Patient Dismissals
Can your provider “fire” you?
Many patients mistakenly believe that medical providers cannot turn away a person in need of care. These individuals are most likely thinking of a federal law, the Emergency Medical Treatment & Labor Act or EMTALA that prohibits hospitals from refusing care to patients who come to the emergency room in need of urgent or emergent treatment. However, this law does not apply outside of hospital emergency departments, and individual physicians and physician assistants (PAs) do have the right to dismiss a patient from active treatment for any reason. To minimize potentially harmful disruptions to medical care, the North Carolina Medical Board (NCMB) expects physicians and PAs to meet certain professional obligations when dismissing a patient.
The “right” way to dismiss
An appropriate dismissal will address each of the following:
- Notification – Patients should receive ample notice (at least 30 days) of their dismissal from care, ideally in writing. The 30-day term should begin upon the patient’s receipt of the dismissal letter and should clearly say whether the patient is being dismissed by the entire medical practice or just from the care of a specific provider.
- Access to care – The dismissal letter should address how the patient will get medical care during the notice period. If a patient is in the midst of a defined treatment – a series of allergy shots, for example – the dismissing provider should make every effort to complete that treatment unless it would pose a danger to the provider or to the medical practice’s staff. If there is no specific course of treatment to complete, a licensee may agree to provide care for acute or urgent matters during the 30-day period or, alternatively, direct the patient to seek care at the nearest urgent care center or emergency room.
- Prescription refills – Patients should be provided with refills for current prescription medications, including any controlled substances they take for chronic conditions. It is not proper for a practice to withhold refills due to a dismissal.
- Access to medical records – Upon dismissal, patients have the right to receive copies and/or transfer of their medical records upon request. Medical providers are expected to fulfill records requests within 30 days and may charge a reasonable fee for supplies and staff time needed to prepare records for copying or transfer. It is never appropriate for a practice to refuse a patient’s request for copies or transfer of records due to dismissal or outstanding medical bills.
Learn more
Making a request for medical records
NCMB position statement on the Licensee-Patient relationship
