consent of both parties or with the consent of other healthcare providers and the client. Some patients may need continued healthcare services, especially the ones with weakness or have disabilities. They may be completely dependent on home healthcare professionals.
Every patient has the right to expect proper access to the services or a substitute before the treatment is terminated. Nevertheless, the patients have the freedom of choosing their healthcare providers and can terminate the doctor-patient relationship at any time.
Even the physicians, nurses, and home healthcare providers have the liberty to withdraw from the case as long as it is performed without causing the patient any harm. A legal claim for patient abandonment is filed if the patient relationship is terminated without prior notice, injury due to abandonment, not providing an appropriate substitute in case of emergency, etc.
Some of the general factors constituting patient abandonment claims are:
- Already established relationship between the doctor and the patient
- Need for continued medical attention during patient abandonment
- Care withdrawal was abrupt without providing alternate care options or allow finding one
- The patient sustained injuries or loss due to abandonment
Patient abandonment can come about in any scenario, such as in a hospital, emergency room, or a private clinic. In some cases, the abandonment may happen unintentionally but still be considered negligent.
Common Legal Claims Due To Patient Abandonment
The physicians, nurses, and other healthcare professionals have to provide their patients with all the necessary care as long as possible. They should not leave the patient in criticality without proper notice of withdrawal or arranging suitable substitute care.
Patient abandonment claims may spring up in many domains, including:
1. Failure To Provide Advance Withdrawal Notice To A Patient
Though physicians have the right to terminate their relationship with a patient, they should communicate it to the patient with prior notice. According to the law, proper notice signifies that the physician should express their withdrawal from the case to the patient and provide sufficient time for the patient to choose another physician or practice of their choice.
If a physician is retiring or relocating to another area, and another physician takes over the cases, the notice should include the qualifications and specialty of the new succeeding physician.
Solution: Physicians who decide to withdraw from the case should either provide alternate care options or adequate time for the patient to choose another physician or practice.
2. Failure To Follow Up After Prescribing Medication
If patients are prescribed medications, physicians are required to follow up at appropriate intervals. Suppose a patient is prescribed a medication for the first time; in that case, a physician should inform about the effects and adverse effects of the medication and ask the patients to call or report to them if they notice any unusual side effects.
Another instance is that certain medications may cause serious side effects. In such a scenario, the physician should initiate a follow-up call and inquire about the patient’s condition.
Some medications necessitate blood testing to monitor certain parameters, and this information must be conveyed to the patient verbally and given in writing. Physicians should also see to it that the patient is prompted to have the testing done.
Solution: Physicians should schedule routine follow-ups with their patients regarding prescription medications, especially medications with known serious adverse effects.
3. Committing To Render Patient Treatment At A Particular Place Or Time
If a physician fails to keep up the promise of rendering treatment at a certain place or time, the physician may be held liable on the legal theory of breach of contract and abandonment. For example, a physician may ask the patient to go to a certain hospital for further treatment or surgery, promising that the physician will come and see the patient there or during the hospital stay.
This type of situation usually occurs in OB/GYN cases. The gynecologists usually promise pregnant women that they will be present during the delivery but fail to show up. Though the physicians are not obligated by law to fulfill such wishes, they can still attend if they have made such promises.
Solution: Physicians must refrain from making any promises, including place and time, to the patients.
4. Failing To Provide Information About Other Surgeons Involved In Different Phases Of Surgical Procedure
An abandonment claim can arise when the doctor fails to inform the patient about another surgeon(s) performing the surgical procedure. It can be an instance of “ghost surgery” where a patient’s operation is performed by another surgeon other than the patient’s surgeon.
An abandonment claim may also be filed when different doctors perform different operation phases without conveying to the patient or obtaining informed consent. Other doctors can perform certain procedures if allowed by the surgeon, such as suturing the open-cut wound after the surgery, monitoring vitals, anesthesia, etc. Such information must be shared with the patient before proceeding with surgery and obtain the patient’s consent.
Solution: Surgeons should obtain the patient’s consent before proceeding with any surgery and also inform them about various other physicians who would assist them during the procedure.
