RE: Discharge letter

[Guest guest]

Dear ,

Thank you for your prompt reply.

I looked at the link.

In my case the patient does not communicate due to her speech impediment and the spouse communicates for her. It was he who threatened to sue me if his wife died. Would I still address the letter to her?

Thanks

Mala

[Guest guest]

Dear ,

You have hit the nail on the head. he is angry because he has been her caretaker for so long. They have been married 65 years and he probably cannot imagine his life without her.

I have done everything according to the book as far as treating her. He just seems frustrated as she is not getting better.

Thank you, I will consult an attorney before discharging her.

Mala

[Guest guest]

I found this link at Medical Economics:How to Cut Loose from a Troublesome Patienthttp://www.memag.com/memag/article/articleDetail.jsp?id=124100 & searchString=dischargingExcerpts:When someone is disruptive or uncooperative, it may be time to part company. But dismiss that person carefully, or you could face a lawsuit."In medicine, we have a long tradition of caring for patients we don't necessarily like," he says. "A little communication can go a long way. I wouldn't automatically discharge someone because he yelled at my secretary once after being kept waiting long beyond his appointment time. Intervention by the doctor can often rectify the frustration. But if the patient is continually abusive or threatening, those are grounds for dismissal. No doctor has to subject himself or his staff to that behavior."Good luck! SetoSouth Pasadena, CAIs it ok for me to discharge a patient based on a verbal threat by her spouse saying that if she died he would sue me. I have seen this patient twice.  So far I have done everything im my capacity to help her. Does anyone have a copy of a discharge letter to share? ThanksMS

[Guest guest]

Mala,I'm no lawyer, so these are just my non-expert thoughts. First of all, I think that as long as your patient is mentally competent, whether blind, deaf. verbally impaired or a non-native English speaker, you have a duty to address that person directly. So any communication should be addressed to her, unless she cannot understand the information that is in the letter.Second, I didn't offer that link as advice that I thought you could or should discharge her. In fact, I think you shouldn't discharge her without consulting an attorney about the potential legal ramifications. As that article states, you could be accused of abandonment and get sued anyways. It seems like there is some other issue going on. You've only met the patient twice and he's already threatening to sue you? Unless you've been grossly negligent, it seems more likely that he is angry about something and directing that anger at you. Maybe he is scared his wife may die and is coping by turning his fear into anger? Without knowing more information, it would seem judicious to try to find out what is behind his threat to sue you, and it may prevent you from getting sued.How about: "Mr. , I understand your concern about your wife's health and I'll certainly do the best that I can to take care of her. But I was troubled when you talked about suing me if she died. Is there something that you feel that should be done differently for her care? If you are dissatisfied with my care for some reason, you always have the option of choosing another physician to take care of her and I would be willing to assist you in finding another physician if that is what you wish to do...." or something like that. Just a suggestion.Since I love linking to articles, here's a relevant one that basically says the most common reason doctors get sued is for lack of communication:Why Some Doctors Get Sued More than Othershttp://www.memag.com/memag/article/articleDetail.jsp?id=111458Good luck! SetoSouth Pasadena, CADear , Thank you for your prompt reply.I looked at the link. In my case the patient does not communicate due to her speech impediment and the spouse communicates for her.  It was he who threatened to sue me if his wife died.  Would I still address the letter to her? Thanks  Mala

[Guest guest]

OK, since you've done everything you can for her, maybe you could offer something that could help him? Respite or hospice care? SSRIs? Referral to a therapist/pastor? SetoSouth Pasadena, CADear ,You have hit the nail on the head.  he is angry because he has been her caretaker for so long. They have been married 65 years and he probably cannot imagine his life without her.I have done everything according to the book as far as treating her.  He just seems frustrated as she is not getting better.  Thank you, I will consult an attorney before discharging her. Mala

[Guest guest]

In my non-attorney opinion, you can basically discharge a patient for any reason

you want, maybe short of the usual discriminatory stuff. You can dismiss a

patient if you simply do not like them. The only real caveat is to not dismiss

if they are currently unstable (ie, new cancer dx, etc). Give them 30 days to

find a new doctor, and provide the number of the local hospital or medical

society for referral to a new doctor. Emphasize the importance of finding a new

primary care doctor right away.

>

> From: DocSingh760@...

