Risk Considerations: Ensuring Safe Discharge of Disgruntled Patients

Discharging a disgruntled or dissatisfied patient from clinical practice is a delicate process that requires careful consideration of the patient’s needs and the safety of the healthcare team and other patients. Although the decision to part ways may be necessary, the healthcare provider should handle the situation with sensitivity and professionalism to prevent escalating behaviors and potential harm.

First and foremost, the healthcare provider should prioritize continuity of care for the patient in question. This involves ensuring the patient has access to an alternative source of healthcare assistance and necessary resources to effectively manage their health after leaving the practice. Referring the patient to the local hospital provider network, insurance plans, and/or the state healthcare association/board to find a new provider can help facilitate a smooth transition and ensure the patient’s well-being.

Moreover, approaching the discharge process with empathy and understanding is imperative. Acknowledging the patient’s concerns and grievances and actively listening to their feedback can help alleviate tension and foster a sense of respect and dignity throughout the process. Although the provider generally is not obligated to provide a reason for terminating the relationship, doing so in a diplomatic and transparent way may help mitigate any negative feelings the patient has. The explanation should be brief and nonpunitive in tone.

Equally important, the healthcare provider should prioritize their own safety and the safety of other patients and staff members. The discharge process should minimize the risk of escalating behaviors that could potentially endanger individuals or disrupt the functioning of the practice. Devising and implementing security measures and training staff on de-escalation techniques can help maintain order and safety. In some cases, the practice might need to involve law enforcement to address threats of violence or harm.

Important note: Healthcare providers generally have the right to terminate relationships with patients for various reasons. However, many legal and ethical considerations should go into these decisions, including state and federal laws, contractual obligations, timing issues, availability of other care providers, and more. Further, exceptions may occur when dealing with violent or aggressive patients. For more detailed information, see MedPro’s guideline Terminating a Provider–Patient Relationship.

In summary, safely discharging disgruntled patients from clinical practice involves a concerted effort to provide the care and support they need, while also maintaining a safe and functioning environment for everyone in the healthcare practice. Healthcare providers should learn relevant protocols and guidelines for managing difficult patient discharges and seek appropriate support when needed. MedPro offers an array of helpful resources and tools, including:

• Active Shooter Preparedness and Response for Healthcare Practices
• Checklist: Terminating a Provider–Patient Relationship
• Guideline: Patient Agreements in Clinical Practice
• Risk Tips: Managing Nonadherent and Difficult Patients
• The Challenge of Difficult Patients: Risk Management Strategies for Handling Inappropriate Patient Behaviors
• Tips and Strategies for De-Escalating Aggressive, Hostile, or Violent Patients

Healthcare professionals can also take advantage of MedPro’s on-demand continuing education programs that cover topics related to provider–patient relationships, violence prevention, complaint management, and more.

MedPro insureds who have questions about safely discharging patients may call their senior risk solutions consultant or MedPro’s Risk Solutions Center at 1-833-ASK-RISK (1-833-275-7475), email AskRisk@MedPro.com, or schedule an appointment at www.medpro.com/dynamic-risk-tools (click on “schedule appointment with risk consultant”).

Disclaimer

This document does not constitute legal or medical advice and should not be construed as rules or establishing a standard of care. Because the facts applicable to your situation may vary, or the laws applicable in your jurisdiction may differ, please contact your attorney or other professional advisors if you have any questions related to your legal or medical obligations or rights, state or federal laws, contract interpretation, or other legal questions.

MedPro Group is the marketing name used to refer to the insurance operations of The Medical Protective Company, Princeton Insurance Company, PLICO, Inc. and MedPro RRG Risk Retention Group. All insurance products are underwritten and administered by these and other Berkshire Hathaway affiliates, including National Fire & Marine Insurance Company. Product availability is based upon business and/or regulatory approval and may differ among companies.

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