5. Failing To Monitor A Patient After Surgery
Even after the surgery, the surgeon remains responsible for the patient’s postoperative care, including infection control and recovery. The surgeon should determine the relative success of the surgery and make informed decisions concerning additional procedures if required. It will be the surgeon’s responsibility to treat any surgical complications that might occur subsequently after the surgery.
Although many state laws allow the surgeon to limit their duty after the surgery, it is good to follow up with the attending physician and determine the patient’s condition until hospital discharge.
Solution: Surgeons must follow up with their patients subsequently after the surgery for a reasonable period.
6. Discharging The Patient From The Hospital Prematurely
Due to the hospital’s pressure, physicians are forced to discharge their patients as soon as possible from the hospital. A patient may file an abandonment claim against the discharging physician if it is determined that the patient was unstable during discharge and needed additional medical care.
In such instances, the court doesn’t accept the physician’s excuses as a means of defense if there was a need for additional medical care and inappropriately communicated to the patient. Hence, physicians should analyze and take their own professional decisions before deciding to discharge a patient from the hospital.
Suppose a patient decides to leave the hospital against the doctor’s advice; in that case, the patient should be made to sign a document affirming their understanding that the discharge is against medical orders.
Solution: A patient should never be discharged for financial reasons unless medically appropriate.
7. Not Providing Proper Instructions To The Patient While Discharging
Appropriate instructions must be provided to the patients while discharging from the hospital or physician’s continuing care if deemed medically appropriate. Physicians should instruct the patient regarding their present medical condition, discharge medications if prescribed, and the circumstances when they may need to contact the physician again.
Appropriate follow-up instructions should be provided, preferably in writing. An abandonment claim may arise if appropriate instructions about immediate medical care are not addressed in case of any unexpected complication.
Solution: Physicians must provide complete discharge instructions to the patients, especially in writing.
8. Not Following Up After Advising The Patient To Visit A Hospital
Sometimes a doctor might get alarmed by the symptoms described by a patient over the phone. The usual course of action, in that case, would be to ask the patients to visit the hospital. The doctor has to contact the hospital and explain the patient’s situation to them and decide if there is a need for the doctor to visit the hospital in person while the said patient is in the hospital. This situation occurs when the patient is sent from the doctor’s office.
A physician can’t simply “hand over” a patient to the hospital even if the care provided is a competent one. Within a reasonable period, which is significantly shorter in case of emergencies, a doctor needs to follow up, failing which there may be a possibility for patient abandonment claim.
Solution: Physicians should always ensure to follow up on their patients during emergencies.
9. Not Providing Patient Coverage While Taking A Vacation
Physicians have the right to take vacations and leave the office for personal reasons. Physicians going on vacation or taking leave should arrange for another doctor to handle in their absence in case of any emergencies or other routine problems.
Doctors working in groups can easily make arrangements with their partners and associates to handle their patients during their absence. It is also important to inform their patients about their absence and how long they won’t be available.
A solo practitioner should ideally arrange for another physician in the vicinity. They should be of the same specialty and equipped to handle emergencies.
Solution: Physicians must arrange for coverage if unavailable for more than one or two days.
10. Failure Of Response To E-Mail
Many physicians have websites and an e-mail system in place. Many physicians find this convenient to use since it allows them to set aside a certain time each day to respond to the e-mails without compromising their daily practice time.
It can establish an implied invitation to patients to use this facility to communicate with the physicians. The downside is that people tend to assume the e-mail response to be immediate. Hence, physicians need to include an official policy or procedure regarding how and when to respond.
Solution: Physicians who use e-mail should have a proper system to respond to the messages within a reasonable time.
A physician always has the right to terminate the professional relationship with a patient for valid reasons. Physicians must take adequate measures to avoid any patient abandonment claims. Providing written notice of termination and continued support for a reasonable time, recommending another qualified physician, and transferring the patient’s medical records to the new physician are some of the precautions.
Although some medical lawsuit-related claims may be incorrect with the doctor wrongly accused of patient abandonment, the physician should be cautious.
Physicians must know the legal nature of an abandonment claim, and periodically audit the general mistakes, and take necessary steps to avoid them.