> Date: 2006/12/01 Fri PM 08:59:31 EST

> To:

> Subject: Discharge letter

>

> Is it ok for me to discharge a patient based on a verbal threat by her

> spouse saying that if she died he would sue me.

>

> I have seen this patient twice. So far I have done everything im my

> capacity to help her.

>

> Does anyone have a copy of a discharge letter to share?

>

> Thanks

> MS

>

>

[Guest guest]

Here is what we have in our EMR for discharging patients.

I like the added touch of giving them a release form to send their records somewhere else.

:-)

Locke, MD

Dismissal from the Practice for Medical, Noncompliance, etc This letter is formatted so that it includes a transfer of care permission on the 2nd page. You have to put in a page break between the letter and the authorization so that it prints on a 2nd page.{._todaysDate}

{PATIENT.LABELNAME}{PATIENT.LABELADDRESS}

RE: Your Dismissal from Care by Alpine Medical Group

Dear {Patient.firstName} {Patient.lastName},

I have decided not to continue as your physician. The reason is: (delete this and see below for what to say)

(indicate a reason or delete this sentence. If you provide a reason, keep it brief and factual. For example, “I’ve recommended treatments and tests, but after repeated discussions you have declined to follow my advice. The physician-patient relationship depends on mutual rapport. Since it appears that you have lost confidence in my advice, I must withdraw as your physician.” )You may require further medical care, so you should place yourself under the care of another physician promptly. You may find other local physicians by using the local phone book Yellow Pages or calling area hospitals for the names of physicians who are accepting new patients. Valley View Hospital (Glenwood Springs, CO) phone number is . Aspen Valley Hospital (Aspen, CO) phone number is .To make it easier for you to transfer your care to another physician, I will remain available to treat you for emergency medical care for fifteen (15) days following the date ({._todaysDate}) of this letter. Please try to make the transfer to a new physician as quickly as possible within that period.When you have selected another physician, please send me a signed authorization so that I can provide a copy of your medical chart to your new physician. I have enclosed a Health Information Release Authorization form in this envelope that may be used for this purpose. Please complete and return the release form to me as soon as possible.

I extend to you my best wishes for your future health.

Sincerely,

{USER.FIRSTNAME} {USER.LASTNAME}=================================================================================

Health Information Release Authorization

To: Alpine Medical Group of the Roaring Fork Valley, 1450 East Valley Road, Ste 101, Basalt, CO 81621Authorization to Use or Disclose My Health InformationPatient name: {PATIENT.FIRSTNAME} {PATIENT.LASTNAME} Date of birth: {PATIENT.DATEOFBIRTH}

My Authorization

You may transfer all my health information maintained by Alpine Medical Group of the Roaring Fork Valley to:

Organization: _________________________________________Physician Name: _______________________________________Clinic Name: __________________________________________Street Address: _________________________________________City: ____________________________ State: _______ Zip Code: ________________Telephone Number: _____-_____-________ Fax Number: _____-_____-________

_________________________ _____-_____-_____ __________Patient or legally authorized individual signature Date Time

____________________ _____________________________________Printed name if signed on behalf of the patient Relationship (parent, legal guardian, etc.)

[Guest guest]

Here’s a question for those of you

(like me) who charge for providing copies of medical records, when you

discharge the patient from your practice, do you waive the charge?

Kathy Saradarian, MD

Branchville, NJ

Solo low-staff practice since

4/03

In practice since 9/90

Practice Partner User since 5/03

[Guest guest]

Thank you for the copy of the discharge letter. I have a group question about the Records Release Form. My own form is very similar (trinitymedicalcare.com/forms), and I noted Brady's is as well. I recently received a note from another doctor that said "Please have the patient fill out a HIPPA Compliant Release Form." The other doctor then sent their own form which had A LOT of extra lingo, disclaimers, etc. It all seemed rather unnecessary, however, I do want to be HIPPA compliant and if I am not, I better change my form right away. Any comments or suggestions? , MD Virginia Beach, VA

Everyone is raving about the all-new Yahoo! Mail beta.

[Guest guest]

If I dismiss the patient I do not charge for copies of my records, if they transfer, I charge what my State Board allows.On 12/3/06, Kathy Saradarian <

qualityfp@...> wrote:

Here's a question for those of you

(like me) who charge for providing copies of medical records, when you

discharge the patient from your practice, do you waive the charge?

