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Patient Abandonment

When a physician or provider may end a relationship with a patient, what notice and transition care they must give, and when ending it - or refusing to start it - becomes actionable.

Informational only - this is not legal advice. These definitions explain general legal vocabulary in plain English. They are not advice about your situation, reading them creates no attorney-client relationship, and the law differs from state to state and changes over time. For advice you can rely on, speak to a lawyer licensed in your state.

What it means

A physician is generally free to decide whom to treat and may end a relationship with a patient for almost any reason - non-payment, a breakdown in trust, abusive conduct, the practice closing or the physician retiring - but not for a discriminatory reason and not in a way that leaves the patient without care at a critical time. Patient abandonment is the name for the second failure: unilaterally terminating the relationship, or failing to attend, without reasonable notice and without giving the patient an opportunity to arrange substitute care, while the patient still needs attention. It is a form of professional negligence, and in most states also a ground for licensing discipline.

What counts as reasonable depends on the patient's condition. Professional ethics rules and most licensing boards expect written notice, continued care for a stated interval while the patient finds another provider, emergency care during that interval, a copy or transfer of records, and help with a referral where the condition requires it; a patient mid-treatment, in the third trimester, on a medication that cannot safely stop, or in a specialty with few alternatives is owed more than a routine patient. A hospital or clinic that discharges a patient still requiring care, or a facility that transfers one for financial reasons, can be liable on the same principle, and hospitals owe emergency patients separate statutory duties.

Two things are not abandonment. A physician who never agreed to treat a person has no relationship to abandon - the duty arises only once one exists, which is why a refusal to accept a new patient is ordinarily lawful (subject to anti-discrimination law and, for emergency departments, the federal screening duty). And a patient who ends the relationship themselves, misses appointments or refuses the plan of care has not been abandoned, though a careful practice documents the patient's choice and the warnings given.

Where this comes from

Patient abandonment is state law - a negligence claim requiring the elements of malpractice and, separately, a ground for discipline under state medical practice acts and board rules. The professional standard is stated in the American Medical Association Code of Medical Ethics, Opinion 1.1.5 (Terminating a Patient-Physician Relationship). Hospital emergency duties are federal, under the Emergency Medical Treatment and Labor Act, 42 U.S.C. § 1395dd. Refusals based on a protected characteristic are governed by federal and state anti-discrimination law, including § 1557 of the Affordable Care Act, 42 U.S.C. § 18116.

When people hire a lawyer for this

A patient dismissed from a practice should ask in writing for the notice period, interim emergency coverage and a records transfer, and should file a complaint with the state licensing board if none is offered; that route is free and is what the boards exist for. A lawsuit is worth discussing with a lawyer only when the gap in care caused a real injury, since abandonment is a malpractice claim with the same proof and cost as any other. A practice that needs to end a relationship should get its letter and interval right before sending it, because the board complaint is the more likely consequence of doing it badly.

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Part of the LawyerLand plain-English legal glossary. Definitions are written from primary sources - statutes and court rules - and each entry states the authority it rests on, or says plainly when the doctrine is state law with no national rule.

If you cannot afford a lawyer, civil legal aid programmes provide free help with many of these problems: civil legal aid programmes by state.

Related free reference tools: statute of limitations for a personal-injury claim, by state, quoted from each state's official text - part of LawyerLand's legal reference tools.