Kathy Saradarian, MD

Branchville, NJ

Solo low-staff practice since

4/03

In practice since 9/90

Practice Partner User since 5/03

-- Pedro Ballester, M.D.Warren, OH

[Guest guest]

I think the AAFP website has sample letters like this located in the practice managment toolbox DocSingh760@... wrote: Does anyone have a copy of a patient discharge letter to share??? Thanks, Singh Bowey, MDEncanto Family Medicine, PLLC333 E. Virginia Ave, Suite 110Phoenix, AZ 85004email: encantofm@...website: encantofamilymedicine.net office fax cell

Need a quick answer? Get one in minutes from people who know. Ask your question on

Yahoo! Answers.

[Guest guest]

Two other sources include your malpractice insurance company and state medical

board.

CAV

From: DocSingh760@...

Date: 2006/12/11 Mon PM 11:31:06 CST

To: practiceimprovement1

Subject: Discharge letter

Does anyone have a copy of a patient discharge letter to share??? Thanks,Singh

[Guest guest]

This is cut/pasted from our EMR, but this is what we use.

I like the touch of adding a release of records page so that they get the point...please go somewhere else, I'm making it really, really easy.

:-)

Locke

http://home.comcast.net/~lockek/CentricityMEL/CentricityMEL.htm#DismissalLetterMedical

Dismissal from the Practice for Medical, Noncompliance, etc This letter is formatted so that it includes a transfer of care permission on the 2nd page. You have to put in a page break between the letter and the authorization so that it prints on a 2nd page.{._todaysDate}

{PATIENT.LABELNAME}{PATIENT.LABELADDRESS}

RE: Your Dismissal from Care by Alpine Medical Group

Dear {Patient.firstName} {Patient.lastName},

I have decided not to continue as your physician. The reason is: (delete this and see below for what to say)

(indicate a reason or delete this sentence. If you provide a reason, keep it brief and factual. For example, “I’ve recommended treatments and tests, but after repeated discussions you have declined to follow my advice. The physician-patient relationship depends on mutual rapport. Since it appears that you have lost confidence in my advice, I must withdraw as your physician.” )You may require further medical care, so you should place yourself under the care of another physician promptly. You may find other local physicians by using the local phone book Yellow Pages or calling area hospitals for the names of physicians who are accepting new patients. Valley View Hospital (Glenwood Springs, CO) phone number is . Aspen Valley Hospital (Aspen, CO) phone number is .To make it easier for you to transfer your care to another physician, I will remain available to treat you for emergency medical care for fifteen (15) days following the date ({._todaysDate}) of this letter. Please try to make the transfer to a new physician as quickly as possible within that period.When you have selected another physician, please send me a signed authorization so that I can provide a copy of your medical chart to your new physician. I have enclosed a Health Information Release Authorization form in this envelope that may be used for this purpose. Please complete and return the release form to me as soon as possible.

I extend to you my best wishes for your future health.

Sincerely,

{USER.FIRSTNAME} {USER.LASTNAME}(insert page break here)

Health Information Release Authorization

To: Alpine Medical Group of the Roaring Fork Valley, 1450 East Valley Road, Ste 101, Basalt, CO 81621Authorization to Use or Disclose My Health InformationPatient name: {PATIENT.FIRSTNAME} {PATIENT.LASTNAME} Date of birth: {PATIENT.DATEOFBIRTH}

My Authorization

You may transfer all my health information maintained by Alpine Medical Group of the Roaring Fork Valley to:

Organization: _________________________________________Physician Name: _______________________________________Clinic Name: __________________________________________Street Address: _________________________________________City: ____________________________ State: _______ Zip Code: ________________Telephone Number: _____-_____-________ Fax Number: _____-_____-________

_________________________ _____-_____-_____ __________Patient or legally authorized individual signature Date Time

____________________ _____________________________________Printed name if signed on behalf of the patient Relationship (parent, legal guardian, etc.)

From: [mailto: ] On Behalf Of DocSingh760@...Sent: Monday, December 11, 2006 10:31 PMTo: practiceimprovement1 Subject: Discharge letter

Does anyone have a copy of a patient discharge letter to share???

Thanks,

Singh

[Guest guest]

Thank you for the discharge letter .

Really appreciate it

Singh